Beliefs, Practices and Health Care Seeking Behavior of Parents Regarding Fever in Children

Abstract

Background and objectives: Fever in children is one of the most common reasons for seeking medical attention. Parents often have misconceptions about the effects to fever, which leads to inappropriate use of medication and nonurgent visits to emergency departments (ED). The aim of this study was to clarify the beliefs on the effects and management of fever and to identify healthcare seeking patterns among parents of febrile children in Latvia. Materials and Methods: Parents and legal guardians of children attending ED with febrile illness were included in the study. Participants were recruited in Children's Clinical University Hospital (CCUH) in Riga, and in six regional hospitals in Latvia. Data on beliefs about fever, administration of antipyretics, healthcare-seeking behavior, and experience in communication with health care workers were collected via questionnaire. Results: In total, 355 participants were enrolled: 199 in CCUH and 156 in regional hospitals; 59.2% of participants considered fever itself as indicative of serious illness and 92.8% believed it could raise the child's body temperature up to a dangerous level. Antipyretics were usually administered at median temperature of 38.0 °C, and the median temperature believed to be dangerous was 39.7 °C; 56.7% of parents usually contacted a doctor within the first 24 h of the illness. Parents who believed that lower temperatures are dangerous to a child were more likely to contact a doctor earlier and out-of-hours; 60.1% of participants had contacted their family doctor prior their visit to ED. Parental evaluation of satisfaction with the information and reassurance provided by the doctors at the hospital was higher than of that provided by their family doctor; 68.2% of participants felt safer when their febrile children were treated at the hospital. Conclusions: Fever itself was regarded as indicative of serious illness and potentially dangerous to the child's life. These misconceptions lead to inappropriate administration of antipyretics and early-seeking of medical attention, even out-of-hours. Hospital environment was viewed as safer and more reassuring when dealing with febrile illness in children. More emphasis must be placed on parental education on proper management of fever, especially in primary care.

Keywords: antipyretics; fever in children; fever phobia; healthcare-seeking behavior; parental beliefs.

Figure 1

Number of children in the families of the participants. The proportion of families having three or more children was significantly higher among the participants in the regional hospitals (OR (95% CI) = 2.1(1.2–3.9), p = 0.009).

Figure 2

Birth order of the children of the participants admitted to emergency departments (ED) during the study.

Figure 3

Parental response to question: “Does fever itself indicate that the illness is serious?”.

Figure 4

Time after the onset of febrile illness at which parents usually seek medical attention.

Figure 5

First doctor visited or contacted after the onset of symptoms of the ongoing febrile episode.

Figure 6

Was the explanation on the nature of illness and reasons for fever satisfactory? (a) Evaluation of the explanation provided by family doctors (applicable to 59.8% of participants in CCUH and 61.1% of participants in regional hospitals); (b) Evaluation of explanation provided by the pediatrician at the hospital (applicable to all participants).

Figure 7

How did the information provided by the doctor affect your level of concern about the illness of your child? (a) Evaluation of assurance provided by family doctors (applicable to 59.8% of participants in CCUH and 61.1% of participants in regional hospitals); (b) Evaluation of assurance provided by the pediatrician at the hospital (applicable to all participants).