Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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대소변 가리기 훈련과 영향을 주는 인자에 관한 연구

A study on the toilet training and influencing factors

  • 김은옥 (전주 예수병원 소아청소년과) ;
  • 윤상현 (전주 예수병원 소아청소년과) ;
  • 장영택 (전주 예수병원 소아청소년과)
  • Kim, Eun Ok (Department of Pediatrics, Presbyterian Medical Center) ;
  • Yun, Sang Hyun (Department of Pediatrics, Presbyterian Medical Center) ;
  • Jang, Young Taek (Department of Pediatrics, Presbyterian Medical Center)
  • 투고 : 2009.04.07
  • 심사 : 2009.06.12
  • 발행 : 2009.07.15
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초록

목 적 : 대소변 훈련 시기와 기간 및 부작용과 이에 영향을 주는 인자 등을 살펴보고, 부모들에게 적절한 교육이 되는 자료를 살펴보고자 이 연구를 시작하였다. 방 법 : 2009년 1월부터 2009년 2월까지 전주예수병원과 전주, 익산, 군산지역 소아청소년과 의원에 방문하는, 만 2-6세 아기 1,370명의 부모를 대상으로 성별, 주거 지역, 가족 관계, 기저귀 종류, 훈련 시작 시기, 낮과 밤에 각각 대소변 가린 시기, 부작용, 엄마의 교육 정도, 맞벌이 여부, 경제 수준 등에 대해서 설문조사하였으며, 대소변 훈련 시작 시기와 기간, 완료 시기 및 영향을 주는 인자와 부작용을 분석하였다. 결 과 : 훈련 시작 시기와 완료 시기는 남녀 차이가 없었으며, 군 지역 거주, 위에 형제 자매가 있는 경우, 천기저귀를 사용하는 경우, 맞벌이, 경제 수준이 낮은 경우에 빨랐다. 낮에 대변 가리기, 낮 소변 가리기, 밤 소변 가리기 완료 시기는 각각 23.7개월, 24.8개월, 32.7개월이었으며, 훈련에 필요한 기간은 각각 4.8개월, 5.9개월, 14.0개월이었다. 훈련 완료 시기는 훈련을 18개월 이전에 시킨 경우에는 22.9개월로 18-24개월의 25.9개월, 25개월 이상의 31.0개월보다 일찍 훈련을 마칠 수는 있었으나, 기간은 18개월 이전에 시킨 경우가 8.4개월로 18-24개월의 5.6개월, 25개월 이상의 3.8개월보다 더 걸렸다. 부작용은 유분증, 변비, 거부 반응, 숨기 순이었으며, 18개월 이전에 훈련을 시킨 경우가 그 이후에 시킨 경우보다 유분증과 거부 반응이 많았다. 결 론 : 대소변 훈련 시기는 최소한 18개월 이후에 아기의 발달사항을 종합적으로 고려한 후에 하는 것이 좋을 것으로 판단되었으며 향후 우리나라의 적절한 권고가 만들어져야 할 것이다.

Purpose : We aimed to determine the ideal age for initiating toilet training and investigate the factors influencing the training. Methods : The study population comprised 1,370 children aged 2-6 years, who visited the pediatric clinics in Jeonju, Iksan, and Gunsan. Their parents were given questionnaires in order to gather data about the types of diapers used, ages when toilet training was initiated and completed for each day and night, its adverse effects, and the educational level and employment and economic status of the mothers. Results : The toilet training initiation age was low for those living in the country, having an elder sibling(s), and using cloth diapers, and for those whose mothers were employed and had a low economic status. The training completion age was 22.9 months when the training was initiated before the age of 18 months; this was lower than the training completion ages of 25.9 and 31.0 months when the training was initiated at the age of 18-24 months and after 25 months, respectively. However, the required durations in these cases were 8.4, 5.6, and 3.8 months, respectively. Encopresis and refusal occurred more often when the training was initiated before the age of 18 months than when initiated after this age. Conclusion : Toilet training should begin at least after the age of 18 months considering the developmental status of infants. It is recommended for the future researchers to develop specific guidelines regarding toilet training.

