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Enurezisi Olan Çocuk/Adölesanların Tedavisinde Davranışsal Tedavi Yöntemleri

Enürezis, idrar kontrolünün beklendi¤i yafltan sonra (4-5 yafl), gece ya da gündüz, yata¤›na ya da giysilerine, istemli yada istemsiz olarak yenileyen (haftada en az 2 kez) idrar kaç›rmad›r. Enürezisin farkl› etyolojik nedenlerle ortaya ç›kabilenbir semptom olmas›, enürezisi farkl› disiplinleri ilgilendiren bir sorun haline getirmifltir. Enürezis ile ilgilenen her disiplinproblemi kendi aç›s›ndan de¤erlendirmekte ve tedaviyi yönlendirmektedir. Enurezis tedavisi için hemflire, hekim,e¤itimci, fizyoterapist, psikiyatristten oluflan multidisipliner bir ekip gerekmektedir. Gündüz alt›n› ›slatma s›kl›¤› 3-4 yafl›nda % 15 olup, her y›l % 15 spontan iyileflme olmaktad›r. Enurezis için bafll›ca iki grup tedavi yöntemi bulunmaktad›r.Bunlar davran›fl de¤ifltirme ve ilaç tedavisi yöntemleridir. Davran›fla dayal› tedavi yöntemlerinde; ilk etapta farmakolojikbir ajana gereksinim duyulmamas›, yan etkisinin olmamas› tercih edilen yönü olmakla beraber; tedaviye uyumsuzluk,s›k aral›klarla takip gerektirebilmesi, sa¤l›k ekibi, hasta ve aile ile iyi bir iletiflimi gerektirmesi, bafllang›çta ailelerin buyönteme güvenmemeleri yöntemin tercih edilmeme sebepleridir. Bu makalede davran›fla dayal› tedavi yöntemlerinden tuvalete¤itimi, motivasyon tedavisi, alarm-uyar› tedavisi, mesane retansiyon e¤itimi, hipnoterapi, akupunktur, refleks terapi,homeopati, biyofeedback, pelvik taban egzersizi, temiz aral›kl› kateterizasyon, nöromodülasyon ve karyopraktik yöntemlerineyer verilmifltir.Anahtar Kelimeler: Enürezis, tedavi, davran›fl de¤ifltirme.

Anahtar Kelimeler:

Enürezis, tedavi, davranış değiştirme

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