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A Cross-Sectional Study on Subjective Fever Assessment in Children by Palpation: Are Fathers as Reliable as Mothers?
Ehud Rosenbloom1,2, Crysta Balis1, Dustin Jacobson3
1Division of Pediatric Emergency Medicine, McMaster Childrens Hospital, Hamilton, ON, Canada.
Insights
Parents cannot accurately detect their child's fever by touch alone. This study found that parental palpation for fever detection in young children lacks reliability for clinical decision-making.
Area of Science:
- Pediatrics
- Clinical Assessment
- Parental Education
Background:
- Fever is a common symptom in pediatric patients.
- Parents frequently rely on tactile assessment (palpation) to gauge their child's temperature.
- The accuracy of parental fever detection by palpation is not well-established.
Purpose of the Study:
- To evaluate the accuracy of parental palpation in identifying fever in children aged 0-4 years.
- To compare the fever detection accuracy between mothers and fathers.
Main Methods:
- Prospective cross-sectional study in a tertiary pediatric emergency department.
- 170 infants and children (0-4 years) and their parents were enrolled.
- Parents assessed fever by palpation; a nurse obtained a rectal temperature for comparison.
Main Results:
- No significant difference in fever detection accuracy between mothers and fathers.
- Sensitivities for fever detection by palpation were 86.4% (mothers) and 88.2% (fathers).
- Specificities were lower: 54.2% (mothers) and 43.1% (fathers), with low positive and negative predictive values.
Conclusions:
- Parental palpation is an unreliable method for accurately assessing fever in young children.
- Healthcare providers should not depend solely on parental reports of fever if not corroborated by temperature measurement.
- Further education on accurate fever assessment in pediatric patients is warranted.
Background:
Fever is common in pediatric patients. Often, parents rely solely on palpation when assessing their child's fever. The objective of the current study was to determine the accuracy of parents in detecting their child's fever by palpation.
Methods:
A prospective cross-sectional study was conducted at the emergency department (ED) of a tertiary pediatric hospital. Infants and children, 0-4 years of age, presenting to the ED with both parents were included. Parents were separately asked if their child had a fever and, if so, were asked to assess the temperature by palpation. A nurse obtained the rectal temperature. The primary outcome measure was the accuracy of fathers and mothers in detecting fever.
Results:
A total of 170 children with their parents were enrolled. The mean ages of the children, mothers, and fathers were 18.9 (SD 0.8) months, 31.1 (SD 6.4) years, and 33.7 (SD 6.9) years, respectively. No statistically significant difference was found between mothers and fathers in the ability to assess fever by palpation (OR 0.65, 95% CI 0.39,-1.08). Sensitivities for detecting fever by palpation for mothers and father were 86.4% and 88.2%, respectively (specificity among mothers: 54.2% and specificity among fathers: 43.1%). The overall negative and positive predictive values were 65.9% (95% CI 55%-75.7%) and 75.7% (95% CI 69.9%-80.8%), respectively.
Conclusions:
Mothers and fathers do not differ in their ability to accurately assess their child's fever by palpation. The low positive and negative predictive values indicate that if temperature was not measured, physicians cannot rely on parents' reports.
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