Avaliação do impacto do acompanhamento psicológico dos pais na frequência de punição de crianças com enurese: ensaio clínico randomizado

Abstract

INTRODUCTION: Parents may see enuresis as a failure in the process of raising children, resulting in punishment and generating anguish and guilt. OBJECTIVES: In this study, the results of the psychological follow-up of parents of enuretic children under treatment are assessed. MATERIALS AND METHODS: Sixty-six children aged 6 to 19 y.o. with monossimptomatic enuresis were randomized into two groups. Children in both groups were evaluated with a voiding and dry nights diary. Treatment was performed with urotherapy and psychological follow-up. In the Experimental Group (GE), the parents were submitted to a psychological counseling every 2 weeks for six months, while in the Control Group (CG) there was no counseling of the parents. All parents answered a questionnaire to evaluate violence against their children (Parent-Child Conflict Tactics Scale - CTSPC) and the Tolerance Scale. The Child Behavior Checklist (CBCL) was applied to evaluate behavior problems. The children also responded the Impact Scale and the Children and Youth Self-Concept Scale – EAC- IJ. RESULTS: Mean age, gender and the CTSPC results, prior to treatment, were similar in both groups. In the assessment of the parents, the CTSPC showed less violence after the treatment in the GE (p = 0.0069). The Tolerance Scale showed that the parents of all enuretic children were intolerant and that, after the treatment, intolerance decreased even more in the GE (p = 0.0003). In assessing the children, the Impact scale showed that they suffer some impact from being enuretic, and that after the follow-up those in the GE had a smaller impact (p = 0.0085) compared to those in the CG. Upon the assessent using the CBCL and the Children and Youth Self-Concept Scale – EAC- IJ, there was no alteration after the intervention. After the treatment, the percentage of dry nights was greater in the GE (52[30-91]) than in the GC (10[3-22.5]) p = 0.0001. CONCLUSION: The children whose parents received a psychological follow-up during the treatment improved their percentage of dry nights and the impact of enuresis, while their parents started coping better with the problem and were more tolerant after receiving the psychological follow-up during their children’s treatment.