Study of the profile of behavioral problems and quality of life indexes in a pediatric cohort of monosymptomatic enuresis
| Autor: | Vera H. Koch, Alexandre Archanjo Ferraro, Simone Nascimento Fagundes Sammour, Guilherme Jorge Sousa e Silva |
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| Rok vydání: | 2017 |
| Předmět: |
Problemas de comportamento
Partially successful Quality of life Male Pediatrics medicine.medical_specialty Adolescent 030232 urology & nephrology Psychological intervention CBCL Monosymptomatic nocturnal enuresis Behavioral problems Treatment and control groups Cohort Studies Qualidade de vida 03 medical and health sciences 0302 clinical medicine Enuresis 030225 pediatrics Desmopressin medicine Humans Desmopressina Deamino Arginine Vasopressin Treatment with alarm Child Enurese noturna monossintomática Patient Care Team Problem Behavior business.industry Antidiuretic Agents lcsh:RJ1-570 lcsh:Pediatrics Tratamento com alarme Combined Modality Therapy Clinical Alarms Pediatrics Perinatology and Child Health Cohort Quality of Life Therapeutic failure Female medicine.symptom business Nocturnal Enuresis |
| Zdroj: | Jornal de Pediatria (Versão em Português), Vol 95, Iss 2, Pp 188-193 (2019) Jornal de Pediatria, Vol 95, Iss 2, Pp 188-193 (2019) Jornal de Pediatria v.95 n.2 2019 Jornal de Pediatria Sociedade Brasileira de Pediatria (SBP) instacron:SBPE Jornal de Pediatria, Volume: 95, Issue: 2, Pages: 188-193, Published: 11 APR 2019 |
| ISSN: | 1678-4782 |
| Popis: | Objective: To evaluate and correlate, before and after the therapeutic intervention, the behavioral problem scores evaluated by the CBCL/6-18 questionnaire and the quality of life indexes evaluated by the PedsQL™ 4.0 in patients with monosymptomatic nocturnal enuresis. Method: After the initial evaluation and completion of the CBCL/6-18 questionnaire, a multidisciplinary evaluation and completion of the PedsQL™ 4.0 questionnaire was performed. Of the initially evaluated 140 children and adolescents aged 6–16 years, 58 were excluded due to non-monosymptomatic enuresis or associated comorbidities. Of the initially included 82 patients, who were randomized to three treatment groups, 59 completed the CBCL/6-18 and PedsQL™ 4.0 questionnaires at the end of the treatment and were included in this study. The α error was set at 5% for ruling out the null hypothesis. Results: Of the total of 59 participants, 45.8% responded with total success, 23.7% were partially successful, 23.7% did not reach the improvement criteria, and 6.8% gave up the treatment. There was a significant increase in quality of life indexes and a reduction of post-intervention behavioral problem scores, in the three proposed modalities, in patients who had a total or partial response to treatment. There was no correlation between higher scores of pre-treatment behavior problems and therapeutic failure. Conclusions: Only the participants who successfully responded to interventions showed improvement in quality of life and behavioral problems, which indicates that enuresis is a primary problem that has a negative impact on these parameters. The authors suggest that it is possible to achieve success in the treatment of monosymptomatic enuresis, even in patients with high pre-intervention behavioral problem scores. Resumo: Objetivo: Avaliar e relacionar, pré e pós-intervenção terapêutica, em pacientes com enurese noturna monossintomática, os escores de problemas de comportamento, avaliados pelo questionário CBCL/6-18, e os índices de qualidade de vida, avaliados pelo PedsQL™ 4.0. Método: Após avaliação inicial e preenchimento CBCL6/18, procedeu-se avaliação multidisciplinar e preenchimento do PedsQL™ 4.0. Das 140 crianças e adolescentes de 6 a 16 anos inicialmente avaliados, 58 foram excluídos por enurese não monossintomática ou comorbidades associadas. Dos 82 pacientes inicialmente incluídos e randomizados em três grupos de tratamento, 59 preencheram o CBCL/6-18 e PedsQL™ 4.0 no fim do tratamento e puderam ser incluídos neste trabalho. O erro alfa foi estabelecido em 5% para descarte da hipótese de nulidade. Resultados: Dos 59 participantes 45,8% responderam com sucesso total, 23,7% tiveram sucesso parcial, 23,7% não atingiram critério de melhoria e 6,8% desistiram do tratamento. Verificou-se aumento significativo dos índices de qualidade de vida e redução dos escores de problemas de comportamento pós-intervenção, nas três modalidades propostas, nos pacientes que obtiveram resposta total ou parcial ao tratamento. Não se demonstrou correlação entre maiores escores de problemas de comportamento pré-tratamento e insucesso terapêutico. Conclusões: Apenas os participantes que responderam com sucesso às intervenções, melhoraram em sua qualidade de vida e problemas comportamentais, o que indica que a enurese é um problema primário que impacta negativamente esses parâmetros. Sugere-se que é viável obter sucesso no tratamento da enurese monossintomática, mesmo em pacientes com altos escores de problemas de comportamento pré-intervenção. Keywords: Monosymptomatic nocturnal enuresis, Behavioral problems, Quality of life, Treatment with alarm, Desmopressin, Palavras-chave: Enurese noturna monossintomática, Problemas de comportamento, Qualidade de vida, Tratamento com alarme, Desmopressina |
| Databáze: | OpenAIRE |
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