Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Office number FAC 5.09, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands.
evidENT, Ear Institute, University College London, London, UK.
BMC Fam Pract. 2019 Jan 23;20(1):18. doi: 10.1186/s12875-019-0908-9.
For unclarified reasons, parents tend to be cautious about administering analgesics to their children, potentially leading to suboptimal management of AOM symptoms. We aim to understand parents' views and expectations of pain management in acute otitis media (AOM) in children.
Qualitative study alongside a cluster-randomised controlled trial (PIM-POM study) aimed at optimising pain management in childhood AOM. We purposefully sampled 14 parents of children diagnosed with AOM by their GP, who were recruited to the trial between November 2017 and May 2018. Semi-structured interviews were held at home in the first two weeks after trial enrollment. Interviews were audio-recorded, transcribed and analyzed thematically.
Parents experienced difficulties in recognising earache and other symptoms of an ear infection. They consulted the GP for a diagnosis, for reassurance and for management advice. Parents shared that, prior to consultation, they had insufficient knowledge of the benefits of correctly dosed pain medication at regularly scheduled intervals. Parents valued the GP's advice on pain management, and were happy to accept pain medication as standalone therapy, provided that the GP explained why antibiotics would not be needed. Parents' views and expectations of pain management in AOM were shaped by previous experiences of AOM within their family; those with a positive experience of pain medication are more likely to use it in subsequent AOM episodes.
Parents of children with AOM consult the GP to help cope with uncertainties in recognising symptoms of AOM, and to receive management advice. It is important that GPs are aware of parents' lack of understanding of the role of pain medication in managing AOM, and that they address this during the consultation.
Netherlands Trial Register, identifier NTR4920 (registration date: 19 December 2014).
由于原因尚不明确，父母在给孩子使用止痛药时往往较为谨慎，这可能导致急性中耳炎（AOM）症状的管理不够理想。我们旨在了解父母对儿童急性中耳炎（AOM）疼痛管理的看法和期望。
这是一项与随机对照试验（PIM-POM 研究）同时进行的定性研究，旨在优化儿童 AOM 的疼痛管理。我们有目的地招募了 14 名由全科医生诊断为 AOM 的儿童的父母，他们在 2017 年 11 月至 2018 年 5 月期间参加了该试验。在试验入组后的前两周，在他们家中进行了半结构化访谈。访谈进行了录音、转录，并进行了主题分析。
父母难以识别耳痛和其他耳部感染症状。他们会去看全科医生进行诊断、寻求安慰和获取管理建议。父母们表示，在咨询之前，他们对按时规律剂量的止痛药的益处了解不足。父母们非常重视全科医生关于疼痛管理的建议，并且乐意接受仅使用止痛药作为治疗方法，只要全科医生解释了为什么不需要使用抗生素。父母对 AOM 疼痛管理的看法和期望受到其家庭中以往 AOM 经历的影响；那些对止痛药有积极体验的人更有可能在后续的 AOM 发作中使用它。
患有 AOM 的儿童的父母会去看全科医生，以帮助他们应对识别 AOM 症状的不确定性，并获得管理建议。全科医生应该意识到父母对止痛药在管理 AOM 中的作用缺乏了解，并在咨询中解决这个问题。
荷兰临床试验注册中心，标识符 NTR4920（注册日期：2014 年 12 月 19 日）。
