家长照顾患有急性中耳炎的儿童的体验：定性分析。
Parents' experiences caring for children with acute otitis media: a qualitative analysis.
机构信息
Division of General Academic Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA.
出版信息
BMC Prim Care. 2022 May 23;23(1):123. doi: 10.1186/s12875-022-01737-4.
BACKGROUND
Little is known regarding parents' experiences caring for children with acute otitis media (AOM). This study aimed to explore parents' experiences caring for their child with AOM, identifying symptoms they observed, their thoughts and feelings about those symptoms, how they managed the episode, and what factors caused them to seek medical evaluation.
METHODS
From October 2019 to February 2020, we conducted 24 semi-structured cross-sectional interviews with parents of children 3 to 36 months of age with AOM diagnosed at primary care offices associated with the Children's Hospital of Pittsburgh regarding (1) symptoms and behaviors that led parents to believe their child might have AOM; (2) symptoms that were most bothersome to parent and child; (3) what parents did in response to these symptoms; (4) motivations for seeking clinical care; and (5) parents' expectations regarding AOM resolution. Data were analyzed using template analysis, resulting in a hybrid inductive/deductive analytic process.
RESULTS
We interviewed 24 parents within 72 h of diagnosis of AOM. Parents frequently believed ear tugging was the symptom most indicative of AOM, despite its presence in only half of the children in this sample. Parents consistently sought medical care when their child had an elevated temperature or lack of sleep, or when symptoms worsened or were unresponsive to home remedies. Parents of children with history of recurrent AOM had less difficulty identifying symptoms of AOM than parents of children with their first ear infection.
CONCLUSIONS
Our findings provide insight into symptoms of AOM that cause parents concern and motivate the use of healthcare services. Parents differed in their abilities to observe and report symptoms of AOM. Thus, when interviewing parents who are concerned their preverbal child has AOM, rather than focusing on ear tugging and fever alone, providers should ascertain all unusual behaviors observed by the parent.
背景
对于父母照顾患有急性中耳炎（AOM）的孩子的经历，人们知之甚少。本研究旨在探讨父母照顾患有 AOM 的孩子的经历，确定他们观察到的症状、他们对这些症状的想法和感受、他们如何处理该病症以及导致他们寻求医疗评估的因素。
方法
2019 年 10 月至 2020 年 2 月，我们对与匹兹堡儿童医院相关的初级保健办公室诊断患有 AOM 的 3 至 36 个月大的儿童的父母进行了 24 次半结构化的横断面访谈，内容涉及（1）父母认为孩子可能患有 AOM 的症状和行为；（2）最令父母和孩子感到不适的症状；（3）父母针对这些症状所做的处理；（4）寻求临床护理的动机；以及（5）父母对 AOM 痊愈的期望。数据采用模板分析进行分析，采用混合归纳/演绎分析过程。
结果
在 AOM 确诊后 72 小时内，我们对 24 位父母进行了访谈。尽管在本样本中只有一半的孩子有耳牵拉症状，但父母经常认为耳牵拉是最能说明 AOM 的症状。当孩子发烧或睡眠不足，或症状加重或对家庭疗法无反应时，父母始终会寻求医疗护理。与首次耳部感染的孩子的父母相比，患有复发性 AOM 病史的孩子的父母更能轻易识别 AOM 的症状。
结论
我们的研究结果深入了解了引起父母关注并促使他们使用医疗保健服务的 AOM 症状。父母在观察和报告 AOM 症状的能力上存在差异。因此，当为疑似患有 AOM 的不会说话的孩子进行问诊时，医生不应仅关注耳牵拉和发烧这两种症状，而应了解父母观察到的所有异常行为。
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