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Primary Nocturnal Enuresis

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Introduction

Enuresis The purpose of this assignment I am going to do Primary Nocturnal Enuresis, the reason why I am going to do this is because I do not know much about Nocturnal enuresis and I would like to find out more. Ethically I am going to maintain confidentiality and by doing this I have changed the names of the child and family that I have based this assignment upon. Forsythe and Butler (1989) Enuresis is the 'involuntary discharge of urine by day or night or both, in a child aged five years or older, in the absence of congenital or acquired defects of the nervous system or urinary tract'. Nocturnal enuresis is bed wetting it can be divided into to Primary and Secondary if a child has gone six months without wetting the bed and then starts wetting the bed it is termed as secondary nocturnal enuresis this is caused by more psychological problems. Primary is when the child has gone six months without wetting the bed. Habel (2001) has noted that nocturnal enuresis is most common in boys and so has Robinson L M (2004) During an enuresis clinic met a family in which two of the four children attend the clinic. Jason 12 and Jane 7 are the two, which attend the clinic they have a brother Jack 15 and a sister Jenny 9, their parents John and Josephine have divorced but have joint custody and the children spend time with both parents but spend most of their time at their mothers house. ...read more.

Middle

When Jane gets the alarm she may not wake for the first week so Josephine might have to wake her until she get used to waking up in the night. Josephine rewards Jason when he turns his alarm and completes the void in the toilet then when he returns to bed re setting the alarm. As Jason takes responsibility for his alarm he has a greater understanding of what is happening and in helping he is getting used to waking up in the night and going to the toilet. The clinic nurse also explained to Josephine to wake Jane when she goes to bed and asking her if she want to go to the toilet this scheme is similar to Azrin N H et al (1974) where the parent wakes the child three hours after falling asleep and asking the child to go to the toilet this would ensure there is very little fluid that might be voided later on in the night causing a wet bed. If it was a dry night then Josephine then reduces this time the next night by fifteen minutes. If Jane has a wet night then the time stays the same. This waking schedule works by lengthening the amount of time that Jane can go without voiding during the night. This waking schedule combined with the alarms is said to be the most effective in dry bed training Richard J Butler (2000). ...read more.

Conclusion

This will boost Jane's self-esteem and her confidence that she will become dry by telling her that her dad did have as well will illustrate that she can become dry just like her dad. Josephine has shown Jane the website for Education and Resources for Improving Childhood Continence (ERIC) which has input by other enuresis suffers so that there are other children that have enuresis to reinforce the fact that it is not an unusual condition. Josephine and John now understand not to punish either child for wetting the bed and to reward them for a dry bed this will help them understand that by wetting the bed they have not done something wrong and it will encourage them to have a dry night. Robinson L M (2004) views her opinion that punishment has no role in the treatment of nocturnal enuresis. The impact on self-esteem and on the emotional health of the child is significant enough without the added insult of punishment for a problem beyond his or her control. Punishment can be subtle and unrecognised by an otherwise well-meaning parent. Josephine has stopped giving nappies to sleep in, on Jason's admittance to the clinic she stopped Jane from wearing nappies at age five and gave them "special" pants that they could wear to bed Robinson L M (2004) states the most common psychological problems from enuresis are embarrassment, anxiety, loss of self-esteem, and effects on self-perception, interpersonal relationships, quality of life, and school performance. Heap J M (2004) also believes that they are low achievers in the school system. ...read more.

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