Coping with Febrile Illness in Children: A Qualitative Interview Study of Parents

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The aim of this study was to investigate parental perception of febrile illness in their children, the most commonly applied management practices, as well as the expectations from clinicians when coping with fever in children. The study included parents of patients admitted to the Emergency and Observation Department of Children’s Clinical University Hospital in Rīga, Latvia. Data were collected via semi-structured interviews. All interviews were transcribed, and the transcripts analysed by inductive thematic analysis. Thirty-four parental interviews were analysed. Six themes emerged from the study, which were: signs causing concern; beliefs regarding fever; assessment and monitoring of fever; fever management practices; help-seeking behaviour; and expectations from the healthcare personnel. Many parents believed that fever could potentially cause injuries to the nervous system, kidneys, the brain, other internal organs, and even cause death. The perceived threat of fever resulted in frequent temperature measurements and administration of antipyretics. Meeting the emotional and information needs of the parents were considered as equally important to meeting the child’s medical needs. The study found that fever phobia exists among parents. Parental misconceptions of fever lead to overly zealous management practices. Parental education initiatives must be organised in order to improve parental knowledge of fever and its management in children.

Al-Eissa, Y. A., Al-Zamil, F. A., Al-Sanie, A. M., Al-Salloum, A. A., Al-Tuwaijri, H. M., Al-Abdali, N. M., Al-Azzam, S. A. (2000). Home management of fever in children: Rational or ritual? Int. J. Clin. Pract., 54 (3), 138–142.

Aronoff, D. M., Neilson, E. G. (2001). Antipyretics: Mechanisms of action and clinical use in fever suppression. Amer. J. Med., 111 (4), 304–315.

Blumenthal, I. (1998). What parents think of fever. Family Practice, 15 (6), 513–518.

Braun, V., Clarke, V. (2006). Using thematic analysis in psychology. Qual. Res. Psychol., 3 (2), 77–101.

Caspe, W. B., Nucci, A. T., Cho, S. (1989). Extreme hyperpyrexia in childhood: Presentation similar to hemorrhagic shock and encephalopathy. Clin. Pediatr., 28 (2), 76–80.

Chang, L.-C., Lee, P.-I., Guo, N.-W., Huang, M.-C. (2016). Effectiveness of simulation-based education on childhood fever management by Taiwanese parents. Pediatr. Neonatol., 57 (6), 467–473.

Creswell, J. W., Poth, C. N. (2018). Qualitative Inquiry and Research Design: Choosing Among Five Approaches. 4th edn. SAGE, Los Angeles, CA. 488 pp.

Crocetti, M., Moghbeli, N., Serwint, J. (2001). Fever phobia revisited: Have parental misconceptions about fever changed in 20 years? Pediatrics, 107 (6), 1241–1246.

Davis, T. (2013). NICE guideline: Feverish illness in children — assessment and initial management in children younger than 5 years. Arch. Dis. Childhood., 98 (6), 232.

Enarson, M. C., Ali, S., Vandermeer, B., Wright, R. B., Klassen, T. P., Spiers, J. A. (2012). Beliefs and expectations of Canadian parents who bring febrile children for medical care. Pediatrics, 130 (4), e905–e912.

Francis, J. J., Johnston, M., Robertson, C., Glidewell, L., Entwistle, V., Eccles, M. P., Grimshaw, J. M. (2010). What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychol. Health, 25 (10), 1229–1245.

Goodman, E. L., Knochel, J. P. (1991). Heat stroke and other forms of hyperthermia. Fever: Basic Mechanisms and Management. Raven Press, New York, 267–287.

Halls, A., van’t Hoff, C., Little, P., Verheij, T., Leydon, G. M. (2017). Qualitative interview study of parents’ perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care. BMJ Open, 7 (9), e015701.

Hay, A. D., Heron, J., Ness, A. (2005). The prevalence of symptoms and consultations in pre-school children in the Avon Longitudinal Study of Parents and Children (ALSPAC): A prospective cohort study. Family Pract., 22 (4), 367–374.

Heron, I., Berg, K. (1978). The actions of interferon are potentiated at elevated temperature. Nature, 274 (5670), 508–510.

Kai, J. (1996a). Parents’ difficulties and information needs in coping with acute illness in preschool children: A qualitative study. BMJ, 313 (7063), 987.

Kai, J. (1996b). What worries parents when their preschool children are acutely ill, and why: a qualitative study. BMJ, 313 (7063), 983–986.

Mackowiak, P. A. (1998). Concepts of fever. Arch. Int. Med., 158 (17), 1870–1881.

McErlean, M. A., Bartfield, J. M., Kennedy, D. A., Gilman, E. A., Stram, R. L., Raccio-robak, N. (2001). Home antipyretic use in children brought to the emergency department. Pediatr. Emerg. Care, 17 (4), 249–251.

Nijman, R. G., Vergouwe, Y., Thompson, M., van Veen, M., van Meurs, A. H. J., van der Lei, J., Oostenbrink, R. (2013). Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: Diagnostic study. BMJ, 346 (16), f1706.

Poirier, M. P., Collins, E. P., McGuire, E. (2010). Fever phobia: A survey of caregivers of children seen in a pediatric emergency department. Clin. Pediatr., 49 (6), 530–534.

Reid, S., Neto, G., Tse, S., Farion, K. J., Marvizi, A., Smith, L., Clarkin, C., Rhode, Moreau, K. (2017). Education in the waiting room: Description of a pediatric emergency department educational initiative. Pediatr. Emerg. Care, 33 (10), e87–e91.

Roberts Jr, N. J. (1991). The immunological consequences of fever. Fever: Basic Mechanisms and Management. Raven Press, New York. 125 pp.

Ron, Y., Dougherty, J. P., Duff, G. W., Gershon, R. K. (1984). The effect of febrile temperatures on biologic actions of interferons: Abrogation of suppression of delayed-type hypersensitivity and antibody production. J. Immunol., 133 (4), 2037–2042.

Schmitt, B. D. (1980). Fever phobia: Misconceptions of parents about fevers. Amer. J. Dis., Child., 134 (2), 176–181.

Simon, H. B. (1993). Hyperthermia. New Engl. J. Med., 329 (7), 483–487

Singhi, S., Padmini, P., Sood, V. (1991). Urban parents’ understanding of fever in children: Its dangers, and treatment practices. Indian Pediatr., 28 (5), 501–505.

Srivastava, P. (2002). Roles of heat-shock proteins in innate and adaptive immunity. Nature Rev. Immunol., 2 (3), 185–194.

Starks, H., Brown Trinidad, S. (2007). Choose your method: A comparison of phenomenology, discourse analysis, and grounded theory. Qual. Health Res., 17 (10), 1372–1380.

Sullivan, J. E., Farrar, H. C. (2011). Fever and antipyretic use in children. Pediatrics, 127 (3), 580–587.

Van den Bruel, A., Haj-Hassan, T., Thompson, M., Buntinx, F., Mant, D. (2010). Diagnostic value of clinical features at presentation to identify serious infection in children in developed countries: A systematic review. Lancet, 375 (9717), 834–845.

Walsh, A., Edwards, H., Fraser, J. (2007). Influences on parents’ fever management: beliefs, experiences and information sources. J. Clin. Nursing, 16 (12), 2331–2340.

Journal Information

CiteScore 2018: 0.3

SCImago Journal Rank (SJR) 2018: 0.137
Source Normalized Impact per Paper (SNIP) 2018: 0.192


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