Rosato-Scott Claire, Alam Mahbub-Ul, Evans Barbara E, Rose Joanne, Wozei Eleanor, Barrington Dani J
School of Civil Engineering, University of Leeds, Leeds, United Kingdom.
Infectious Disease Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.
PLOS Glob Public Health. 2023 May 15;3(5):e0001194. doi: 10.1371/journal.pgph.0001194. eCollection 2023.
Little is known about how children in humanitarian contexts experience self-wetting. Children can wet themselves due to having the medical condition of urinary incontinence (the involuntary leakage of urine), or due to them not wanting to or not being able to use the toilet facilities available (social or functional incontinence). Self-wetting is a global public health challenge: the physical health of children can suffer; they can miss out on educational and social opportunities; they may face increased protection risks; and the emotional effect on daily life can be significantly negative. The Story Book methodology was developed to facilitate conversations with children aged five to eleven in humanitarian contexts (specifically refugee settlements in Adjumani District, Uganda; and refugee camps in Cox's Bazar, Bangladesh) about self-wetting to understand how humanitarian professionals can best meet the needs of children that wet themselves. This paper has evaluated how far the Story Book methodology meets the specific requirements of conducting research a) in a humanitarian context; b) with young children; and c) on a personal and highly sensitive topic. Data has been used from Story Book sessions held with children in Adjumani District and Cox's Bazar, and from semi-structured interviews held with adults known to have participated in the planning and/or facilitation of the sessions. The evaluation found that although the Story Book methodology provided deep insights into how children in humanitarian contexts experience self-wetting, it was not always implemented as designed; it is not practical to implement in humanitarian settings; and it was not acceptable to all participants and facilitators as a research tool. Changes have been recommended to improve the methodology as a research tool to better understand how children experience personal health issues, but even with such changes the methodology will remain better suited to non-humanitarian contexts.
对于处于人道主义环境中的儿童如何经历自我尿床情况，我们知之甚少。儿童可能因患有尿失禁（尿液不自主泄漏）这一医学状况而尿床，或者是因为他们不想或无法使用现有的厕所设施（社交性或功能性尿失禁）。自我尿床是一项全球性的公共卫生挑战：儿童的身体健康可能会受到影响；他们可能会错过教育和社交机会；可能面临更高的保护风险；对日常生活的情感影响可能非常负面。故事书方法的开发是为了促进与五岁至十一岁处于人道主义环境中的儿童（具体是乌干达阿朱马尼区的难民定居点以及孟加拉国科克斯巴扎尔的难民营）就自我尿床问题进行交流，以了解人道主义专业人员如何能够最好地满足尿床儿童的需求。本文评估了故事书方法在多大程度上满足了在人道主义环境中、与幼儿以及就个人且高度敏感的话题进行研究的特定要求。数据来自在阿朱马尼区和科克斯巴扎尔与儿童举行的故事书环节，以及与已知参与了这些环节规划和/或协助工作的成年人进行的半结构化访谈。评估发现，尽管故事书方法为了解处于人道主义环境中的儿童如何经历自我尿床提供了深刻见解，但它并不总是按设计实施；在人道主义环境中实施不切实际；并且作为一种研究工具，并非所有参与者和协助者都能接受。已建议做出改变以改进该方法作为一种研究工具，以便更好地了解儿童如何经历个人健康问题，但即便做出这些改变，该方法仍将更适合非人道主义环境。
