Drivers for inappropriate fever management in children: a systematic review
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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.
KeywordsAttitudes Children Fever Fever management Knowledge Parents
MK is an Honorary Research Fellow at the Health Research Board Clinical Research Facility, Cork (CRF-C), Ireland. We would like to acknowledge the assistance of Professor Joe Eustace, Director CRF-C, who supplemented training and publication costs for this study. We would also like to acknowledge the support of Mr Joe Murphy (Librarian, Mercy University Hospital, Cork, Ireland) who assisted with search design.
No funding was received to conduct this study.
Conflicts of interest
The authors have no relevant competing interests to declare.
- 3.de Bont EG, Peetoom KK, Moser A, Francis NA, Dinant GJ, Cals JW. Childhood fever: a qualitative study on GPs’ experiences during out-of-hours care. Fam Pract. 2015;32(4):449–55.Google Scholar
- 12.US Department of Health and Human Services National Centre for Health Statistics. Health US, 2010. Hyattsville, MD: US Department of Health and Human Services; 2011.Google Scholar
- 28.National Collaborating Centre, for Mental Health. Dementia: A NICE-SCIE guideline on supporting people with dementia and Their carers in health and social care. Leicester (UK): British Psychological Society; 2007. (NICE Clinical Guidelines, No. 42.) Appendix 12 Data extraction forms for qualitative studies]. http://www.ncbi.nlm.nih.gov/books/NBK55467/. Accessed 12 Dec 2014.
- 29.CASP Checklists Oxford: CASP. 2014. http://www.casp-uk.net/#!casp-tools-checklists/c18f8. Accessed 14 Dec 2015.
- 30.Akers J, Aguiar-Ivanez R, Baba-Akbari Sari A, Beynon S, Booth A. Systematic reviews: CRD’s guidance for undertaking reviews in health care. York: NHS Centre for Reviews and Dissemination; 2009.Google Scholar
- 32.NVivo qualitative data analysis software; QSR International Pty Ltd. Version 10.Google Scholar
- 50.Cabral C, Ingram J, Hay AD, Horwood J. “They just say everything’s a virus”—parent’s judgment of the credibility of clinician communication in primary care consultations for respiratory tract infections in children: a qualitative study. Patient Educ Couns. 2014;95(2):248–53.CrossRefPubMedGoogle Scholar
- 52.Kelly MS, J. Shiely, F. O’Sullivan, R. McGillicuddy, A. McCarthy, S. Parental knowledge, attitudes and beliefs regarding fever in children: an interview study. BMC Public Health. 2016. (Under review).Google Scholar