Nocturnal enuresis in Syrian migrant children: a qualitative study on diagnosis, treatment, and care experiences

This study aims to examine, through qualitative methods, the challenges experienced by families during the diagnosis and treatment processes of nocturnal enuresis in Syrian children. For this qualitative type of study in-depth interviews were conducted face to face with 19 mothers of children with nocturnal enuresis who applied to Migrant Health Center (MHC). Some socio-demographic information, their experiences, believes about nocturnal enuresis disease were asked. The interviews were terminated after data saturation had been reached. All interviews were audio-recorded with the permission of the participants. Data were analyzed using thematic content analysis to identify emerging themes through a systematic and transparent process after transcription of the audio records. A total of five themes and twelve subthemes were identified. The themes were as follows: “Perceived Importance of Early Disease Diagnosis,” “Experiences and Perceptions of the Diagnostic Process in Nocturnal Enuresis,” “Treatment Approaches and Management Strategies in Nocturnal Enuresis,” “Knowledge and Illness Perceptions Regarding Nocturnal Enuresis,” and “Barriers to Healthcare Access”. All participants emphasized that early diagnosis accelerates treatment and leads to better treatment outcomes. Regarding the period between the onset of symptoms and seeking medical care, participants mentioned factors such as the belief that bedwetting would resolve spontaneously, the absence of daily symptoms, and the distance of the hospital as reasons for delayed consultation. Concerning treatment approaches, participants referred to lifestyle recommendations such as fluid restriction, psychological support, and pharmacological therapy. These interventions were generally described as beneficial. However, those who perceived nocturnal enuresis as a genetic condition reported fewer health-seeking behaviors, such as consulting a physician or adhering to medical recommendations. Participants also reported experiencing barriers to accessing healthcare services, including language difficulties, long distances to hospitals, and difficulty obtaining appointments. Economic hardship was another commonly mentioned obstacle to accessing healthcare. The findings indicate that although mothers recognize the importance of early diagnosis, health-seeking behaviors may be delayed due to cultural beliefs, perceived spontaneity of symptom resolution, and accessibility barriers. Additionally, the perception of nocturnal enuresis as a hereditary and non-modifiable condition may reduce active engagement in treatment processes. These findings highlight the need for culturally sensitive health education, and migrant-inclusive health policies, including strengthened primary care services within MHCs to improve health in vulnerable populations.