发热恐惧症：中国一家儿童医院住院病房与门诊部护理人员的比较调查
Fever phobia: a comparison survey between caregivers in the inpatient ward and caregivers at the outpatient department in a children's hospital in China.
作者信息
Dong Lili, Jin Jiahui, Lu Yili, Jiang Lili, Shan Xiaoou
机构信息
Department of Pediatric, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang Province, 325027, China.
Children's hospital of Zhengzhou, Zhengzhou, Henan Province, 450018, China.
出版信息
BMC Pediatr. 2015 Oct 19;15:163. doi: 10.1186/s12887-015-0475-8.
BACKGROUND
Fever in children is one of the most common clinical symptoms and a chief complaint and a main reason that caregivers took the children to the outpatient service or admitted to hospital. Studies have found that the majority of parents surveyed at a hospital pediatric clinic held unrealistic and unwarranted concerns about fevers, first termed as 'fever phobia' by Schmitt in 1980. In the present study, we explore whether 'fever phobia' exists in Chinese caregivers and investigate whether such phobia is alleviated when admitted to hospital after propaganda of fever related knowledge by doctors and nurses.
METHODS
A questionnaire was distributed to caregivers of children who visited the pediatric outpatient department and those with caregivers in the wards between June 2012 and Feb 2013 in Wenzhou, China.
RESULTS
Data were obtained from 621 caregivers, 305(49%) from the OPD and 316(51%) from the ward. Most caregivers of the two groups (OPD vs. ward group, 75.1 vs. 74.4%) believed fever could cause brain damage. 77.7% (76.0 vs. 81.3%) caregivers were very worried when their children had fever and 12.8% (14.1 vs. 11.4%) caregivers would check the temperature within 30 min. Moreover, 68.0% (63.0 vs. 72.8%, P < 0.05) caregivers would give their children antipyretics during sleep and 39.9% (40.3 vs. 39.6%) would administrate antipyretics when temperature was above 38 °C. After admitted to hospital, 83.9% caregivers stated to have received education about fever and 96.5% felt relieved. Less caregivers (ward group vs. OPD, 42.4 vs. 46.9%, P < 0.05) from ward group would give antipyretics with a temperature under 38.5 °C and less (0.6 vs. 4.9%, P < 0.05) preferred cold sponging as physical cooling method compared to the OPD caregivers. Alarmingly, more caregivers (42.7 vs. 34.3%, P < 0.05) in the ward group believed fever could lead to death or/and deafness (17.4 vs. 10.5%, P < 0.05) and even 0.6% caregivers in the ward group chose aspirin when the children had fever.
CONCLUSION
'Fever phobia' also exists in Chinese caregivers. Fever related knowledge propaganda after admitted to hospital did not work effectively to improve the caregivers' understanding and management of fever and an effective way to alleviate 'Fever phobia'.
背景
儿童发热是最常见的临床症状之一，是家长带孩子前往门诊就诊或住院的主要原因及主诉。研究发现，在一家医院儿科门诊接受调查的大多数家长对发热存在不切实际且毫无根据的担忧，这种情况在1980年被施密特首次称为“发热恐惧症”。在本研究中，我们探讨中国家长中是否存在“发热恐惧症”，并调查在医生和护士对发热相关知识进行宣传后，患儿住院时这种恐惧是否会减轻。
方法
2012年6月至2013年2月期间，在中国温州，向儿科门诊就诊患儿的家长以及病房患儿的家长发放问卷。
结果
共获得621名家长的数据，其中305名（49%）来自门诊，316名（51%）来自病房。两组中的大多数家长（门诊组与病房组，分别为75.1%和74.4%）认为发热会导致脑损伤。77.7%（门诊组76.0%，病房组81.3%）的家长在孩子发热时非常担心，12.8%（门诊组14.1%，病房组11.4%）的家长会在30分钟内测量体温。此外，68.0%（门诊组63.0%，病房组72.8%）的家长会在孩子睡觉时给其服用退烧药，39.9%（门诊组40.3%，病房组39.6%）会在体温高于38℃时给孩子服用退烧药。住院后，83.9%的家长表示接受了有关发热的教育，且96.5%的家长感到放心。与门诊组家长相比，病房组较少（病房组与门诊组，分别为42.4%和46.9%，P<0.05）的家长会在体温低于38.5℃时给孩子服用退烧药，较少（病房组0.6%，门诊组4.9%，P<0.05）的家长选择冷湿敷作为物理降温方法。令人担忧的是，病房组中更多（42.7%与34.3%，P<0.05）的家长认为发热可能导致死亡或/和耳聋（17.4%与10.5%，P<0.05），甚至病房组中有0.6%的家长在孩子发热时选择阿司匹林。
结论
中国家长中也存在“发热恐惧症”。住院后进行的发热相关知识宣传未能有效提高家长对发热的认识和处理能力，不是减轻“发热恐惧症”的有效方法。
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