الفهرس 
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Abstract
Nocturnal Enuresis is one of the most common health problems that affect the social and psychological aspects of children and their parents. It is considered as a source of embarrassment and upsetting for children because it affects negatively on their self-esteem which consequently refrain them from certain age-appropriate activities. Family members have many responsibilities in managing their children with nocturnal enuresis . Hence, assessment of family care is a fundamental step in pediatric nursing intervention.
The aim of the current study was to determine the family care for their children with nocturnal enuresis.
The study was conducted in out patient departments at sidi- salim Hospital-kafr -Elsheikh. A convenience sampling of 150 caregivers of children with Nocturnal Enuresis comprised the study subjects and fulfill the following criteria as children’s age was five years or more and free from other diseases.
One tool was used to collect the needed data which called family care for children with Nocturnal Enuresis structured interview schedule .It was developed by the researcher after thorough review of relevant and recent literature to assess family care for children with Nocturnal Enuresis. It was include two parts:
Part I: Family and Children’s characteristics as well as Clinical data:
A. Familycharacteristics include caregivers’ level of education and occupation, residence, number of children and others family members.
B. Children’s characteristics and clinical data comprised the child‟s age, gender, birth order, level of education, onset and duration of disease, common medication, emotional triggers and family medical history.
part II: Family care for children with Nocturnal Enuresis:
It was comprised the assessment items of family care that are done by caregivers for their children which include physical, psychological care ,therapeutic measures and behavior modification
The items of tool scored according to three pointslikert scale that ranged from 1-3 as follows: Never =1, sometimes = 2, always = 3.
The total score of family care for children with nocturnal enuresis was transformed intoqualitative manner as unsatisfactory level that was less than 65% and satisfactory level was 65% and more
The tool was tested for its content validity by five experts in the pediatric nursing field. The validity was 99%
Reliability of the tool was ascertained using an appropriate cronbach‟s coefficient alpha test. Its value was 0.783.
A pilot study was carried out on 15 caregivers who have children with nocturnal enuresis to test clarity and feasibility of the tool. No modification was done . These caregivers were excluded from the total sample size.
Every caregivers accompanying the child was individually interviewed approximately 20-25 minutes during attending in the outpatient department
Data were collected over 3months starting from December 2017 till February 2018.
Summary
The main results of the present study revealed the following:
Morethan one third of children (36.7%) their age ranged from 6 to less than 9 years
Approximately two third of children (62.7%) were female and 37.3% of them were male.
Nearly half of children (50.7%) were in elementary schools.
The birth order of children was the second for 42.7%.
The majority of children (84.7%) were in the rural area.
The onset of illness was less than 6 years for 50.7% of children.
The causes of children‟s disease were physical /or organic cause for 28% of children, psychological cause for 37.3% of them .while 34.7 of children don‟t know.
Highest percent of caregivers (71%) attain unsatisfactory score for their performance in provided care for their children with Nocturnal Enuresis. On the other hand, the minority of them (29%) gain satisfactory score.
Forty percent of caregivers were always avoiding water intake for their children after dinner
Awaking up the children once or twice at night to urinate were reported by caregivers either never (14%) or sometimes (42.7%).
Avoiding taking caffeine drinks for children at night were done by caregivers either never (24.7) or sometimes (41.3%).
The majority of caregivers (84.7%) were always caring for children to go to bathroom before bedtime .
Nearly three quarters of caregivers (76%) were always cleaning children‟s perineal area after bedwetting.
More than half of caregivers (59.3%) were always giving the child adequate fluids during the day time.
High percent of caregivers (80.7%) were always lightening the distance between the child’s room to the bathroom and 84% of them making the child ’s room close to the bathroom as possible .
Caring for children to go to bathroom frequently during the daytime were always done by nearly half of caregivers(52.7%) .
More than half of caregivers(58.0%) werealways providing privacy to the their children during voiding .
Punishing the child for bedwetting was done by more than half of caregivers either always (34%) or sometimes (30%).
Fifty one point three percent of caregivers were sometimes explaining the child‟ s condition according his age .
The majority of caregivers (84%) were never sharing experience with other families having the same problem.
More than half of caregivers (56%) were either never (12.7%) or sometimes (44.7%) keeping the disease confidentiality from others.
More than one third of caregivers (44.0%) were always avoiding of criticism the child‟s condition /or behavior
Most of the caregivers (90.9%) were giving their children pharmacological therapy at regular interval.
The majority of caregivers (81.8%) were always giving the prescribed dose of the pharmacological therapy .
Summary
All caregivers (100%) were always going to physician for child‟s therapy follow up.
Herbal treatment and practice of kegal exercise were always done by high percent of caregivers ( 95% , 70.7% respectively ) .
More than half of caregivers were never (9.4%) or sometimes (47.3%) training their children for water restriction before bed time.
About three quarter of caregivers (74%) were always training their children to go to bathroom before bed time .
Training of child to wake up for urination during sleep were either never (13.3%) or sometimes (48,7%) done by caregivers.
All caregivers (100%) were never training their children for applying enuresis alarm during night.
Approximately half of the caregivers (50.7%) were sometimes training their children for self-observation and evaluation
All the caregivers (100%) were always training the child for dry bed during night
Most of caregivers (90.7%) were always cleaning their children bed immediately after bedwetting .
High percent of caregivers (79.3%) were always recording the child’s progress on charts for each dry night in the week.
More than half of caregivers (60.7%) were always providing incentive for independent toileting.
More than half of caregivers (57. 3%) were always rewarding their children for dry nights .
More than half of caregivers (53.3%) were always rewarding their children for number of dry days.
Practicing bladder strengthening exercises for their children were sometimes done by of the majority of caregivers (87%).