키워드

참고문헌

  1. Mark LW. Guide to toilet training. New York: American Academy of Pediatrics, 2003:1-89
  2. Stadtler AC, Gorski PA, Brazelton TB. Toilet training methods, clinical interventions, and recommendations. Pediatrics 1999;103:1359-61
  3. Ivor BH, Ruth B, Malla R, Tina LC. Beliefs about the appropriate age for initiating toilet training: are there racial and socioeconomic differences? J Pediatr 2006;149:165-8 https://doi.org/10.1016/j.jpeds.2006.03.004
  4. Stadtler AC, Gorski PA, Brazelton TB. Toilet training guidelines: the role of the clinician in toilet training. Pediatrics 1999;103:1364-6
  5. Blum NJ, Taubman B, Nemeth N. Relationship between age at initiation of toilet training and duration of training: a prospective study. Pediatrics 2003;111:810-4 https://doi.org/10.1542/peds.111.4.810
  6. Howe AC, Walker CE. Behavioral management of toilet training, enuresis, and encopresis. Pediatr Clin North Am 1992;39:413-32
  7. Brazelton TB, Christophersen ER, Frauman AC, Gorski PA, Poole JM, Stadtler AC, et el. Instruction, timeliness, and medical influences affecting toilet training. Pediatrics 1999; 103:1353-8
  8. Steven PS. Caring for your baby and young child: Birth to age five. 4th ed. New York: American Academy of Pediatrics, 2004:321-3
  9. Brazelton TB. A child-oriented approach to toilet training. Pediatrics1962;29:121-8
  10. Mota DM, Barros AJ. Toilet training: methods, parental expectations and associated dysfunctions. J Pediatr 2008;84: 9-17 https://doi.org/10.2223/JPED.1752
  11. Schum TR, Kolb TM, McAuliffe TL, Simms MD, Underhill RL, Lewis M. Sequential acquisition of toilet-training skills: a descriptive study of gender and age differences in normal children. Pediatrics 2002;109:e48 https://doi.org/10.1542/peds.109.3.e48
  12. JA, King DR, Maccoby EE, Jacklin CN. Secular trends and individual differences in toilet-training progress. J Pediatr Psychol 1984;9:457-67 https://doi.org/10.1093/jpepsy/9.4.457
  13. Stein Z, Susser M. Social factors in the development of sphincter control. Dev Med Child Neurol 1967;9:692-706 https://doi.org/10.1111/j.1469-8749.1967.tb02352.x
  14. Largo RH, Stutzle W. Longitudinal study of bowel and bladder control by day and at night in the first six years of life. I: Epidemiology and interrelations between bowel and bladder control. Dev Med Child Neurol 1977;19:598-606 https://doi.org/10.1111/j.1469-8749.1977.tb07993.x
  15. Ahn HS. Hong chang yee textbook of pediatrics. 9th ed. Seongnam: Daehan Printing & Publishing Co, Ltd, 2007:33
  16. Rugolotto S, Sun M, Blum NJ, Taubman B. Toilet training. Pediatrics 2004;113:180-1 https://doi.org/10.1542/peds.113.1.180
  17. Bakker E, Wyndaele JJ. Changes in the toilet training of children during the last 60 years: the cause of an increase in lower urinary tract dysfunction? BJU Int 2000;86:248-52 https://doi.org/10.1046/j.1464-410x.2000.00737.x
  18. Gerrard SD, Richmond JB. Psychogenic megacolon manifested by fecal soiling. Pediatrics 1954;10:474-81
  19. Richmond JB, Eddy EJ, Garrard SD. The syndrome of fecal soiling and megacolon. Am J Orthopsychiatry 1954;24:391- 401 https://doi.org/10.1111/j.1939-0025.1954.tb02027.x