Psychosocial Issues

No child wants to wake up in a wet bed!
By: Renee Mercer, MSN, CPNP

Review of Psychosocial Issues

A recent paper published by DOVE, a leading United States enuresis clinic, identified bedwetting as the third most stressful life event for children, behind only divorce and parental arguments. For children experiencing bedwetting symptoms, swift treatment can be vital to their continued well-being. Effective bedwetting treatments can eliminate years of wetting for the majority of children with nocturnal enuresis. Parents should never simply wait for a child to "grow out of it."

No Punishment is Necessary. Unfortunately, findings suggest that 20-36% of parents punish their children for bedwetting. Punishments, even those as innocuous as withdrawal of privileges or increased household chores, have no effect. Since wetting is an involuntary act which the children do not control, punishment is inappropriate.

A child’s enuresis can be a source of conflict between parents — especially since there is no one cause and treatment. If a parent was enuretic themselves, they may understand their child’s experience, but they may also choose not to relive past humiliations. Often the issue wasn't previously discussed between spouses, and couples are unsure how to handle the extra workload of changing bedding and getting the child up during the night. This can cause even the best parents to become frustrated with their child and with each other.

Children with Enuresis Often Experience Lower Self-esteem and a Less Positive Self-concept. Children with enuresis often go to great lengths to hide their wetting from other family members and their friends. Parents report that their children deny any wetting even though they find wet sheets and clothing night after night. A child with enuresis commonly tries to avoid some of the social activities typical for their age group, such as sleepovers or group trips. As children reach middle and high school, overnight school trips and camps become stressful events to be escaped. Since this is the age where children should be developing independence, enuresis can have a highly negative impact. Feelings of shame, inferiority, and isolation are common. Often children feel that they are alone in having this problem.

Treatment is Beneficial. Research does indicate that feelings of inadequacy and shame dissipate once the enuresis in cured. Children who have received treatment for nocturnal enuresis show rapid improvements in social behavior and self-concept. Emotional support and encouragement from parents are important elements of this psychological recovery.