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PEDIATRICS Vol. 113 No. 2 February 2004, pp. 334-344

Coping, Commitment, and Attitude: Quantifying the Everyday Burden of Enuresis on Children and Their Families

Jeanne M. Landgraf, MA*, Jennifer Abidari, MD{ddagger}, Bartley G. Cilento, Jr., MD§, Christopher S. Cooper, MD||, Seth L. Schulman, MD and Joseph Ortenberg, MD, FAAP#

* HealthAct, Boston, Massachusetts
{ddagger} Department of Urology, Stanford University School of Medicine, Stanford, California
§ Harvard Medical School and Department of Urology, Children’s Hospital, Boston, Massachusetts
|| Department of Urology, Division of Pediatric Urology, University of Iowa, Iowa City, Iowa
Division of Nephrology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
# Department of Urology, Louisiana State University Health Sciences Center/Children’s Hospital, New Orleans, Louisiana

Objective. To develop and evaluate a parent-completed questionnaire for use by clinicians as part of routine care to assess the burden of diurnal and nocturnal enuresis on children and their families.

Methods. The questionnaire consisted of items that measure the impact on the child and his/her parent, the child’s coping ability and commitment to treatment, previous treatment success, family frustration and overall cohesion, and parental attitudes about enuresis and its treatment. Questionnaires (n = 208) were completed by parents during the child’s scheduled office visit for enuresis at 5 specialty clinics across the United States. Traditional criteria were used to assess reliability and validity of the questionnaire, including analysis of variance.

Results. Success rates provide evidence that many of the items in the child scale (79%) and all items in the parent scale (100%) met stringent criteria. {alpha} values were .62 and .77, respectively. Statistically significant differences were observed for the scales across responses on all but 1 global item, the majority of parental attitude items, whether the child urinated at bedtime, and the number of pads used. These findings suggest that the child’s coping ability and commitment and the family’s overall cohesion and frustration with the problem influence parental perceptions about the impact of enuresis on the child and the family.

Conclusions. Findings about the performance of the new measure were satisfactory and suggest that, after further refinement, it should prove as a useful tool for clinicians treating enuresis in children.

Key Words: quality of life • outcomes • pediatric enuresis • measurement

Abbreviations: PEMQOL, Pediatric Enuresis Module to assess quality of life

Received for publication Jan 2, 2003; Accepted May 27, 2003.




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