Çocuklarda monosemptomatik enürezisi tedavi etmeli miyiz?

Year 2013, Volume: 8 Issue: 3, 21 - 26, 01.08.2013

Sacit Nuri Görgel Osman Köse Nida Dincel Cengiz Girgin

Abstract

Amaç: Monosemptomatik enürezisli çocuklarda ve annelerinde tedavi öncesi dönemde hayat ve uyku kalitesini değerlendirmek.Gereç ve Yöntemler: İki yüz kırk olgu çalışmaya dahil edildi. Olguların 124’ü monosemptomatik enürezisli hasta ve 116’sı sağlık problemi olmayan çocuklardı. Çocuklarda yaşam kalitesi Pediatric Quality of Life Inventory PEDSQL ile değerlendirildi. Annelerde hayat kalitesi Short-Form Health Survey SF-36 ile değerlendirildi. Çocuklarda ve annelerinde hayat kalitesi Pittsburgh Sleep Quality Index PSQI ile değerlendirildi.Bulgular: Emosyonel ve okul fonksiyon skalası monosemptomatik enüzesli çocuklarda ‘child self-report and parent proxy-report’ kontrol grubuna göre anlamlı olarak yüksekti p=0.02, p=0.03 ve p=0.03, p=0.04 . Annelerin yaşam kalitesinin değerlendirildiği SF-36 ya göre emosyonel ve vücut ağrı skoru enürezisli çocukların annelerinde anlamlı olarak daha düşüktü p=0.02 ve 0.04 . Çocuklar arasında toplam PSQI skoru ve alt gruplarında anlamlı fark saptanmazken subjektif uyku kalitesi, uyku latensi ve PSQI toplam skoru enürezisli çocukların annelerinde anlamlı olarak daha yüksekti p=0.04, p=0.03 ve p=0,02 .Sonuç: Monosemptomatik enürezis tedavi öncesi dönemde çocukların ve annelerin hayat kalitesini olumsuz olarak etkileyen bir hastalıktır. Ek olarak çocuklarının hastalığı nedeniyle sis is a disease that negatively affects the quality of life of children and their mothers before treatment. In additon sleep quality of their mothers are adversly affected because of children’s disease. Moannelerin uyku kalitesi de bozulmaktadır. Bu nedenlerden dolayı çocuklarda monosemptomatik enürezis tedavi edilmelidir

Keywords

Monosemptomatik enürezis , Yaşam kalitesi , Uyku kalitesi

Should we treat monosymptomatic enuresis in children?

Abstract

Objective: To evaluate quality of life and sleep in monosymtomatic enuretic children and their mothers before treatment. Materials and Methods: Two hundrend fourty cases were included to this study. Of the cases 124 had monosymptomatic enuresis and 116 voluntary children had no health problems. The quality of life was evaluated according to Pediatric Quality of Life Inventory PEDSQL in children. Quality of life for their mothers were evaluated using the Short-Form Health Survey SF-36 . Sleep quality of children and their mothers were evaluated according to Pittsburgh Sleep Quality Index PSQI . Results: Emotional and school functioning were significantly higher in children with monosymptomatic enuresis than that of controls for child self-report and parent proxy-report p=0.02, p=0.03 and p=0.03, p=0.04 respectively . The quality of life of the mothers as shown by SF-36, the emotional domain score and bodily pain score were significantly lower compared to controls p=0.02 and 0.04 . However PSQI total and subgroup scores were not stasitically significant in between children groups, subjective sleep quality, sleep latency domain scores and total scores in enuretic children’s mothers were significantly higher than healty group p=0.04 ,p=0.03 and p=0,02 respectively . Conclusions: Monosymptomatic enure sis is a disease that negatively affects the quality of life of children and their mothers before treatment. In additon sleep quality of their mothers are adversly affected because of children’s disease. Monosymptomatic enuresis should be treated in children because of these reasons

