Taveras Elsie M, Durousseau Sharon, Flores Glenn
Center for Child Health Care Studies, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA.
Pediatr Emerg Care. 2004 Sep;20(9):579-87. doi: 10.1097/01.pec.0000139739.46591.dd.
To examine childhood fever beliefs and practices in a multiethnic, multiracial, and socioeconomically diverse sample.
Cross-sectional survey.
Parents of children attending a hospital clinic, neighborhood health center, and a private practice.
Two hundred seventy-four parents were interviewed; 45% were Latino; 15%, African-American; 25%, white; and 14%, other (excluded from further analysis, leaving a final sample size of 235). Latinos (11%) and African-Americans (7%) were more likely than whites (0%) to have no thermometers (P < 0.006). Only 42% of parents knew the correct temperature for fever. Greater proportions of Latinos (55%) and African-Americans (44%) take their child to the emergency department for fever than whites (21%; P < 0.001 and P = 0.02, respectively). Multivariate analyses revealed that parents who had not graduated from high school had 5 times the odds of not using a thermometer to check for fever and triple the odds of not asking a health care provider for fever advice, and parents of uninsured children were 5 times less likely to bring their febrile child to the emergency department. Low-income parents significantly more often used the emergency department and remedies other than antipyretics for their febrile children. Latino parents were more likely to believe that certain Latino folk illnesses cause fever, and African-American parents had triple the odds of not knowing the correct temperature for fever.
Parents' beliefs and practices regarding childhood fever vary by race, ethnicity, sociodemographics, and the child's insurance coverage. Educating parents about fever, improving access to health insurance and primary care, and ensuring that families have thermometers may enhance appropriate use of health services and improve outcomes for febrile children.
在一个多民族、多种族且社会经济背景多样的样本中,研究儿童发热相关的观念和行为。
横断面调查。
在医院门诊、社区健康中心和私人诊所就诊儿童的家长。
共访谈了274名家长;其中45%为拉丁裔;15%为非裔美国人;25%为白人;14%为其他种族(排除在进一步分析之外,最终样本量为235)。拉丁裔(11%)和非裔美国人(7%)没有体温计的比例高于白人(0%)(P < 0.006)。只有42%的家长知道发热的正确体温。因发热带孩子去急诊科的拉丁裔(55%)和非裔美国人(44%)比例高于白人(21%)(分别为P < 0.001和P = 0.02)。多因素分析显示,未高中毕业的家长不使用体温计检查发热的几率是其他人的5倍,不向医疗服务提供者咨询发热建议的几率是其他人的3倍,未参保儿童的家长带发热孩子去急诊科的可能性低5倍。低收入家长更常带发热孩子去急诊科,且使用退热药以外的其他治疗方法。拉丁裔家长更倾向于认为某些拉丁裔民间疾病会导致发热,非裔美国家长不知道发热正确体温的几率是其他人的3倍。
家长关于儿童发热的观念和行为因种族、民族、社会人口统计学特征以及孩子的保险覆盖情况而异。对家长进行发热教育、改善医疗保险和初级医疗服务的可及性,并确保家庭拥有体温计,可能会促进医疗服务的合理使用,改善发热儿童的治疗效果。