Universidade de São Paulo (USP), Faculdade de Medicina, São Paulo, SP, Brazil.
Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Pediatria, Hospital das Clínicas, Instituto da Criança (ICr), São Paulo, SP, Brazil.
J Pediatr (Rio J). 2019 Mar-Apr;95(2):188-193. doi: 10.1016/j.jped.2017.12.006. Epub 2018 Feb 8.
To evaluate and correlate, before and after the therapeutic intervention, the behavioral problem scores evaluated by the CBCL/6-18 questionnaire and the quality of life indexes evaluated by the PedsQL™ 4.0 in patients with monosymptomatic nocturnal enuresis.
After the initial evaluation and completion of the CBCL/6-18 questionnaire, a multidisciplinary evaluation and completion of the PedsQL™ 4.0 questionnaire was performed. Of the initially evaluated 140 children and adolescents aged 6-16 years, 58 were excluded due to non-monosymptomatic enuresis or associated comorbidities. Of the initially included 82 patients, who were randomized to three treatment groups, 59 completed the CBCL/6-18 and PedsQL™ 4.0 questionnaires at the end of the treatment and were included in this study. The α error was set at 5% for ruling out the null hypothesis.
Of the total of 59 participants, 45.8% responded with total success, 23.7% were partially successful, 23.7% did not reach the improvement criteria, and 6.8% gave up the treatment. There was a significant increase in quality of life indexes and a reduction of post-intervention behavioral problem scores, in the three proposed modalities, in patients who had a total or partial response to treatment. There was no correlation between higher scores of pre-treatment behavior problems and therapeutic failure.
Only the participants who successfully responded to interventions showed improvement in quality of life and behavioral problems, which indicates that enuresis is a primary problem that has a negative impact on these parameters. The authors suggest that it is possible to achieve success in the treatment of monosymptomatic enuresis, even in patients with high pre-intervention behavioral problem scores.
在治疗干预前后,通过 CBCL/6-18 问卷评估行为问题评分,并通过 PedsQL™ 4.0 评估生活质量指数,评估单纯性夜间遗尿症患者的这些评分,并进行相关性分析。
在初始评估和完成 CBCL/6-18 问卷后,进行多学科评估并完成 PedsQL™ 4.0 问卷。在最初评估的 140 名 6-16 岁的儿童和青少年中,由于非单纯性遗尿或相关合并症,有 58 人被排除在外。在最初纳入的 82 名患者中,随机分为三组治疗组,有 59 名患者在治疗结束时完成了 CBCL/6-18 和 PedsQL™ 4.0 问卷,并纳入本研究。α 误差设定为 5%,以排除无效假设。
在总共 59 名参与者中,45.8%的人完全成功,23.7%的人部分成功,23.7%的人未达到改善标准,6.8%的人放弃了治疗。在三种治疗方式中,完全或部分有反应的患者生活质量指数显著提高,治疗后行为问题评分降低。治疗前行为问题评分较高与治疗失败之间没有相关性。
只有对干预措施有完全或部分反应的参与者在生活质量和行为问题方面有所改善,这表明遗尿症是一个主要问题,对这些参数有负面影响。作者认为,即使在治疗前行为问题评分较高的患者中,也有可能成功治疗单纯性夜间遗尿症。