title: Increased Risk of Physical Punishment among Enuretic Children with Family History of Enuresis.
abstract: OBJECTIVE
  Some parents blame their children for bedwetting and, therefore, punish them. This study aimed to assess the rate of punishment experienced by enuretic children and associated causative factors.
  
  
  METHODS
  A total of 87 children 6 to 15 years old with monosymptomatic enuresis were assessed individually. Parents answered the questions in the tolerance scale. The forms of punishment were classified as verbal, chastisement and physical aggression. Family history of enuresis was considered only when 1 or both parents had experienced enuresis.
  
  
  RESULTS
  Of the 35 girls and 52 boys with a mean ± SD age of 9.3 ± 2.3 years 67 had a family history of enuresis. Of the 67 parents 57 (85.0%) had a history of being punished due to enuresis. All children experienced some sort of verbal punishment. Children who had a family history of enuresis were more prone to being punished by physical aggression than those without such a family history (32 of 67 or 47.8% vs 4 of 20 or 20%, OR 3.7, 95% CI 1.1-12.1, p = 0.03). Punishment was found 3 times more frequently in girls than in boys (20 of 35 or 57.1% vs 16 of 52 or 30.8%, OR 3.0, 95% CI 1.2-7.3). Parents of 79 of the 87 children (90.8%) had high scores on the tolerance scale regardless of the history of enuresis.
  
  
  CONCLUSIONS
  Enuretic children are at a high risk for experiencing some kind of punishment. Children whose parents had enuresis are at risk for being physically punished. Parents should be taught about the involuntary nature of enuresis and the fact that no punishment would help improve the condition.
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Brazil.
authors.forename: Cacilda Andrade
authors.initials: CA
authors.lastname: Sá
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Brazil.
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Gusmão Paiva
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Brazil.
authors.forename: Maria Clotilde Lima Bezerra
authors.initials: MC
authors.lastname: de Menezes
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Brazil.
authors.forename: Liliana Fajardo
authors.initials: LF
authors.lastname: de Oliveira
authors.affiliation: Hospital e Maternidade Therezinha de Jesus of the School of Medical Sciences and Health of Juiz de Fora, Juiz de Fora, Brazil.
authors.forename: Carlos Augusto
authors.initials: CA
authors.lastname: Gomes
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Brazil.
authors.forename: André Avarese
authors.initials: AA
authors.lastname: de Figueiredo
authors.affiliation: State University of Feira de Santana, Feira de Santana, Brazil.
authors.forename: José
authors.initials: J
authors.lastname: de Bessa
authors.affiliation: Hospital e Maternidade Therezinha de Jesus of the School of Medical Sciences and Health of Juiz de Fora, Juiz de Fora, Brazil. Electronic address: jose.murillo@ufjf.edu.br.
authors.forename: José Murillo B
authors.initials: JM
authors.lastname: Netto
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis; D010290:Parents; D011678:Punishment; D018570:Risk Assessment
keywords: child abuse; enuresis; parents; punishment; urinary bladder