title: Parental perception and factors associated with treatment strategies for primary nocturnal enuresis.
abstract: OBJECTIVE
  The aim was to investigate the factors influencing parents seeking reasonable managements for their child and their overall outlook toward primary nocturnal enuresis (PNE).
  
  
  METHODS
  We recruited 93 children with PNE from enuresis clinics and requested their parents to complete questionnaires regarding their child's medical history and behavior, their methods for coping with PNE, and their perception of enuresis. Logistic regression models were applied to investigate factors influencing the parents to adopt a positive approach toward enuresis and to subsequently seek a medical consultation.
  
  
  RESULTS
  One-third of the parents had an encouraging attitude toward children with PNE, whereas slightly less than half reacted with anger. The more educated the father or the younger the child with NE, the larger the possibility of the parents utilizing a positive approach, such as encouragement, for coping with NE. Factors that influenced parents to seek medical consultation for NE were socioeconomic status, maternal educational level, and the age and birth order of their child.
  
  
  CONCLUSIONS
  From our results, angry and frustrated parents (43.0%) were significantly more likely to punish their child for bedwetting than were parents who approached NE positively (comfort and encouragement; 33.3%). A lack of encouragement may negatively affect the self-esteem of children with NE. Moreover, an individual's self-esteem or confidence, both of which can help them eliminate NE, determines the person's behavioral response to bedwetting. In our study, approximately 50% of the parents who approached NE positively (comfort and encouragement) or inconsistently (ambivalence) reported that they comforted their child after bedwetting.
  
  
  CONCLUSIONS
  Nearly half the parents reacted angrily to children with NE, and some parents even punished their child. The parents' socioeconomic background, education, and the age and birth order of the child were the factors associated with their seeking active treatment for NE. A father's education and young age of the child were factors that influenced parents who preferred positive approaches, such as encouragement, for coping with NE.
authors.affiliation: Department of Neuroscience, Hamilton College, Clinton, NY, USA.
authors.forename: Thomson T
authors.initials: TT
authors.lastname: Tai
authors.affiliation: Department of Biology, College of the Holy Cross, Worcester, MA, USA.
authors.forename: Brent T
authors.initials: BT
authors.lastname: Tai
authors.affiliation: Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan. Electronic address: june@cch.org.tw.
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Chang
authors.affiliation: Department of Surgery, Erlin Christian Hospital, Chanhua, Taiwan; Division of Urology, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Kuo-Hsuan
authors.initials: KH
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004644:Emotions; D005191:Family Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000628:therapy*; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Behavior; Childhood development; Nocturnal enuresis; Parental perception; Primary nocturnal enuresis