Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.
Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA.
J Pediatr Urol. 2020 Oct;16(5):535.e1-535.e8. doi: 10.1016/j.jpurol.2020.10.002. Epub 2020 Oct 18.
Much of our knowledge about the impact of urinary incontinence (UI) on children is derived from surveys. While these studies provide an overview of the UI experience, personal interviews may offer additional nuances and a more detailed perspective of what the experience of UI is for children. Objective To conduct interviews and use qualitative analysis to explore the experiences of children with UI, with a particular focus on (1) the impact of UI on participants' lives, (2) which coping strategies children with UI use, and (3) the emotional effects of UI.
Semi-structured interviews of children with non-neurogenic and non-anatomic UI recruited from a pediatric urology clinic were audio recorded and verbatim transcribed. Eligibility included: age 8-17 years, history of UI, English fluency, and being able to participate in a 30 min interview. Conventional content analysis was performed to identify themes directly from the transcripts. Coders independently and iteratively coded transcripts (intercoder reliability >0.85) until inductive thematic saturation was achieved.
There were substantial practical and emotional impacts on the 30 (14 males, 16 females) children (median age 11.5 years) with UI. Participants relayed significant interference with social activities like sports and sleepovers, which often lead to avoidant behavior of these activities. By contrast, most stated that UI did not impair school performance. The most strongly and consistently expressed emotions were embarrassment and anxiety. Nevertheless, children described a wide variety of adaptations, including behavioral and cognitive, to manage their incontinence and its effects on their lives (Summary Table).
This is the first qualitative study that describes the experiences and perspectives of children with UI. Surveys of this population suggest a lower health-related quality of life, particularly in emotional well-being, self-esteem and relationships. This work augments this body of literature and shows how UI interferes with their daily life and is a major source of embarrassment and anxiety. Despite this, children with UI display strong resilience and adapt to their condition. The study was limited in that the sample was biased to those presenting to a urology clinic and was not designed to compare differences in UI experience between ages, genders, or treatment types.
This study, the first qualitative exploration of the emotional responses and coping behaviors of children with UI, shows significant social impact and negative emotional responses but marked resiliency. These findings should be considered when developing a comprehensive treatment strategy for children with UI.
我们对尿失禁（UI）对儿童影响的了解很大程度上来自调查。虽然这些研究提供了 UI 体验的概述，但个人访谈可能会提供更多细微差别，并更详细地了解儿童的 UI 体验。目的：进行访谈并使用定性分析来探索患有 UI 的儿童的体验，特别关注：（1）UI 对参与者生活的影响；（2）患有 UI 的儿童使用的应对策略；（3）UI 的情绪影响。
从小儿泌尿科诊所招募的非神经源性和非解剖性 UI 儿童进行半结构化访谈，访谈内容进行录音并逐字记录。入选标准包括：年龄 8-17 岁，有 UI 病史，英语流利，能够参加 30 分钟的访谈。采用常规内容分析方法直接从转录本中确定主题。编码员独立且反复对转录本进行编码（编码员间信度>0.85），直到归纳主题达到饱和。
30 名（14 名男性，16 名女性）患有 UI 的儿童（中位年龄 11.5 岁）的生活受到了实质性的实际和情感影响。参与者描述了社交活动（如运动和过夜）受到显著干扰，这通常导致他们回避这些活动。相比之下，大多数人表示 UI 不会影响学业表现。最强烈和一致表达的情绪是尴尬和焦虑。然而，儿童描述了广泛的适应方式，包括行为和认知，以管理他们的失禁及其对生活的影响（总结表）。
这是第一项描述患有 UI 的儿童的经历和观点的定性研究。该人群的调查表明，他们的健康相关生活质量较低，尤其是在情绪健康、自尊和人际关系方面。这项工作补充了这方面的文献，并表明 UI 如何干扰他们的日常生活，成为尴尬和焦虑的主要来源。尽管如此，患有 UI 的儿童表现出很强的适应能力。该研究存在局限性，即样本偏向于泌尿科诊所就诊的人群，并且没有设计用于比较不同年龄段、性别或治疗类型的 UI 体验差异。
这项对患有 UI 的儿童情绪反应和应对行为的首次定性探索研究表明，社会影响显著，负面情绪反应明显，但适应能力很强。在为患有 UI 的儿童制定全面的治疗策略时，应考虑这些发现。
