[Treatment of persistent nocturnal enuresis in children of Turkish and Moroccan migrants requires extra attention for the family]. / Behandeling van hardnekkige enuresis nocturna bij kinderen van Turkse en Marokkaanse migranten vraagt extra aandacht voor het gezin.

ABSTRACT

OBJECTIVE: To assess the effect of the clinical dry bed training according to Azrin/Messer for Turkish and Moroccan children with nocturnal enuresis aged 11 years or more, living in the Netherlands, as compared with native Dutch children. SETTING: Overvecht Hospital, Utrecht. DESIGN: Comparative and follow-up study. METHOD: After an admission period of 8 days a home training of two months was given. 40 migrant children and 43 Dutch children were trained. Improvement rates were measured on the day of hospital discharge, after three and after nine months. Several adjustments, based on cultural differences, were needed in the course of the project. RESULTS: On the day of discharge about 90% of both children groups showed improvement. After three months 60% of migrant children and 81% of Dutch children showed improvement, after nine months 61% and 70% respectively. In the end 51% of the Dutch children and 36% of the migrant children remained dry. The parents of migrant children believed their children would alter their micturition behaviour when they met disapproval, punishment and shame. CONCLUSION: The clinical dry bed training is suitable for migrant children if intensive and time consuming support can be given during the follow-up period, especially to the parents (in Dutch children, training of just the child often suffices). Frequent home visits, use of interpreters and active involvement of the parents are needed. A positive approach with emphasis on praise instead of punishment and shame has to be taught to the parents.