Fever Phobia in Korean Caregivers and Its Clinical Implications

Kwak, Young Ho; Kim, Do Kyun; Jang, Hye Young; Kim, Jin Joo; Ryu, Jeong Min; Oh, Seong Beom; Lee, Eui Jung; Lee, Jisook; Lee, Jin Hee; Jung, Jin Hee; Han, Seung Baik

doi:10.3346/jkms.2013.28.11.1639

Cited by 18 publications

(25 citation statements)

References 14 publications

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“…If parents were more aware of this natural course of postvaccination fever, they may be less anxious and reduce the use of antipyretics, thereby reducing unnecessary medical care [40,41]. We would expect parents to have a more positive outlook regarding vaccinations once their fears concerning fever had been more fully addressed [15].…”

Section: Discussionmentioning

confidence: 99%

“…For these reasons, postvaccination fever can cause excessive anxiety in parents and caregivers [10-12]. Previous studies have indicated that parent perceptions and fear of fever have not significantly changed over the past 20 years and are still common in the Korean population [13-15]. Postvaccination fever phobia could lead to unnecessary testing, treatment (including the overuse of antipyretics), and emergency department visits, which increase both medical costs and the possibility of side effects [7,16].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Postvaccination Fever Response Rates in Children Derived Using the Fever Coach Mobile App: A Retrospective Observational Study

Ahn¹,

Zhiang²,

Kim³

et al. 2019

JMIR Mhealth Uhealth

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Background Postvaccination fever is a mild adverse event that naturally improves without complications, but is highly prevalent and can be accompanied by febrile convulsions in some cases. These adverse effects may cause parents to delay or avoid vaccinating their children. Objective This study aimed to identify postvaccination fever patterns and the ability of antipyretics to affect changes in these patterns from data collected from a mobile app named Fever Coach. Methods Data provided by parents of feverish children derived from a mobile app, Fever Coach, were used to identify postvaccination fever patterns according to vaccinations and the use of antipyretic drugs. We selected single vaccination records that contained five or more body temperature readings performed within 48 hours of vaccination, and we analyzed postvaccination fever onset, offset, duration, and maximum body temperature. Through observing the postvaccination fever response to vaccination, we identified the effects of antipyretic drugs on postvaccination fever onset, offset, and duration times; the extent of fever; and the rate of decline. We also performed logistic regression analysis to determine demographic variables (age, weight, and sex) involved in relatively high fevers (body temperature ≥39°C). Results The total number of Fever Coach users was 25,037, with 3834 users having entered single vaccination records, including 4448 vaccinations and 55,783 body temperature records. Most records were obtained from children receiving the following vaccinations: pneumococcus (n=2069); Japanese encephalitis (n=911); influenza (n=669); diphtheria, tetanus, and pertussis (n=403); and hepatitis A (n=252). According to the 4448 vaccination records, 3427 (77.05%) children had taken antipyretic drugs, and 3238 (89.15%) children took antibiotics at body temperatures above 38°C. The number of children taking antipyretics at a body temperature of 38°C was more than four times that of those taking antipyretics at 37.9°C (307 vs 67 cases). The number of instances in which this temperature threshold was reached was more than four times greater than the number when the temperature was 37.9°C. A comparative analysis of antipyretic and nonantipyretic cases showed there was no difference in onset time; however, offset and duration times were significantly shorter in nonantipyretic cases than in antipyretic cases (P<.001). In nonantipyretic cases, offset times and duration times were 9.9 and 10.1 hours shorter, respectively, than in antipyretic cases. Body temperatures also decreased faster in nonantipyretic cases. Influenza vaccine-associated fevers lasted relatively longer, whereas pneumococcus vaccine-associated fevers were relatively short-lived. Conclusions These findings suggest that postvaccination fever has its own fever pattern, which is dependent on vaccine type and the presence of antipyretic drugs, and that postvaccination temperature monitoring may ease fever phobia and reduce the unnecessary use of antipyretics in medical care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Postvaccination Fever Response Rates in Children Derived Using the Fever Coach Mobile App: A Retrospective Observational Study

