Ko Lauren N, Chuang Kai-wen, Champeau Angelique, Allen I Elaine, Copp Hillary L
Harvard Medical School, Boston, Massachusetts; University of California-San Francisco (KC, AC, IEA, HLC), San Francisco, California.
Harvard Medical School, Boston, Massachusetts; University of California-San Francisco (KC, AC, IEA, HLC), San Francisco, California.
J Urol. 2016 Apr;195(4 Pt 2):1232-8. doi: 10.1016/j.juro.2015.09.091. Epub 2016 Feb 28.
Lower urinary tract dysfunction in school-aged children is common and yet data are lacking on current teacher practice regarding bathroom use and daytime incontinence during classroom hours. We determined the prevalence of elementary school teachers who promote lower urinary tract health and identified predictors for and against such behavioral promotion.
We performed an electronic cross-sectional survey among self-identified teachers using targeted social media advertisement during a 1-week period in July 2014. The empirical survey tool consisted of 27 questions and collected data on 5 principal domains, including 1) teacher demographics, 2) rules and regulations on water intake and bathroom use during classroom hours, 3) characteristics of school bathrooms in terms of safety, supervision and suitability for use, 4) experience with and management of students with daytime incontinence and 5) training on the topic of lower urinary tract health. Predictors for promoting lower urinary tract health were identified by multivariable logistic regression.
Of the 4,166 teachers who completed the survey 88% indicated that they encourage students to hold urine. Despite strict bathroom protocols 81% of teachers allowed children unlimited access to water. Of the teachers 82% reported never having undergone any professional development on bathroom regulations for children. Overall only 24% of surveyed teachers met criteria for promoting lower urinary tract health. The odds of promoting lower urinary tract health decreased with ascending grade level (OR 0.80, 95% CI 0.76-0.84). Conversely it increased if teaching experience was greater than 5 years (OR 1.66, 95% CI 1.39-1.98) or professional development on the subject had been received (OR 1.42, 95% CI 1.18-1.70).
Of elementary school teachers 76% are not promoting lower urinary tract health in school-aged children. Professional development training on the topics of lower urinary tract dysfunction and/or lower urinary tract health may be beneficial, particularly for educators who teach higher grades and those with less teaching experience.
学龄儿童下尿路功能障碍很常见，但目前缺乏关于教师在课堂上对学生使用卫生间及日间尿失禁的做法的数据。我们确定了促进下尿路健康的小学教师的比例，并确定了支持和反对这种行为促进的预测因素。
2014年7月，我们在为期1周的时间里，通过有针对性的社交媒体广告，对自行认定的教师进行了电子横断面调查。实证调查工具包括27个问题，收集了5个主要领域的数据，包括：1）教师人口统计学数据；2）课堂上关于饮水和使用卫生间的规章制度；3）学校卫生间在安全性、监管和适用性方面的特点；4）对日间尿失禁学生的处理经验和管理情况；5）下尿路健康主题的培训。通过多变量逻辑回归确定促进下尿路健康的预测因素。
在完成调查的4166名教师中，88%表示他们鼓励学生憋尿。尽管有严格的卫生间规定，但81%的教师允许孩子无限制地喝水。82%的教师报告说从未接受过任何关于儿童卫生间规定的专业培训。总体而言，只有24%的受访教师符合促进下尿路健康的标准。促进下尿路健康的几率随着年级的升高而降低（比值比0.80，95%置信区间0.76-0.84）。相反，如果教学经验超过5年（比值比1.66，95%置信区间1.39-1.98）或接受过该主题的专业培训（比值比1.42，95%置信区间1.18-1.70），则几率会增加。
76%的小学教师没有促进学龄儿童的下尿路健康。关于下尿路功能障碍和/或下尿路健康主题的专业发展培训可能会有所帮助，特别是对于教高年级的教育工作者和教学经验较少的人。
