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

Objective: 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. Methods: 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. Results: 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. Conclusions: 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.