Parental and health care provider understanding of childhood fever: a Canadian perspective

Karwowska, Anna; Nijssen–Jordan, Cheri; Johnson, David W.; Davies, H. Dele

doi:10.1017/s1481803500007892

Cited by 87 publications

(151 citation statements)

References 16 publications

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“…[1][2][3][4][5][6][7][8][9][10][11][12] Some of this fear is productive. Concerns regarding dehydration and signs that might indicate serious underlying illness are reasonable and important; however, a substantial proportion of parents in our study held unrealistic fears about the consequences of fever and most monitored and treated fever aggressively.…”

Section: Discussionmentioning

confidence: 99%

“…Several items regarding feared outcomes and treatment practices were modeled after questions from Schmitt' s 1980 survey 1 to facilitate comparison with this and other studies that have used these questions. [1][2][3][4]6,9,11 Further questions were developed to explore other areas of interest related to parental beliefs, behaviors, expectations, and satisfaction. Included questions utilized multiplechoice, Likert scale, or open-ended response formats.…”

Section: Methodsmentioning

confidence: 99%

“…Beginning with a survey in 1980, researchers have documented significant degrees of "fever phobia" in parents from numerous countries. [1][2][3][4][5][6][7][8][9][10][11][12] These fears have contributed to making fever the most common reason for parents to bring their children to the emergency department (ED). 13 Previous studies have demonstrated that parents use a combination of lay beliefs and their interpretation of medical knowledge to assess the welfare of their child during illness.…”

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confidence: 99%

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

et al. 2012

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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

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“…31 The most consistently identified serious concern of caregivers and health care providers is that high fevers, if left untreated, are associated with seizures, brain damage, and death. 1,25,32,33 It is argued that by creating undue concern over these presumed risks of fever, for which there is no clearly established relationship, physicians are promoting an exaggerated desire in parents to achieve normothermia by aggressively treating fever in their children.…”

Section: Treatment Goalsmentioning

confidence: 99%

Fever and Antipyretic Use in Children

Sullivan¹,

Farrar²

2011

Pediatrics

366

313

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Fever in a child is one of the most common clinical symptoms managed by pediatricians and other health care providers and a frequent cause of parental concern. Many parents administer antipyretics even when there is minimal or no fever, because they are concerned that the child must maintain a “normal” temperature. Fever, however, is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications. Thus, the primary goal of treating the febrile child should be to improve the child's overall comfort rather than focus on the normalization of body temperature. When counseling the parents or caregivers of a febrile child, the general well-being of the child, the importance of monitoring activity, observing for signs of serious illness, encouraging appropriate fluid intake, and the safe storage of antipyretics should be emphasized. Current evidence suggests that there is no substantial difference in the safety and effectiveness of acetaminophen and ibuprofen in the care of a generally healthy child with fever. There is evidence that combining these 2 products is more effective than the use of a single agent alone; however, there are concerns that combined treatment may be more complicated and contribute to the unsafe use of these drugs. Pediatricians should also promote patient safety by advocating for simplified formulations, dosing instructions, and dosing devices.

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“…PARENTAL 'FEVER PHOBIA' Schmitt coined the term 'fever phobia' (27) over 25 years ago because fever can result in considerable anxiety in families who are fearful that its effects could be deleterious and permanent. Several Canadian surveys (28,29) demonstrate that parents worry a great deal about their febrile child. For over 500 parents surveyed by Karwowska et al (28), the main concern was that fever might directly harm their child due to seizures (68% of respondents), dehydration (76%) or brain damage (47%).…”

Section: Discussionmentioning

confidence: 99%

Clinical management of fever in children younger than three years of age

Pusic¹

2007

Paediatrics &Amp; Child Health

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MV Pusic. Clinical management of fever in children younger than three years of age. Paediatr Child Health 2007;12(6):469-472.The clinical management of febrile children continues to evolve, especially in the light of vaccines against Haemophilus influenzae type B and more recently, Streptococcus pneumoniae. These vaccines have decreased the risk of serious bacterial illness in most children, allowing for a more selective approach to investigation and empirical treatment. However, children younger than three months of age still require an aggressive approach to investigation and careful follow-up. Certain laboratory criteria can allow safe management of even young infants on an outpatient basis. The present article outlines an age-based approach to investigation and management of children with fever.Key Words: Bacteremia; Fever; Meningitis; Occult bacteremia; Urinary tract infection La prise en charge clinique de la fièvre chez les enfants de moins de trois ans La prise en charge clinique des enfants fébriles continue d'évoluer, notamment depuis l'adoption des vaccins contre l'Haemophilus influenzae de type B et, plus récemment, contre le Streptococcus pneumoniae. Ces vaccins réduisent le risque de maladie bactérienne grave chez la plupart des enfants, ce qui permet d'adopter une approche plus sélective des explorations et du traitement empirique. Toutefois, il faut toujours privilégier une approche plus musclée des explorations et un suivi attentif auprès des enfants de moins de trois mois. Certains critères de laboratoire permettent la prise en charge sécuritaire des nourrissons très jeunes en consultations externes. Le présent article propose une approche adaptée à l'âge des explorations et de la prise en charge des enfants fébriles.

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Parental and health care provider understanding of childhood fever: a Canadian perspective

Cited by 87 publications

References 16 publications

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

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

Fever and Antipyretic Use in Children

Clinical management of fever in children younger than three years of age

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