Parental perspectives on evaluation and management of fever in young infants: an interview study

Abstract

Background: Young febrile infants typically undergo meticulous evaluation to rule out serious bacterial infection. Parental perspectives on the process of evaluation and management of febrile infants can influence treatment satisfaction and outcomes. This study aimed to describe the perspectives of parents of young infants presenting to hospital with fever.

Methods: We conducted semistructured, face-to-face interviews with parents of healthy, term infants aged less than 3 months, admitted to a tertiary children's hospital in Sydney, Australia, during the management of a febrile illness. The interview transcripts were thematically analysed.

Results: 36 parents of 27 infants participated. All infants underwent a complete sepsis work up, received empiric antibiotics and made a complete recovery. Parental empowerment was central to the three themes identified: expecting reassurance and support (overwhelming responsibility, heightened vulnerability), facilitators for parental empowerment (medical attentiveness, medical partnership, gaining closure and a sense of validation), and barriers to empowerment (unexpected medical seriousness, relinquished control, failed expectations of support and limited capacity for advocacy).

Conclusions: Caring for a febrile infant is overwhelming for parents. When confronted by unexpected tests and hospitalisation, they fear the possibility of a severe illness, experience a sense of helplessness and loss of control as their infant undergoes painful tests, and doubt their own ability to meet their infant's needs. Family-centred care strategies that inform and support parents, acknowledging their concerns and distress, while involving them in the medical management, may promote parental empowerment and build better alliances between parents and healthcare providers.