Walsh Anne, Edwards Helen, Fraser Jenny
School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.
J Clin Nurs. 2007 Dec;16(12):2331-40. doi: 10.1111/j.1365-2702.2006.01890.x. Epub 2007 Apr 5.
To identify parents' knowledge, beliefs, management and sources of information about fever management.
Despite numerous studies exploring parents' management of childhood fever; negative beliefs about fever and overuse of antipyretics and health services for mild fevers and self-limiting viral illnesses continue to be reported.
Qualitative design using semi-structured interviews and discussions.
Fifteen metropolitan parents whose children were aged six months to five years, volunteered to participate in individual interviews or group discussions. Recruitment was through Playgroup Queensland's online newsletter and letters from two childcare centres to all parents. Verbatim and audio data were collected by an experienced moderator using a semi-structured interview guide.
Two transcripts were independently analysed by two researchers; categories, sub-headings and codes were independently developed, crosschecked and found comparable. Remaining transcripts were analysed using developed categories and codes.
Fever, determined through behavioural changes, was perceived as 'good', a warning that something was wrong. High fever, reported as 38.0-39.1 degrees C, was considered harmful; it must be prevented or reduced irrespective of concerns about antipyretics. Positive febrile experiences reduced concern about fever. Negative experiences such as febrile convulsions, media reports of harm, not receiving a definitive diagnosis, inaccessibility to regular doctors and receiving conflicting information about fever management increased the concerns. Parents seek information about fever from multiple sources such as doctors, books and other parents.
Parents' experiences with and information sources about fever and fever management influenced their knowledge, beliefs and practices. Positive experiences reduce concerns, health service usage and sometimes antipyretic usage. Negative experiences increase concerns, monitoring and antipyretic and health service usage.
Health professionals need to update their fever management knowledge ensuring that it is based on the latest scientific knowledge. They must provide parents of young children with consistent, reliable information preferably before their first child's first febrile episode.
确定家长关于发热管理的知识、观念、处理方式及信息来源。
尽管有大量研究探讨家长对儿童发热的处理；但仍有报道称，家长对发热存在负面观念，且对于轻度发热和自限性病毒疾病过度使用退烧药及医疗服务。
采用半结构式访谈和讨论的定性设计。
15位居住在大城市、孩子年龄在6个月至5岁的家长自愿参与个人访谈或小组讨论。通过昆士兰亲子游戏小组的在线时事通讯以及两家儿童保育中心给所有家长的信件进行招募。由一位经验丰富的主持人使用半结构式访谈指南收集逐字记录和音频数据。
两位研究人员独立分析两份访谈记录；独立制定类别、副标题和编码，交叉核对并发现具有可比性。其余访谈记录使用已制定的类别和编码进行分析。
通过行为变化确定的发热被视为“有益的”，是身体出现问题的警示信号。体温在38.0 - 39.1摄氏度的高烧被认为是有害的；无论对退烧药有何担忧，都必须预防或降低体温。积极的发热经历会减少对发热的担忧。诸如热性惊厥、媒体关于发热危害的报道、未得到明确诊断、无法看普通医生以及收到关于发热管理的相互矛盾的信息等负面经历会增加担忧。家长从医生、书籍和其他家长等多个来源获取有关发热的信息。
家长的发热及发热管理经历和信息来源影响了他们的知识、观念和行为。积极的经历会减少担忧、医疗服务使用，有时也会减少退烧药的使用。负面经历会增加担忧、监测以及退烧药和医疗服务的使用。
卫生专业人员需要更新他们的发热管理知识，确保其基于最新的科学知识。他们必须在幼儿首次发热发作之前，最好为家长提供一致、可靠的信息。
