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Discursive Analysis of Pediatrician's Therapeutic Approach towards Childhood Fever and Its Contextual Differences: An
Francisco Vicens-Blanes1, Rosa Miró-Bonet1, Jesús Molina-Mula1
1Departamento de Enfermería y Fisioterapia, University of Balearic Islands, 07122 Palma, Spain.
Insights
Pediatricians recognize the importance of managing childhood fever discomfort but face implementation challenges. Inpatient physicians advocate for better primary care parental education, while both settings see room for improvement, especially in antipyretic use.
Area of Science:
- Pediatrics
- Clinical Practice
- Qualitative Research
Background:
- Fever is a primary clinical sign in infants, frequently managed by pediatricians.
- Understanding pediatrician approaches to childhood fever is crucial for effective care.
- Pediatricians play a key role in managing children's fevers and family concerns.
Purpose of the Study:
- To explore pediatricians' perspectives on childhood fever management.
- To compare approaches to fever in pediatric hospitalization versus primary care settings.
- To identify challenges and potential improvements in fever treatment strategies.
Main Methods:
- Qualitative ethnomethodological study.
- In-depth interviews with pediatricians in hospital and primary care settings.
- Analysis of pediatrician responses to theoretical clinical cases.
Main Results:
- Eight key categories emerged: understanding, significance, therapeutic strategies, evidence engagement, family concerns, COVID-19 impact, professional relationships, and suggestions for change.
- Pediatricians acknowledge the need to address fever-related discomfort but face implementation barriers.
- Inpatient pediatricians highlighted the need for enhanced parental education from primary care.
Conclusions:
- Pediatricians face challenges in implementing recommended fever management strategies.
- Improved parental education by primary care physicians is recommended by inpatient pediatricians.
- Pediatricians, particularly in inpatient settings, are open to practice changes regarding antipyretic administration.
Abstract:
Introduction: Fever stands out as the predominant clinical indicator in infancy. Pediatricians encounter fever routinely in their daily practice, playing a crucial role in their interactions with children and families. Objective: The aim is to examine pediatricians' viewpoints, understanding, and approaches regarding childhood fever in two healthcare settings: pediatric hospitalization (emergency and inpatient ward) and primary care. Methods: A qualitative study was conducted using an ethnomethodological approach. Pediatricians working in the specified pediatric settings participated in in-depth interviews where theoretical clinical cases were presented for analysis. Results: Following the examination of the discourses, the codes were organized into eight categories: Understanding of fever, Significance ascribed to fever, Therapeutic strategies, Engagement with the evidence, Family apprehensions regarding fever, Influence of the COVID-19 Pandemic, Inter- and intra-professional relationships, and Suggestions for change: Conclusions: Pediatricians acknowledge the importance of addressing discomfort in the treatment of fever, but express challenges in implementing these recommendations. Pediatricians in inpatient settings emphasize the need for enhanced parental education from primary care, while those in primary care recognize the potential for improvement. Inpatient pediatricians are open to implementing changes in their daily practices, particularly concerning the administration of antipyretics.
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