Analysis Of Emotional Behavior Problems And Related Factors In Children With Enuresis

BackgroundNocturnal enuresis（NE）is defined as bedwetting more than once every four weeks at night for no less than 3 months in children older than 5 years of age.Children with NE often suffer from emotional and behavioral problems that can lead to decreased academic performance,increased levels of social anxiety,and even the development of psychiatric disorders,posing significant clinical challenges in treating NE.Currently,there are few studies on risk factors associated with co-morbid emotional behavior problems in NE in China.Identifying the prevalence characteristics and influencing factors of emotional behavior problems in children with NE and developing interventions for children with NE with emotional behavior problems have become the focus of current research.Therefore,it is necessary to explore the current status of emotional and behavioral problems and the influencing factors of NE patients,which can provide a reference for individualized treatment of children with NE in clinical settings.ObjectivesTo understand the current situation of emotional and behavioral problems and sleep breathing disorders in children with enuresis,analyze the influencing factors of emotional and behavioral problems in children with enuresis,and clarify the relationship between emotional and behavioral problems and sleep breathing disorders in children with enuresis,it can provide a theoretical basis for developing comprehensive interventions to improve emotional and behavioral problems in children with enuresis.MethodsA total of 4500 parents of primary and secondary school students were surveyed in 5primary and secondary schools in a county in Henan Province from September 2019 to March 2020 using a stratified randomized integer sampling method.NE inclusion criteria:Respondents had NE since childhood and involuntary urination during sleep still occurred >1 time per month after age >5.NE exclusion criteria:Children with organic diseases were excluded.The following were used:（1）General information questionnaire;（2）Urine loss questionnaire;（3）Strength and difficulties questionnaire（SDQ）;（4）Pediatric Sleep Questionnaire（PSQ）.Epidata 3.1 was used for data entry,and independent samples t test,one-way ANOVA test,Pearson correlation analysis,and multiple linear regression analysis were performed using SPSS25.0 software.Results1.4500 questionnaires were actually distributed,4120 were collected,3912 valid questionnaires were returned,and the effective recovery rate was 86.93%.Among the 3912 children and adolescents,7.82%（306/3912）suffered from enuresis.2.The children with enuresis had a total score of（20.58±5.38）for emotional and behavioral problems,with the highest scoring dimension being the pro-social behavior dimension（7.53±2.25）,the hyperactivity dimension（4.65±2.23）,the emotional symptoms dimension（2.97±2.47）,the peer interaction dimension（2.75±1.65）,and the character problems The score of the dimension of emotional symptoms was（2.97±2.47）,the score of the dimension of peer interaction was（2.75±1.65）and the score of the dimension of conduct problems was（1.95±1.67）.3.The score of sleep breathing disorder in children with enuresis was（4.08±3.16）,where the highest score was for the attention deficit dimension（1.49±1.58）,and 40 patients were detected with sleep breathing disorder.4.Multiple linear regression analysis showed that gender,poor academic performance and number of bedwetting were influential factors for emotional symptoms in children with enuresis（P < 0.05）.The presence of concomitant daytime lower urinary tract symptoms was an influential factor for character problems in children with enuresis（P <0.05）.Boys,age,poor academic performance,and number of bedwetting were influential factors for hyperactivity in children with enuresis（P < 0.05）.Poor academic performance,caregiver literacy,and number of bedwetting were influential factors for peer interaction in children with enuresis（P < 0.05）.The number of bedwetting and the presence of daytime lower urinary tract symptoms were factors influencing the total score of difficulties in children with enuresis（P < 0.05）.5.The results of Pearson correlation analysis showed that the total difficulty score and its scores on each dimension were positively correlated with snoring,nocturnal breathing problems,sleepiness,attention deficit,and total sleep score in children with enuresis（P < 0.05）.Conclusions1.Children with enuresis have high levels of emotional behavior problems and sleep breathing disorders.2.Age,gender,academic achievement,caregiver literacy,and the presence of daytime lower urinary tract symptoms influence the level of emotional and behavioral problems in children with enuresis.Therefore,such factors need to be focused on when assessing emotional and behavioral problems in children with enuresis.