Ahn¹,

Zhiang²,

Kim³

et al. 2019

JMIR Mhealth Uhealth

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“…The literature search process is summarised in Figure . For the final analysis, we retained 76 papers published between 1985 and 2018 (, S61–S78), which had been published in English between 1985 and 2018 (references from 61 to 88 are listed in Appendix ). The other languages did not identify any suitable papers.…”

Section: Resultsmentioning

confidence: 99%

“…The possible occurrence of fever phobia was addressed by 65 papers that covered 26 521 caregivers (,,,,,,,,,,,,S61–S78). Fever phobia was detected in all of the reports.…”

Section: Resultsmentioning

confidence: 99%

Systematic review finds that fever phobia is a worldwide issue among caregivers and healthcare providers

et al. 2019

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Aim: Fever phobia describes exaggerated concerns about the consequences of childhood fever and broader awareness is needed in everyday clinical practice. We investigated the factors associated with fever phobia in caregivers and healthcare providers and the geographical distribution of the issue. Methods:The National Library of Medicine, Excerpta Medica and Google Scholar databases were searched. Results:We retrieved 76 papers, published in English from 1985 to 2018, which covered wide areas of Asia, Europe, America, Africa and Australia. The occurrence of fever phobia was confirmed in 65 papers covering 26 521 caregivers. A number of factors were significantly associated with fever phobia, including low educational or socioeconomic levels, a history of febrile seizures in the child and young maternal age. Fever phobia was also more common in Bedouins and in people from Latin America, Southern Italy and Turkey. There were also 15 papers that addressed fever phobia among 4566 healthcare providers. All the reports suggested that a fear of fever and a tendency to over treat was common among physicians and nurses.Conclusion: Fever phobia was a common world phenomena that affected caregivers and healthcare providers. SUPPORTING INFORMATIONAdditional supporting information may be found online in the Supporting Information section at the end of the article:Appendix S1 References from S61 to S88.

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“…The idea of ‘fever phobia’ was introduced in 1980 by Schmidt and describes unrealistic parental perceptions of fever [19]. Since then, other research has confirmed that parental perceptions are largely unjustified [17,19-23]. Parental responses to fever lead to over engagement with healthcare practitioners and futile consultations [4,24].…”

Section: Introductionmentioning

confidence: 99%

The knowledge, attitudes and beliefs of carers (parents, guardians, healthcare practitioners, crèche workers) around fever and febrile illness in children aged 5 years and under: protocol for a qualitative systematic review

et al. 2015

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BackgroundMany parents consider fever a disease in itself and feel disempowered when their child is ill. Numerous guidelines have been produced; however, their target audience remains healthcare professionals and not carers of children in general. A reliable source of information will decrease worry in parents and carers when managing a febrile child.Methods/DesignA systematic search will be conducted in nine electronic databases. Articles published in English, or with an abstract published in English, will be eligible for inclusion in the review. Unpublished literature, grey literature and consultation with experts in the area will be used to supplement database searching. Titles and abstracts of studies will be screened for inclusion in the study by two independent reviewers against pre-determined inclusion and exclusion criteria. A data extraction form will be designed and data will be extracted to provide detail of the included studies by a further two reviewers. Quality assessment of studies will be conducted by two additional independent reviewers and results will be used to moderate included studies. All disagreements will be resolved through discussion until consensus is reached. Thematic synthesis will be used to analyse results.DiscussionCorrect management of fever in children is not well understood in the general population. Although carers can identify fever and febrile illness in children, determination of the severity of fever proves challenging. Research is needed to cohere existing evidence and identify knowledge gaps. It is envisaged that results of this review will contribute to the development of trustworthy, accessible guidelines for parents and carers of children with fever or febrile illness.Systematic review registrationPROSPERO CRD42014009812

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Fever Phobia in Korean Caregivers and Its Clinical Implications

Cited by 18 publications

References 14 publications

Postvaccination Fever Response Rates in Children Derived Using the Fever Coach Mobile App: A Retrospective Observational Study

Postvaccination Fever Response Rates in Children Derived Using the Fever Coach Mobile App: A Retrospective Observational Study

Systematic review finds that fever phobia is a worldwide issue among caregivers and healthcare providers

The knowledge, attitudes and beliefs of carers (parents, guardians, healthcare practitioners, crèche workers) around fever and febrile illness in children aged 5 years and under: protocol for a qualitative systematic review

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