Parental and medical knowledge and management of fever in Italian pre-school children

Abstract

BackgroundGuidelines for the management of fever in children have been recently published, however “fever phobia” is still spreading. To provide information which may sustain educational interventions tailored to our population we investigated the parental and medical knowledge and management of fever in preschool children.MethodsA questionnaire was administered to a convenient sample of Italian parents and paediatricians. The questionnaire elicited information about definition and cause of fever, concerns about fever, method of temperature measurement, and treatment modalities.ResultsOverall, 388 parents and 480 paediatricians were interviewed. All the parents believed that fever could cause at least one harmful effect and 89.9% (n = 349) believed that, if left untreated, it can cause brain damage or seizures. Parents used multiple resources to obtain information about fever but 67.8% (n = 264) considered paediatricians as their primary resource. Several wrong behaviours were found in the same proportions among parents and paediatricians: 78.5% of paediatricians (n = 377) and 77.8% of parents (n = 302) used physical method to reduce fever (P = 0.867); 27.0% of paediatricians (n = 103) and 21.4% (n = 83) of parents declared to alternate ibuprofen and acetaminophen (P = 0.953). Differently, 73.1% (n = 351) of paediatricians preferred oral to rectal administration of antipyretics compared to 48.7% (n = 190) of parents (P < 0.0001). Worrisomely, 1.4% of paediatricians and 1.2% of parents declared to use acetylsalicylic acid or steroids as second-choice antipyretics (P = 0.937) and 6.7% (n = 26) of parents declared to use table- or teaspoons for determining the dose of drug.ConclusionsPaediatricians’ attitudes greatly influence the parental behaviours and beliefs. Implementation of educational programs regarding the management of the febrile child are needed in our setting.

Fever phobia 35 years later: did we fail?

“…The results reported by Sahm et al are generally in line with those reported by other observational studies in the last three to four decades, both in Western countries and in those with more limited resources (2)(3)(4)(5). However, the most important differences between the Sahm et al study and previous findings are that parents taking part in the latest study declared that fever was actually a good thing for the body and they were reluctant to use medicine to treat fever.…”

“…Some practices, such as the use of acetylsalicylic acid and steroids, have been abandoned, and some, such as a cool bath, are now used less often. However, large studies seem to indicate that fever phobia persists and antipyretic drugs are still overused (3)(4)(5). Considering that we do seem to have failed in part to provide effective guidance to parents, how did this happen?…”

“…It is difficult to objectively measure the evolution of parents' knowledge and attitudes regarding symptomatic management of fever given the variability in design and settings among studies and/or ongoing recommendations (1)(2)(3)(4)(5). Some practices, such as the use of acetylsalicylic acid and steroids, have been abandoned, and some, such as a cool bath, are now used less often.…”

Management of acute fever in children: Guideline for community healthcare providers and pharmacists

“…[1,2] Furthermore, there is confusion about how and whether to manage fever. Antipyretics are frequently prescribed or purchased over-the-counter (OTC), specifically to bring down body temperature in an ill child, [2][3][4][5] paracetamol and ibuprofen being the most frequently purchased OTC medicines for children. [3] Although fevers are often a presenting symptom of a self-limiting viral infection, they are also associated with serious bacterial infections, such as meningitis and pneumonia, and other non-infective illnesses.…”

Assessment of the knowledge of medical officers in the management of children presenting with febrile illnesses

“…Chiappini et al in their study in Italy also assessed paediatricians' knowledge on the management of fever 12 . Overall, 480 paediatricians were interviewed.…”