Abstract General Information

Title

EMOTIONAL AND BEHAVIORAL PROBLEMS AND THEIR ASSOCIATED FACTORS IN CHILDREN AND ADOLESCENTS WITH ENURESIS

Introduction and objective

Enuresis children showed shyness, inferiority, fear of communication with others, and the level of Social anxiety was significantly higher than that of healthy children. The co incidence of enuresis and sleep apnea is high. Research has shown that enuresis combined with sleep breathing disorders can seriously affect the quality of life of children. However, there are not many reports on common emotional and behavioral problems and their influencing factors in children and adolescents with enuresis in China. At the same time, there is a lack of research on the relationship between emotional and behavioral problems in children with enuresis and sleep breathing disorders. The purpose of this study is to investigate the current situation and influencing factors of emotional and behavioral problems in Chinese enuresis patients, and to provide reference for personalized treatment of enuresis in clinical practice

Method

From October 2021 to March 2022, a stratified random cluster sampling method was used to select 5 primary and secondary schools in a certain county of Henan province. A survey was conducted using a general information questionnaire, a strengths and difficulties questionnaire(SDQ), and a pediatric sleep questionnaire(PSQ). Single and multiple factor analyses were conducted on the factors that affect the emotions and behaviors of enuresis children. The inclusion criteria for enuresis are those who are over 5 years old and still cannot control urination during sleep, resulting in urinary leakage. The frequency of enuresis is greater than 1 occurrence per month and the duration is at least three months. The exclusion criteria were obvious organic diseases (such as lower urinary tract obstruction of bladder, nervous system disease), incomplete questionnaire, etc. Analyze whether the prevalence of enuresis in children and adolescents is related to factors such as gender, age, place of residence, family history, child personality, academic performance, caregivers, caregiver education, constipation, and family history of enuresis. In addition, an analysis was conducted on the emotional and behavioral issues, as well as sleep breathing disorders, of children and adolescent enuresis patients.

Results

The detection rate of emotional and behavioral problems in the enuresis group was 56.53% (173/306), significantly higher than the detection rate of 40.43% (1458/3606) in normal children. Through t-test, the total scores of emotional symptoms, hyperactivity, and difficulty in the enuresis group were significantly higher than those in the normal group, and the differences were statistically significant (t=-4.646,-4.903,-5.175, all P<0.001). However, there was no statistically significant difference (all P>0.05) in the scores of conduct problems, peer interaction, and social behavior between the two groups, as shown in Table 2. The results of univariate analysis showed that there were statistically significant differences in academic performance, caregiver education level, family history, and whether children with constipation and enuresis had emotional and behavioral problems (F=17.768,t=3.949,2.289,-2.432, all P<0.05). There was no statistically significant difference in gender, age, personality, caregiver, place of residence, and emotional and behavioral issues between enuresis patients and enuresis patients (all P>0.05).
The score of sleep breathing disorder in enuresis patients is (4.08 ± 3.16) points. The Pearson correlation analysis results showed that there was a positive correlation between the total difficulty score of enuresis children and adolescents and snoring, nocturnal breathing problems, drowsiness, attention deficit, and total sleep score (all P<0.05).
The total score of children and adolescents with enuresis was divided into dependent variables, and the five statistically significant variables (PSQ total score, caregiver education level, constipation, family history, and academic performance) in univariate and correlation analysis were used as independent variables for multiple linear regression analysis. The results show that high total PSQ scores, low caregiver education, constipation, and poor academic performance are the influencing factors for emotional and behavioral problems in enuresis children and adolescents(t=5.512,-2.768,2.778,4.326, all P<0.05).

Conclusion

The detection rate of emotional and behavioral problems is high in children with enuresis．The influencing factors include sleep－disordered breathing caregivers’low literacy children’s poor academic performance and constipation which need to be more concerned