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家长对儿童发热的信念、实践和医疗寻求行为。

Beliefs, Practices and Health Care Seeking Behavior of Parents Regarding Fever in Children.

机构信息

Department of Pediatrics, Riga Stradins University, Vienibas gatve 45, LV-1004 Riga, Latvia.

Department of Pediatrics, Children's Clinical University hospital, Vienibas gatve 45, LV-1004 Riga, Latvia.

出版信息

Medicina (Kaunas). 2019 Jul 22;55(7):398. doi: 10.3390/medicina55070398.

Abstract

Fever in children is one of the most common reasons for seeking medical attention. Parents often have misconceptions about the effects to fever, which leads to inappropriate use of medication and nonurgent visits to emergency departments (ED). The aim of this study was to clarify the beliefs on the effects and management of fever and to identify healthcare seeking patterns among parents of febrile children in Latvia. Parents and legal guardians of children attending ED with febrile illness were included in the study. Participants were recruited in Children's Clinical University Hospital (CCUH) in Riga, and in six regional hospitals in Latvia. Data on beliefs about fever, administration of antipyretics, healthcare-seeking behavior, and experience in communication with health care workers were collected via questionnaire. In total, 355 participants were enrolled: 199 in CCUH and 156 in regional hospitals; 59.2% of participants considered fever itself as indicative of serious illness and 92.8% believed it could raise the child's body temperature up to a dangerous level. Antipyretics were usually administered at median temperature of 38.0 °C, and the median temperature believed to be dangerous was 39.7 °C; 56.7% of parents usually contacted a doctor within the first 24 h of the illness. Parents who believed that lower temperatures are dangerous to a child were more likely to contact a doctor earlier and out-of-hours; 60.1% of participants had contacted their family doctor prior their visit to ED. Parental evaluation of satisfaction with the information and reassurance provided by the doctors at the hospital was higher than of that provided by their family doctor; 68.2% of participants felt safer when their febrile children were treated at the hospital. Fever itself was regarded as indicative of serious illness and potentially dangerous to the child's life. These misconceptions lead to inappropriate administration of antipyretics and early-seeking of medical attention, even out-of-hours. Hospital environment was viewed as safer and more reassuring when dealing with febrile illness in children. More emphasis must be placed on parental education on proper management of fever, especially in primary care.

摘要

发热是儿童就医最常见的原因之一。家长们常常对发热的影响存在误解,这导致他们不恰当地使用药物,以及在非紧急情况下到急诊部门(ED)就诊。本研究旨在阐明家长对发热的影响和管理的看法,并确定拉脱维亚发热儿童的就医模式。

本研究纳入了在发热性疾病就诊于 ED 的儿童的家长和法定监护人。研究对象在里加的儿童临床大学医院(CCUH)和拉脱维亚的六家地区医院招募。通过问卷收集了有关发热的信念、退热剂的使用、就医行为以及与卫生保健工作者沟通的经验等数据。

共有 355 名参与者入组:CCUH 199 名,地区医院 156 名;59.2%的参与者认为发热本身表明病情严重,92.8%的人认为发热可能导致体温升高至危险水平。退热剂通常在中位数体温 38.0°C 时使用,中位数认为危险的体温为 39.7°C;56.7%的家长通常在发病后 24 小时内首次联系医生。认为较低的体温对儿童有危险的家长更可能更早地、在非工作时间联系医生;60.1%的参与者在就诊 ED 前曾联系过他们的家庭医生。与在医院就诊时医生提供的信息和安慰相比,家长对家庭医生提供的信息和安慰的满意度更高;68.2%的参与者认为当他们的发热儿童在医院接受治疗时感到更安全。

发热本身被认为是严重疾病的指标,对儿童的生命有潜在危险。这些误解导致了不恰当地使用退热剂和及早寻求医疗关注,甚至是在非工作时间。在处理儿童发热时,医院环境被认为更安全,更能让人安心。必须更加重视家长对正确管理发热的教育,特别是在初级保健中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/785d/6681325/4a24c5b8c78e/medicina-55-00398-g001.jpg

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