Enürezis Tanılı Çocuklarda Davranışsal Tedavi Yöntemleri

Yıl 2024, Cilt: 6 Sayı: 2, 364 - 377, 25.08.2024

Tuba Gıynaş , Nurdan Akçay Didişen

Öz

Enürezis, herhangi bir organik neden olmaksızın gece ya da gündüz, yatağına ya da giysilerine, istemli ya da istemsiz olarak haftada en az 2 kez idrar kaçırma olarak tanımlanmaktadır. Enürezin prevalansı sosyoekonomik duruma ve ebeveynlerin eğitim düzeyine göre farklılık göstermektedir. Genel olarak bildirilen sıklık beş yaşındaki çocuklarda %15’ dir. Enürezisin altında yatan sebepler hala tartışılmakta ve araştırılmaktadır. Bu sebeplerin tam olarak ne olduğu söylenememekle birlikte; etiyolojisinin karmaşık ve multifaktöriyel olduğu düşünülmektedir. Enürezis farklı etiyolojik nedenlerle ortaya çıkabilen bir semptom olduğu için, farklı disiplinleri ilgilendiren bir problemdir. Bu durum sonucu olarak enürezis ile ilgilenen her disiplin problemi kendi açısından değerlendirerek tedaviyi yönetmektedir. Bu nedenle enürezis tedavisi için çocuk sağlığı ve hastalıkları uzmanı, çocuk psikiyatristi, çocuk psikoloğu, fizik tedavi uzmanı ve pediatri hemşiresinden oluşan multidisipliner bir ekip gerekmektedir. Enüresizin tedavisi için, farmakolojik ve farmakolojik olmayan tedavi yöntemleri mevcuttur. Davranışsal tedavi yöntemleri olarak adlandırılan farmakalojik yöntemler arasında; tuvalet eğitimi, mesane ve sfinkter eğitimi, motivasyon tedavisi, alarm-uyarı tedavisi, biyofeed-back, nöromodülasyon, akupunktur, karyopratik, hipnoterapi, homeopati bu yöntemleri bulunmaktadır. Sonuç olarak enürezis tedavisinde farklı tedavi seçenekleri bulunmakla birlikte öncelikli olan tedavi yaklaşımı davranışsal tedavi yöntemleridir. Bu tedavi yöntemleri, tek başına kullanılabildikleri gibi birbirlerinin kombinasyonları şeklinde de kullanılabilmektedir. Bu yöntemlerin çocuğa uygulanmasında pediatri hemşireleri hem çocuk hem aile için önemli bir role sahiptir ve bu yöntemlerin uygulamasında peddiatri hemşirelerinin çok önemli katkılarının olacağı düşünülmektedir.

Anahtar Kelimeler

Enürezis, Davranış Terapisi, Davranış Değiştirme.

Behavioral Treatment Methods in Children with Enuresis

Öz

Enuresis was evaluated as a voluntary or involuntary loss of exit to children or clothes, day or night, at least 2 times a week, in the exclusion of organic causes. The prevalence of enuresis shows its effect according to socioeconomic status and education level. The overall reported frequency is 15% in children aged five years. The underlying causes of enuresis are still debated and investigated. Although it cannot be said exactly what these reasons are; Sevens whose etiology is complex and multifactorial. Enuresis is a problem that targets different disciplines, as it is a symptom that can occur with different etiological findings. As a result of this situation, the discipline dealing with enuresis evaluates the problem from his own perspective and manages the treatment. Therefore, a multidisciplinary team consisting of a doctor, child psychiatrist, child psychologist, physical therapist and nurse is required for the treatment of enuresis. There are pharmacological and non-pharmacological treatment modalities for the treatment of enuresis. Among the pharmacological methods called behavioral treatment methods; these methods are toilet training, bladder and sphincter training, motivation therapy, alarm-warning therapy, biofeed-back, neuromodulation, acupuncture, chiropractic, hypnotherapy, homeopathy. As a result, although enuresis treatment has different treatment options, the previous treatment approach is behavioral treatment methods. These treatment methods can be used alone or as end-uses. Pediatric nurses have an important place in the application of these methods to the child and it is thought that pediatric nurses will have a very important contribution in the application of these methods.

Anahtar Kelimeler

Enuresis, Behavior Therapy, Behavior Modification.

Kaynakça

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