Keywords

Monosymtomatic Enuresis , Quality of Life , Sleep Quality

References

• Neveus T, Lackgren G, Tuvemo T, et al. Enuresis-background and treatment. Scand J Urol Nephrol Suppl 2000;206:1-44.
• M. Cendron, “Primary nocturnal enuresis: current,” Am Fam Physician 1999; 59: 1205-1214.
• Semolic N, Ravnikar A, Meglic A, Japelj-Pavesić B, Kenda RB. The occurrence of primary nocturnal enuresis and as- sociated factors in 5-year-old outpatients in Slovenia.Acta Paediatr. 2009 ;98:1994-8.
• C. K. Yeung, “Nocturnal enuresis (bedwetting),” Current Opinion in Urology 2003; 13: 337–343.
• T. Neveus, P. Eggert, J. Evans et al., “Evaluation of and treat- ment for monosymptomatic enuresis: a standardization do- cument from the international children’s continence soci- ety,” Journal of Urology 2010;183: 441–447.
• W. L. M. Robson, “Evaluation and management of enure- sis,” The New England Journal of Medicine. 2009;360:1429– 1436.
• Guidelines on Paediatric Urology. S. Tekgül, H. Riedmil- ler, H.S. Dogan, E. Gerharz, P. Hoebeke, R. Kocvara, R. Nij- man, Chr. Radmayr, R. Stein European Association of Uro- logy 2012.45-46.
• Hägglöf B, Andren O, Bergström E, Marklund L, Wendeli- us M: Self-esteem in children with nocturnal enuresis and urinary incontinence: improvement of self-esteem after tre- atment. Eur Urol 1998; 33: 16.
• Bastiaansen D, Koot HM, Ferdinand RF, Verhulst FC: Qu- ality of life in children with psychiatric disorders: self-, pa- rent, and clinician report. J Am Acad Child Adolesc Psychi- atry 2004; 43: 221.
• Russell KM, Hudson M, Long A et al: Assess-ment of health-related quality of life in children with cancer: con- sistency and agreement between parent and child reports. Cancer 2006;106: 2267.
• M. J.Morison, “Living with a young person who wets the bed: the families’ experience.,” British Journal of Nursing. 2000;9:572–578.
• F. Assiri, A. Al-Yousif, and N. Al-Mahmoud, “Nocturnal enuresis among children attending Kifan primary health care center in Kuwait,” Alexandria Bulletin.2007;43:879–887.
• Varni JW, Seid M, Kurtin PS: PedsQL 4.0: reliability and va- lidity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Me- dical care 2001, 39:800-812.
• Ware JE Jr, Sherbourne CD. TheMOS 36-item Short-Form Health Survey (SF-36) I. Conceptual framework and item selection. Med Care 1992;30:473-483.
• Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kup- fer DJ. The Pittsburgh Sleep Quality Index: a new instru- ment for psychiatric practice and research. Psychiatry Res. 1989; 28: 193–213.
• Spilker B: Quality of life and pharmacoeconomics in clinical trials. Philadelphia: Lippincott-Raven; 2nd ed, 1996.
• Pal DK: Quality of life assessment in children: a review of conceptual and methodological issues in multidimensional health status measures. Journal of epidemiology and com- munity health 1996; 50:391-396.
• World Health Organization: Constitution of the World He- alth Organization: Basic document. Geneva, Switzerland. 1948.
• Varni JW, Burwinkle TM, Limbers CA, Szer IS: The PedsQL as a patient reported outcome in children and adolescents with fibromyalgia: an analysis of OMERACT domains. He- alth and quality of life outcomes 2007;5:9.
• Felder-Puig R, Baumgartner M, Topf R, Gadner H, For- mann AK: Healthrelated quality of life in Austrian elemen- tary school children. Medical care 2008, 46:432-439.
• Varni JW, Burwinkle TM, Seid M, Skarr D: The PedsQL 4.0 as a pediatric population health measure: feasibility, reliabi- lity, and validity. Ambulatory pediatrics: the official journal of the Ambulatory Pediatric Association 2003;3:329-341.
• Mistry RD, Stevens MW, Gorelick MH: Health-related qu- ality of life for pediatric emergency department febrile ill- nesses: an evaluation of the Pediatric Quality of Life Inven- tory 4.0 Generic Core Scales. Health and quality of life out- comes 2009;7:5.
• Varni JW, Burwinkle TM, Katz ER, Meeske K, Dickinson P: The PedsQL in pediatric cancer: reliability and validity of the Pediatric Quality of Life Inventory Generic Core Scales, Multidimensional Fatigue Scale, and Cancer Module. Can- cer 2002:94;2090-2106.
• Varni JW, Burwinkle TM, Berrin SJ, Sherman SA, Artavia K, Malcarne VL, Chambers HG: The PedsQL in pediatric ce- rebral palsy: reliability, validity, and sensitivity of the Gene- ric Core Scales and Cerebral Palsy Module. Developmental medicine and child neurology. 2006;48:442-449.
• Varni JW, Limbers CA, Bryant WP, Wilson DP: The PedsQL Multidimensional Fatigue Scale in type 1 diabetes: feasibi- lity, reliability, and validity. Pediatric diabetes 2009;10:321- 328.
• Varni JW, Seid M, Smith Knight T, Burwinkle T, Brown J, Szer IS: The PedsQL in pediatric rheumatology: reliability, validity, and responsiveness of the Pediatric Quality of Life Inventory Generic Core Scales and Rheumatology Module. Arthritis and rheumatism 2002;46:714-725.
• Goldstein SL, Rosburg NM, Warady BA, Seikaly M, McDo- nald R, Limbers C, Varni JW: Pediatric end stage renal di- sease health-related quality of life differs by modality: a PedsQL ESRD analysis. Pediatr Nephrol 2009;24:1553-1560.
• Lv R, Wu L, Jin L et al: Depression, anxiety and quality of life in parents of children with epilepsy. Acta Neurol Scand 2009; 120: 335-341.
• Klassen AF, Klaassen R, Dix D et al: Impact of caring for a child with cancer on parents’ health-related quality of life. J Clin Oncol 2008; 26: 5884-89.
• Ader R and Cohen N: Psychoneuroimmunology: conditio- ning and stress. Annu Rev Psychol 1993;44:53-85.
• Evrim Aksanlı Meydan, Mahmut Civilibal, Murat Elev- li, Nilgün Selcuk Duru, Nazlican Civilibal. The quality of life of mothers of children with monosymptomatic enuresis nocturna. Int Urol Nephrol 2012;44:655–659.
• Eryilmaz, M. M., Ozdemir, C., Yurtman, F., Cilli, A. & Ka- raman, T. Quality of sleep and quality of life in renal trans- plantation patients. Transplant Proceedings 2005; 37:2072– 2076.