Nocturnal Enuresis
Conditions
Keywords
Empowerment; Mothers; Nocturnal Enuresis; Knowledge; Practices; Quality of Life.
Brief summary
This study aimed to evaluate the effect of the empowerment program on the knowledge, practices, and quality of life of mothers of children with nocturnal enuresis in a two-arm randomized controlled trial.
Detailed description
Nocturnal enuresis is a common pediatric condition that adversely affects children's physical, psychological, and social well-being, as well as the quality of life of their families. Mothers play a central role in the day-to-day management of children with nocturnal enuresis; however, insufficient knowledge and inappropriate management practices may reduce the effectiveness of treatment and increase the family burden. Objective: This randomized controlled trial aimed to evaluate the effectiveness of an empowerment program for mothers of children with nocturnal enuresis in improving their knowledge, self-reported practices, and quality of life. Methods: A two-arm parallel randomized controlled trial was conducted at the Outpatient Urinary Incontinence Clinic, Centre for Social and Preventive Medicine, Cairo University, Egypt. A total of 200 eligible mothers were randomly allocated to either an intervention group that received the structured empowerment program or a wait-list control group that received routine care during the study period. Outcomes were assessed at baseline (T0), four weeks after the intervention (T1), and three months after the intervention (T2).
Interventions
BEHAVIORALMother Empowerment Program for Nocturnal Enuresis
The intervention is a structured nurse-led behavioral empowerment program designed for mothers of school-age children with nocturnal enuresis. The program is delivered in Arabic through 30-minute small-group sessions (3-5 mothers per group) using interactive teaching, discussion, and an educational booklet developed by the research team. The educational content includes the definition and types of nocturnal enuresis, causes and risk factors, diagnostic evaluation, complications, behavioral management strategies, fluid management, bladder training, reward systems, alarm therapy, medication adherence, hygiene measures, and family support strategies. Mothers receive the educational booklet at the completion of the sessions for continued home reference. The intervention aims to improve maternal knowledge, caregiving practices, and family quality of life. Participants are evaluated at baseline (T0), 4 weeks after the intervention (T1), and 3 months after the intervention
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
This randomized controlled trial aims to evaluate the effectiveness of a structured educational empowerment program delivered to mothers of children diagnosed with nocturnal enuresis. Eligible participants will be randomly assigned to either the intervention group or the control group. Mothers in the intervention group will receive a comprehensive educational program that includes information about nocturnal enuresis, behavioral management techniques, lifestyle modifications, bladder training, fluid management, positive reinforcement strategies, and psychological support. Participants in the control group will receive routine care provided by the study setting. Outcomes will be measured before the intervention and after completion of the educational program using validated questionnaires assessing knowledge, caregiving practices, and quality of life.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Mothers aged 18 years or older. Mothers of school-age children diagnosed with nocturnal enuresis. Child aged 6-12 years attending the outpatient urinary incontinence clinic at the Centre for Social and Preventive Medicine, Cairo University. Able to communicate in Arabic. Willing to participate and provide written informed consent. Available to complete baseline, post-intervention (4 weeks), and 3-month follow-up assessments.
Exclusion criteria
Mothers of children with secondary nocturnal enuresis caused by serious neurological, endocrine, or structural urinary tract disorders. Mothers whose children have severe cognitive impairment or medical conditions preventing participation in the educational program. Mothers currently participating in another structured educational or behavioral intervention related to nocturnal enuresis. Mothers unwilling or unable to provide informed consent or complete study assessments. Mothers planning to relocate or unlikely to complete follow-up evaluations.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mothers' Knowledge Regarding Nocturnal Enuresis | Baseline (T0), 4 weeks after intervention (T1), and 3 months after intervention (T2) | Mothers' knowledge regarding nocturnal enuresis will be assessed using the researcher-developed Nocturnal Enuresis Structured Knowledge Questionnaire (15 items). Knowledge scoring system: "Two" scores were given for a completely correct answer, "one" score for an incomplete correct answer, and "zero" for an incorrect or unknown answer. The higher scores reflect higher levels of knowledge about nocturnal enuresis. The total knowledge scores are categorized into three levels: unsatisfactory knowledge (less than 50%), partially satisfactory knowledge (50%-75%), and satisfactory knowledge (more than 75%). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mothers' Self-Reported Practices Regarding Nocturnal Enuresis | Baseline (T0), 4 weeks after intervention (T1), and 3 months after intervention (T2) | Mothers' self-reported practices will be assessed using a researcher-developed 15-item checklist covering behavioral management practices, including fluid management, bladder training, reward systems, alarm therapy, hygiene, and follow-up care. Each performed practice is scored as 1 and each non-performed practice as 0. Higher scores indicate better practice. Self-reported practices scoring system: Each item was given one score if performed, and a score of zero for actions not performed. Total scores were classified as follows: poor practices (less than 50%), fair practices (50%-75%), and good practices (more than 75%). |
| Mothers' Quality of Life | Baseline (T0), 4 weeks after intervention (T1), and 3 months after intervention (T2) | Mothers' quality of life will be measured using the Modified Pediatric Enuresis Module on Quality of Life-Short Form (PEMQOL-SF). The instrument consists of 16 items evaluating the impact of nocturnal enuresis on the child and family. Scores are transformed to a 0-100 scale according to the instrument scoring guidelines. The PEMQOL-Short Form is made up of 16 questions: 7 questions concerning the impact on the child's well-being (child impact scale) and 9 questions concerning its impact on the family's emotional and social well-being (family impact scale). Response options for both scales have five levels each: A lot, Quite a bit, Some, A little bit, and Not at all. For ease of interpretation, the raw scale scores are converted to a 0-100 continuum using a standard mathematical formula. A score of more than 50 is considered a significant effect on psychological well-being. |
Countries
Egypt
Outcome results
None listed