Parents’ information needs, self-efficacy and influences on consulting for childhood respiratory tract infections: a qualitative study

Abstract

BackgroundAcute respiratory tract infection (RTI) is the most common reason why parents consult primary care in the UK. Little is known about parents’ perceptions of what may help them to make an appropriate decision to consult when their child is ill and how to improve self-care.Using qualitative methods, this study aimed to explore parents’ views on support and information needs prior to consulting when children have RTIs with cough, and identify the triggers and barriers to consulting primary care.Methods7 focus groups and 30 semi-structured interviews were held with 60 parents (with children aged 5 months - 17 years) from a range of socio-economic backgrounds. Topics discussed were informed by the Health Belief Model, and explored parents’ concerns and beliefs about susceptibility and severity of RTIs, beliefs about the triggers and barriers to consulting, and information and support seeking behaviour undertaken before consulting primary care. Discussions were audio-recorded, transcribed and analysed using thematic methods.ResultsParents from all socio-economic backgrounds sought information from a wide range of sources about RTIs in children in order to identify which of their child’s symptoms should be of concern and trigger a visit to the doctor. The perception of threat to a child of RTI (with cough) was increased with more severe illness and by perceived susceptibility to illness of a particular child; whilst experience with other children increased parental efficacy to cope with childhood cough at home. Psychological models of health behaviour informed the understanding of cultural beliefs and attitudes that underpin health related behaviours.ConclusionA wide range of perceptions influence the likelihood that parents will seek help from primary care for a child with cough; these perceptions are similar across socio-economic groups. Parents’ experience, confidence and efficacy influence the likelihood of consulting primary care for their child’s RTI. Parents would value consistent advice from a trusted source that addresses common concerns and supports home care and decision making about help seeking.

“It's safer to …” parent consulting and clinician antibiotic prescribing decisions for children with respiratory tract infections: An analysis across four qualitative studies

“…In previous work (Ingram et al, 2013) we found that the Health Belief Model (Rosenstock et al, 1994) was useful for understanding the parent beliefs which influenced their decision to consult. In particular, the constructs of perceived severity of the illness, perceived susceptibility to the illness, self-efficacy in relation to home management of the illness, perceived benefits of consulting, and cues to action (i.e.…”

“…Although mainly self-limiting, they are a significant cause of concern for parents because of impacts on the child and family, and concerns about serious illness (Cornford et al, 1993;Kai, 1996a,b). Parents' decision to consult is influenced by perceived threat severity (Wyke et al, 1990;Cornford et al, 1993;Kai, 1996a;Neill, 2000;Ingram et al, 2013), the perceived benefits of consulting, and an expectation of assessment, information, advice or treatment (Kai, 1996a;Neill, 2000;Ingram et al, 2013). Parents are uncertain how to assess illness severity (Kai, 1996a;Francis et al, 2008;Neill, 2010;Ingram et al, 2013) and when to consult (Neill and Carter, 2012;Ingram et al, 2013).…”

Influence of Clinical Communication on Parents’ Antibiotic Expectations for Children With Respiratory Tract Infections

“…Previous studies have either examined communication within the consultation itself without asking participants what they were thinking 25,[34][35][36][37] or interviewed participants without an accurate record of what was actually said within the consultation. 15,38 Participants in our study may have modified their behavior because they knew they were being video recorded, although both parents and clinicians assured us these consultations did not seem different to them. This study recruited parents from a wide range of neighborhoods, and although we deliberately included parents from a wide range of ethnicities (including families from the Black African and Eastern European communities), very few of Asian ethnicity were recruited.…”

Maternal Uncertainty about Infants’ Hospitalization for Acute Childhood Illness: A Qualitative Study

“…Previous studies have reported similar findings that mothers felt ambiguity about their appropriateness of management [34] [37]. Neill et al…”

“…Langer et al reported that mothers' concern was closely linked to the cause of fever when their children had fever [33]. Ingram et al also reported that all mothers of children who had cough referred to multiple causes before deciding on what to do [34]. Therefore, a lack of information about the causes of the illness is particularly important when we consider the uncertainty of mothers of children with ACI.…”