Self-disclosure dynamics in psychological crisis among Chinese pediatric patients with severe nocturnal enuresis: A qualitative inquiry.

Abstract

Severe nocturnal enuresis in children is not only a medical condition but also a significant psychological burden, often leading to emotional distress and social stigma. Many affected children struggle with self-disclosure of their psychological struggles, which can exacerbate mental health challenges. The objective is to explore the barriers and facilitators of self-disclosure regarding psychological crises in children with severe enuresis, with the aim of providing a foundation for alleviating psychological distress and improving mental health outcomes. Purposive sampling was employed to select 13 pairs of children with severe enuresis and their parents from a specialized hospital's urology department. Data were collected through in-depth interviews, and the Colaizzi 7-step method was used to analyze, summarize, and refine the themes. Factors influencing psychological crisis disclosure in children with severe enuresis included four barriers and ten subthemes. Barriers included emotional disorders (e.g. shame, low self-esteem), psychological burdens (e.g. impact on class participation, fear of sleeping, recurrent anxiety), moral constraints (e.g. limited expressive ability, avoidance of social interaction), and a lack of a safe disclosure environment (e.g. parents' high expectations, excessive anxiety and punishment, social prejudice). Facilitators included perceived benefits of disclosure and mastery of disclosure-related skills. The self-disclosure of psychological crises in children with severe enuresis is influenced by multiple factors. Clinical nursing and health services should address these factors at various levels to foster positive self-cognition and create a supportive environment for self-disclosure, thereby alleviating psychological distress and promoting mental health.