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      Beliefs and practices regarding childhood fever among parents: a cross-sectional study from Palestine

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          Abstract

          Background

          Fever is an extremely common occurrence in paediatric patients and the most common cause for a child to be taken to the doctor. The literature indicates that parents have too many misconceptions and conflicting information about fever management. The aim of this study was to identify parents’ beliefs and practices regarding childhood fever management.

          Methods

          We conducted a cross-sectional survey among parents whose children were enrolled and presented for health care at primary health care clinics in the Nablus region of Palestine. Data were collected using structured questionnaire interviews with parents. The questionnaire consisted of ‘yes/no’ responses and multiple-response questions. Descriptive statistics were used.

          Results

          Overall, 402 parents were interviewed. All parents believed that fever could cause at least one harmful effect if left untreated. The harmful effects most frequently reported by parents were brain damage (38.1%), dehydration (15.7%), and other organs damage such as liver and kidney damage (14.2%). The study showed that 65.4% of parents would recognise fever by only touching the child, 31.6% would measure the temperature and 3.0% would assess temperature by touching and measuring the child. Antipyretic was preferred to be used by 34.8% of parents, while 49.8% stated that they preferred cold sponges, and 3.2% stated that they preferred homeopathic methods to treat fever. The most common factors influencing frequency of medication administration included physician’s instruction (61.7%), the degree of elevated temperature (14.9%) and instructions on the medication leaflet (13.7%). Of the participant parents, 53.2% believed antipyretics used to reduce fever were harmful. Parents reported the most harmful outcomes from these antipyretics to be allergic reactions (20.9%), effects on the stomach (16.9%), kidney damage (16.2%) and overdose (11.4%).

          Conclusions

          Parents were anxious when dealing with a feverish child, which resulted in incorrect or inappropriate practices. Parents require reliable evidence-based information about the care of feverish children. These results indicate a need to develop and evaluate educational programs in our setting that will provide parents with education on fever and fever management.

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          Most cited references28

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          Health status and health services in the occupied Palestinian territory

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            Fever phobia: misconceptions of parents about fevers.

            Eighty-one parents bringing their children to a hospital-based pediatric clinic were surveyed about their understanding of fever. Most parents were unduly worried about low-grade fever, with temperatures of 38.9 degrees C or less. Their overconcern was designated "fever phobia." Most parents (52%) believed that moderate fever with a temperature of 40 degrees C or less can cause serious neurological side-effects. Hence, most parents treated fever aggressively: 85% gave antipyretic medication before the temperature reached 38.9 degrees C and 68% sponged the child before the temperature reached 39.5 degrees C. A review of the literature showed that the only serious complications of fever were febrile status epilepticus and heat stroke, two rare entities. The great concern of parents about fever is not justified. Health education to counteract "fever phobia" should be a part of routine pediatric care.
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              Fever phobia revisited: have parental misconceptions about fever changed in 20 years?

              Fever is one of the most common reasons that parents seek medical attention for their children. Parental concerns arise in part because of the belief that fever is a disease rather than a symptom or sign of illness. Twenty years ago, Barton Schmitt, MD, found that parents had numerous misconceptions about fever. These unrealistic concerns were termed "fever phobia." More recent concerns for occult bacteremia in febrile children have led to more aggressive laboratory testing and treatment. Our objectives for this study were to explore current parental attitudes toward fever, to compare these attitudes with those described by Schmitt in 1980, and to determine whether recent, more aggressive laboratory testing and presumptive treatment for occult bacteremia is associated with increased parental concern regarding fever. Between June and September 1999, a single research assistant administered a cross-sectional 29-item questionnaire to caregivers whose children were enrolled in 2 urban hospital-based pediatric clinics in Baltimore, Maryland. The questionnaire was administered before either health maintenance or acute care visits at both sites. Portions of the questionnaire were modeled after Schmitt's and elicited information about definition of fever, concerns about fever, and fever management. Additional information included home fever reduction techniques, frequency of temperature monitoring, and parental recall of past laboratory workup and treatment that these children had received during health care visits for fever. A total of 340 caregivers were interviewed. Fifty-six percent of caregivers were very worried about the potential harm of fever in their children, 44% considered a temperature of 38.9 degrees C (102 degrees F) to be a "high" fever, and 7% thought that a temperature could rise to >/=43.4 degrees C (>/=110 degrees F) if left untreated. Ninety-one percent of caregivers believed that a fever could cause harmful effects; 21% listed brain damage, and 14% listed death. Strikingly, 52% of caregivers said that they would check their child's temperature
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                Author and article information

                Journal
                BMC Pediatr
                BMC Pediatr
                BMC Pediatrics
                BioMed Central
                1471-2431
                2013
                28 April 2013
                : 13
                : 66
                Affiliations
                [1 ]Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
                [2 ]Department of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
                [3 ]WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, Malaysia
                [4 ]Department of Clinical Pharmacy and Pharmacotherapy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
                [5 ]PharmD program, College of medicine and health sciences, An-Najah National University, Nablus, Palestine
                Article
                1471-2431-13-66
                10.1186/1471-2431-13-66
                3641948
                23622106
                a350d115-71e1-4045-b9b5-28e1e100a118
                Copyright ©2013 Zyoud et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 3 February 2013
                : 24 April 2013
                Categories
                Research Article

                Pediatrics
                children,fever management,belief,temperature
                Pediatrics
                children, fever management, belief, temperature

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