一项关于儿童触诊主观发热评估的横断面研究：父亲与母亲一样可靠吗？

A Cross-Sectional Study on Subjective Fever Assessment in Children by Palpation: Are Fathers as Reliable as Mothers?

作者信息

Rosenbloom Ehud, Balis Crysta, Jacobson Dustin, Conway Melanie, Cheng Ji, Kozer Eran

机构信息

Division of Pediatric Emergency Medicine, McMaster Childrens Hospital, Hamilton, ON, Canada.

Pediatric Emergency Department, Meir Medical Center, Kefar Saba, Israel.

出版信息

Emerg Med Int. 2020 Feb 12;2020:3534267. doi: 10.1155/2020/3534267. eCollection 2020.

DOI:10.1155/2020/3534267

PMID:32104604

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7037523/

Abstract

BACKGROUND

Fever is common in pediatric patients. Often, parents rely solely on palpation when assessing their child's fever. The objective of the current study was to determine the accuracy of parents in detecting their child's fever by palpation.

METHODS

A prospective cross-sectional study was conducted at the emergency department (ED) of a tertiary pediatric hospital. Infants and children, 0-4 years of age, presenting to the ED with both parents were included. Parents were separately asked if their child had a fever and, if so, were asked to assess the temperature by palpation. A nurse obtained the rectal temperature. The primary outcome measure was the accuracy of fathers and mothers in detecting fever.

RESULTS

A total of 170 children with their parents were enrolled. The mean ages of the children, mothers, and fathers were 18.9 (SD 0.8) months, 31.1 (SD 6.4) years, and 33.7 (SD 6.9) years, respectively. No statistically significant difference was found between mothers and fathers in the ability to assess fever by palpation (OR 0.65, 95% CI 0.39,-1.08). Sensitivities for detecting fever by palpation for mothers and father were 86.4% and 88.2%, respectively (specificity among mothers: 54.2% and specificity among fathers: 43.1%). The overall negative and positive predictive values were 65.9% (95% CI 55%-75.7%) and 75.7% (95% CI 69.9%-80.8%), respectively.

CONCLUSIONS

Mothers and fathers do not differ in their ability to accurately assess their child's fever by palpation. The low positive and negative predictive values indicate that if temperature was not measured, physicians cannot rely on parents' reports.

摘要

背景

发热在儿科患者中很常见。通常，家长在评估孩子发热时仅依靠触诊。本研究的目的是确定家长通过触诊检测孩子发热的准确性。

方法

在一家三级儿科医院的急诊科进行了一项前瞻性横断面研究。纳入了0至4岁、由父母双方陪同前来急诊科就诊的婴幼儿及儿童。分别询问父母他们的孩子是否发热，如果发热，要求他们通过触诊评估体温。护士测量直肠温度。主要结局指标是父亲和母亲检测发热的准确性。

结果

共纳入了170名儿童及其父母。儿童、母亲和父亲的平均年龄分别为18.9（标准差0.8）个月、31.1（标准差6.4）岁和33.7（标准差6.9）岁。在通过触诊评估发热的能力方面，母亲和父亲之间未发现统计学上的显著差异（比值比0.65，95%置信区间0.39，-1.08）。母亲和父亲通过触诊检测发热的敏感性分别为86.4%和88.2%（母亲中的特异性：54.2%，父亲中的特异性：43.1%）。总体阴性和阳性预测值分别为65.9%（95%置信区间55%-75.7%）和75.7%（95%置信区间69.9%-80.8%）。