Beliefs and Expectations of Canadian Parents Who Bring Febrile Children for Medical Care

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Fever phobia is a ubiquitous problem throughout the world. As a result, fever is pharmacologically overtreated, and medical attention is frequently sought by worried parents. WHAT THIS STUDY ADDS:Most Canadian parents fear their child' s fever, resulting in aggressive surveillance and treatment. Parents expect information about fever etiology and how to care for their ill child. Few parents expect antibiotics and satisfaction with care is high. abstract OBJECTIVES: The purpose of this survey was to study the beliefs, expectations, and satisfaction of Canadian parents regarding fever and the treatment of their febrile children. METHODS:A survey was developed exploring caregiver beliefs and treatment strategies, as well as expectations and satisfaction with medical care. Some items were modeled after previous studies to allow comparison. Caregivers with febrile children were recruited from 2005 to 2007 at 3 urgent care centers and emergency departments in Edmonton, Canada: a pediatric emergency department (n = 376), an urban urgent care center (n = 227), and a suburban urgent care clinic (n = 173). RESULTS:High and rapidly rising temperature, as well as physical symptoms associated with fever, caused concern in most parents surveyed. Seventy-four percent of parents felt that the elevated temperature from fever was dangerous and 90.3% always try to treat it. Forty degrees Celsius was the most commonly sited threshold for danger. Identifying the cause (80.6%) and seriousness (87.4%) of fever were the most common stressors identified. Caregivers expected to receive information about the child' s illness and appropriate treatment. The parents most often wanted information about febrile seizures and the potential dangers of febrile illness. Only 16.7% of caregivers expected antibiotics. Nearly 92% of subjects were usually satisfied with medical care.CONCLUSIONS: Fever phobia continues to be a significant issue for Canadian parents. As a result, they treat fever aggressively and often seek medical attention. Good communication is important for medical staff caring for febrile children and typically leads to satisfied parents.

Awareness of parents of children with fever

“…He found that 30% of parents could not define normal temperature. 8 Similar results were reported by Purssell"s et al a decade later. Durousseau et al found that 42% parents knew fever threshold which is in agreement with the present study.…”

“…6 Many parents administer antipyretics even when there is minimal or no fever, because they are concerned that the child must maintain a "normal" temperature. 8 Harmful effects of fever alone are rare and are found mainly in very ill and compromised children or in children with fever persisting for more than 5 days, high core temperature (> 39°C) and fever in an infant less than 1 ~ 2 months of age or when it is associated with signs of severe underlying disease. 6 Fever may be useful as a defence mechanism as the body's immune response can be strengthened at higher temperatures; however, there are arguments for and against the usefulness of fever, and the issue is controversial.…”

“…Enarson et al in their study found three forth parents (74.1%) correctly identified it to be bactericidal, few parents 27.1% defined it as anti-viral. 8 This difference may be due to high education and mass awareness in Canada.…”

A current analysis of caregivers’ approaches to fever and antipyretic usage

“…Results were analyzed using the American Academy of Pediatrics (AAP) and National Institute for Health and Clinical Excellence (NICE) recommendations [2,15]. A substantial proportion of parents in our study held unrealistic concerns about fever and its consequences, and most used antipyretics excessively, both of which were common findings in other studies as well [4][5][6][7][8][9][10][11][12]. Increased use of antipyretics and wrong external cooling methods to reduce fever, waking sleeping febrile children to administer antipyretics, and routine use of antipyretics before and after vaccination reflects heightened concern about the harmful effects of fever.…”

“…Although fever is a beneficial host response, it is an important cause of anxiety for parents and leads to undue and excessive use of antipyretics [2,3]. For more than three decades, beginning with a survey conducted by Schmitt in 1980, researchers have demonstrated significant degrees of "fever phobia" in caregivers from different countries [4][5][6][7][8][9][10][11][12].…”