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Drivers for inappropriate fever management in children: a systematic review
M Kelly1, S McCarthy2,3, R O'Sullivan4,5
1Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland. 113223823@umail.ucc.ie.
Insights
Parental knowledge, attitudes, and beliefs about childhood fever are complex and varied. Consistent, accurate information from healthcare professionals is crucial for effective fever management and reducing parental anxiety.
Area of Science:
- Pediatrics
- Child Health
- Parental Education
Background:
- Fever is a common childhood symptom causing parental anxiety and varied management approaches.
- Inconsistent fever management can lead to over- or under-dosing of antipyretics.
- Understanding parental perspectives is key to improving fever care.
Purpose of the Study:
- To synthesize evidence on parental knowledge, attitudes, and beliefs regarding childhood fever.
- To identify factors influencing parental fever management strategies.
- To inform consistent communication for better fever care.
Main Methods:
- Systematic literature search across ten databases.
- Inclusion of qualitative and quantitative studies.
- Narrative synthesis for quantitative data and thematic analysis for qualitative data.
Main Results:
- Identified three key areas from quantitative studies: parental practices, knowledge, and information seeking.
- Revealed three themes from qualitative studies: control, family impact, and experiences.
- Highlighted the multifaceted nature of parental fever management.
Conclusions:
- Parental management of childhood fever is influenced by diverse factors.
- A coherent and consistent approach to communicating fever management is needed.
- Timely, accurate information from healthcare professionals can reduce inappropriate fever management.
Abstract:
Background Fever is one of the most common childhood symptoms and accounts for numerous consultations with healthcare practitioners. It causes much anxiety amongst parents as many struggle with managing a feverish child and find it difficult to assess fever severity. Over- and under-dosing of antipyretics has been reported. Aim of the review The aim of this review was to synthesise qualitative and quantitative evidence on the knowledge, attitudes and beliefs of parents regarding fever and febrile illness in children. Method A systematic search was conducted in ten bibliographic databases from database inception to June 2014. Citation lists of studies and consultation with experts were used as secondary sources to identify further relevant studies. Titles and abstracts were screened for inclusion according to pre-defined inclusion and exclusion criteria. Quantitative studies using a questionnaire were analysed using narrative synthesis. Qualitative studies with a semi-structured interview or focus group methodology were analysed thematically. Results Of the 1565 studies which were screened for inclusion in the review, the final review comprised of 14 studies (three qualitative and 11 quantitative). Three categories emerged from the narrative synthesis of quantitative studies: (i) parental practices; (ii) knowledge; (iii) expectations and information seeking. A further three analytical themes emerged from the qualitative studies: (i) control; (ii) impact on family; (iii) experiences. Conclusion Our review identifies the multifaceted nature of the factors which impact on how parents manage fever and febrile illness in children. A coherent approach to the management of fever and febrile illness needs to be implemented so a consistent message is communicated to parents. Healthcare professionals including pharmacists regularly advise parents on fever management. Information given to parents needs to be timely, consistent and accurate so that inappropriate fever management is reduced or eliminated. This review is a necessary foundation for further research in this area.
