Saarikoski A, Koppeli R, Salanterä S, Taskinen S, Axelin A
Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland; Department of Nursing Science, University of Turku, Turku, Finland.
Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland.
J Pediatr Urol. 2018 Feb;14(1):56.e1-56.e7. doi: 10.1016/j.jpurol.2017.09.009. Epub 2017 Sep 23.
Daytime incontinence and enuresis are common problems in otherwise healthy children, and negatively influence their social lives and self-esteem. Motivation for treatment is often a real clinical problem. Children's experiences of their incontinence treatments have not been previously described.
The aim of this study was to describe children's experiences of the Voiding School intervention as a treatment for their incontinence.
A qualitative, descriptive focus-group study with a purposive sample was conducted at a Finish university hospital in 2014. Children aged 6-12 years participated in the Voiding School at an outpatient clinic. The intervention included two 1-day group visits 2 months apart. The educational content was based on the International Children Continence Society's standards for urotherapy. The education was delivered with child-oriented teaching methods. At the end of the second visit, 19 children were interviewed in five groups. Data were analysed with inductive content analysis.
The children described incontinence as an embarrassing problem, which they had to hide at any cost. They had experienced bullying and social isolation because of it. Normal outpatient visits emphasized adult-to-adult communication, which made the children feel like outsiders. The children perceived the Voiding School as a nice and child-oriented experience. Making new friends was especially important to younger boys who felt that the Voiding School day was too long and issue-oriented. In the Voiding School, videos and 'learning by doing' helped the children to understand the basis of given advice, and they were able to learn new habits, which gave them control over the incontinence; this helped them to become 'the boss of the bladder'. Sharing experiences and improvements in their incontinence with their peers supported the children's self-esteem and encouraged them to do new things, such as staying overnight with friends. These experiences helped them to acquire control over the problem (Summary Figure).
According to the children's experiences, normal outpatient visits were only appointments for adults, and not very useful for children. In the Voiding School, they were respected as being the main person, and their views were listened to. The results underlined the importance of a child-oriented approach to patient education with regard to children, and provided encouragement to further develop the intervention.
Child orientation, peer support, learning by doing, and understanding the cause and effect helped children to gain control over their bladders. Based on the children's experiences, this could be achieved by a voiding school.
白天尿失禁和遗尿在其他方面健康的儿童中是常见问题，会对他们的社交生活和自尊产生负面影响。治疗动机往往是一个实际的临床问题。此前尚未描述过儿童对其尿失禁治疗的体验。
本研究的目的是描述儿童对排尿学校干预作为其尿失禁治疗方法的体验。
2014年在芬兰一家大学医院进行了一项定性、描述性焦点小组研究，采用目的抽样法。6至12岁的儿童在门诊参加了排尿学校。干预包括相隔2个月的两次为期1天的小组就诊。教育内容基于国际儿童尿控协会的尿疗标准。采用以儿童为导向的教学方法进行教育。在第二次就诊结束时，19名儿童分五组接受了访谈。采用归纳性内容分析法对数据进行分析。
孩子们将尿失禁描述为一个令人尴尬的问题，他们不惜一切代价都要隐瞒。他们因此经历过欺凌和社交孤立。普通门诊就诊强调成人与成人之间的交流，这让孩子们觉得自己像局外人。孩子们认为排尿学校是一次愉快且以儿童为导向的体验。结交新朋友对年幼的男孩尤为重要，他们觉得排尿学校的时间太长且以问题为导向。在排尿学校，视频和“边做边学”帮助孩子们理解所给建议的依据，他们能够养成新习惯，从而控制尿失禁；这帮助他们成为“膀胱的主人”。与同龄人分享尿失禁方面的经历和改善情况增强了孩子们的自尊，并鼓励他们尝试新事物，比如和朋友过夜。这些经历帮助他们掌控了问题（总结图）。
根据孩子们的体验，普通门诊就诊只是成人的预约，对孩子们用处不大。在排尿学校，他们被视为主要人物并受到尊重，他们的观点也会被倾听。研究结果强调了以儿童为导向的患者教育方法对儿童的重要性，并为进一步完善该干预措施提供了鼓励。
以儿童为导向、同伴支持、边做边学以及理解因果关系有助于儿童控制膀胱。基于孩子们的体验，排尿学校可以实现这一点。
