'Fever phobia' in the emergency department: a survey of children's caregivers

Abstract

Objectives: To investigate children's caregivers' attitudes towards fever in an emergency department setting.

Methods: A 25-item questionnaire was formulated, on the basis of similar previous published surveys, for administration to a convenience sample of caregivers. It was administered by a medical translator after triage, before assessment by a physician. Most questions were multiple choice, a few open-ended.

Results: Three hundred questionnaires were administered to caregivers and 264 were analyzed. A high proportion (82%) of caregivers professed to be 'very worried' about fever. Temperatures that were felt to require treatment were relatively low (one-third treating <37.9 degrees C), but many respondents measured body temperature at the axilla. Similar to previously published studies, the main specific concerns were possible central nervous system damage (24%), seizures (19%) and death (5%), although worries about discomfort and signs of serious illness were also expressed by a significant number of respondents (11%). Similar to older surveys, home treatment of fever was worrisome, with too-frequent dosing (acetaminophen <q4h, 27%; ibuprofen <q6h, 50%) and possibly inappropriate topical treatments (76%) being used. The presence of both parents in the emergency department was associated with lower levels of worry.

Conclusions: We found high levels of anxiety among caregivers presenting to a hospital emergency department with a complaint of fever in a child. Many caregivers appear to confuse effects of fever with the harmful effects of hyperthermia. Aggressive and potentially dangerous home therapy and monitoring of fever is common among the caregivers surveyed.