‘Do I don’t I call the doctor’: a qualitative study of parental perceptions of calling the GP out‐of‐hours

Abstract

The purpose of this study was to investigate how parents use the GP out‐of‐hours service. There was a lack of information about how parents managed childhood illness and what strategies they put in place to help them to cope before calling the GP. The investigation of parental perceptions was based on a qualitative design using in‐depth interviews of 29 families from a semi‐rural location in the south‐east of England. All parents said they found dealing with a sick child out‐of‐hours stressful and were concerned to make the right decision for their child. Furthermore, parents usually employed a reasonable strategy in attempting to manage the child’s illness. This study demonstrated that the decision to call the doctor was not taken lightly. Many parents had implemented useful strategies prior to calling the doctor. However, most parents were also aware of their limitations and feared doing the wrong thing. It would seem that on occasion this fear combined with factors such as a lack of social support and loss of parental confidence resulted in calling the doctor out of hours to seek ‘peace of mind’. A rethink is needed among health professionals about the ‘problem’ of out‐of‐hours calls. GPs could actively seek to empower parents by educating them about minor illness during visits and consultations. It is not enough to offer reassurance to parents that their children are fine. Health visitors and other health professionals who come into contact with young families may help to educate and empower.

Containing acute childhood illness within family life: a substantive grounded theory

“…Repeatedly parents were found to strive 'to do the right thing', for their child and in the eyes of others, by attempting to conform to informal social rules (ISRs) for the management of common acute childhood illness. Previous research also identified a desire to do the right thing for the child (Ehrich, 2000;Houston and Pickering, 2000;Neill, 2000;Polyzoi et al, 2003). It is evident that this is an expectation of families, which, given the desire to be seen to do the right thing -to manage the impressions created for their audience (the researcher) -might be expected in conversations about parenting.…”

“…More recent research (Ehrich, 2003;Houston and Pickering, 2000;Liggins, 1993;Watson, 1991) has focused on examining the underlying reasons for patterns of service use, rather than demonizing service users for failing to behave as professionals believe they should. There is some evidence in that research (Ehrich, 2003;Houston and Pickering, 2000) and in this study (albeit based on the families' perspective) that professionals' behaviour during consultations is shaped by these expectations of appropriate service use, illustrated in accounts of consultations which have resulted in families feeling 'silly' for having sought a doctor's opinion. Findings in this area generated the concept of felt or enacted criticism from which experiences parents learn the informal social rules for the management of acute childhood illness.…”

Which early ‘red flag’ symptoms identify children with meningococcal disease in primary care?

“…[12][13][14][15] Symptoms that concern parents the most include fever, cough, rash, change in behaviour, and increased severity of illness, particularly in younger children. 12,14 The findings of the present study suggest that parents are correct to be worried about rash, photophobia, neck pain/stiffness, or change in behaviour in a febrile child, particularly if the latter involves drowsiness or confusion.…”

‘Do I, don’t I ask for help?’

“…Calling the doctor is a real dilemma for parents (Houston and Pickering, 2000). Parents are particularly sensitive to, or rather sensitized by, the experiences of criticism from HCPs.…”