Analysis of Nurses' and Physicians' Attitudes, Knowledge, and Perceptions toward Fever in Children: A Systematic Review with Meta-Analysis

Randomized controlled study: The effect of video-based distance education for approaching children with fever on parents' knowledge levels and fever management

AIM

The aim of the study was to evaluate the impact of distance learning, comprising of videos specifically designed for the management of fever in children, on parents' knowledge and practice of fever management.

METHOD

It was a randomized controlled pre/post-test study with 99 parents (mainly mothers, n = 91) of acute febrile children. The intervention group received fever management video training. "Descriptive Survey Form", "Fever and Fever Management Knowledge Form" and "Parent Fever Management Scale" were used to collect data. Cohen's d and 95% confidence interval were used to evaluate the effect size. The study was registered as NCT05707624 in Clinical Trials, retrospectively.

RESULTS

The intervention group's knowledge increased significantly from 52.2% to 65.5% (p = 0.003, d = 0.632) in the post-test. "Parent Fever Management Scale" scores of the intervention group were significantly lower (p < 0.001, d = 0.731) than the control group in the post-test.

CONCLUSION

The video training significantly enhanced parents' understanding of fever management, resulting in an effective reduction of their caregiving burden.

PRACTICE IMPLICATIONS

Fever management videos can be a valuable tool for parental education, particularly in clinical settings, aiding pediatric nurses in educating parents.

Discursive analysis of nursing care toward childhood fever and its contextual differences: An ethnomethodological study

Fever is the most common clinical sign during infancy. Nurses deal with fever in children most directly and it is an integral aspect of their role as pediatric nurses. The objective of this study is to analyze the perceptions, knowledge and attitudes toward childhood fever of nurses in three health contexts: pediatric hospitalization, pediatric emergency and primary care. To respond this objective, a qualitative study with ethnomethodological approach has been carried out. In-depth interviews were conducted and theoretical clinical cases were presented to nurses working in pediatrics in the three settings studied. After the analysis of the discourses, the codes were classified into three categories: static and number-centric knowledge, dependent nursing attitude, and unconscious model nurses. On the one hand, when we analyze and compare the perceptions, attitudes and knowledge of the nurses between the different contexts, we find differences that consist mainly of what the context requires of them. On the other hand, in general and regardless of the context, the nurses interviewed place themselves in a traditional framework when faced with the phenomenon of fever in children.

Parents' Knowledge and Management of Fever: "Parents Versus Fever!"

OBJECTIVE

Parents' lack of knowledge about fever causes fear and incorrect practices. This study aims to investigate the fever knowledge level, concerns, and practices of parents of preschool children.

MATERIALS AND METHODS

In this descriptive, cross-sectional study, conducted between July 2021 and July 2022, a survey was conducted among parents of children aged 6 months to 5 years who did not have a history of febrile seizure and/or chronic disease, either in themselves or their siblings.

RESULTS

A total of 386 parents, with a mean age of 33.6 ± 6.38 years and a mean number of children of 1.85 ± 0.9, participated in the study. Approximately one-third of parents started giving antipyretics to their child before the body temperature reached 38°C (32.4%) and/or used them alternately (34.5%). Moreover, approximately two-thirds (67.1%) tended to seek medical help within the first 12 hours. Parents who could not define fever correctly (66.6%) were more likely to start giving antipyretics before the child's body temperature reached 38°C [odds ratio (OR) 2.83 (1.70-4.71), P .001] and seek medical help within the first 12 hours [OR 1.81 (1.16-2.82), P = .008]. As the number of children or length of parenting increased, parents started giving antipyretics before the body temperature reached 38°C [OR 1.61 (1.26-2.06), P < .001; OR 1.04 (1.01-1.08), P = .048] and used them alternately [OR 1.07 (1.03-1.11), P = .001; OR 1.28 (1.02-1.62), P = .031].

CONCLUSION

This study demonstrates that a substantial proportion of parents still cannot define fever correctly, and inappropriate antipyretic use is more prevalent among experienced parents with multiple children and/or longer lengths of parenting.

Childhood fever and medical students: A multicentre, educational intervention

AIM

Misconceptions and non-evidence-based practices toward childhood fever are reported worldwide. Medical students might be ideal candidates to introduce long-lasting changes in clinical practice. However, no study has gauged the effectiveness of an educational intervention to improve fever management in this population. We conducted an educational, interventional study on childhood fever among final-year medical students.

METHODS

We conducted a prospective, multicentre interventional study employing a pre/post-test design. Participants from three Italian Universities filled in a questionnaire just before the intervention (T0), immediately after (T1) and 6 months later (T2) in 2022. The intervention was a two-hour lecture focused on the pathophysiology of fever, recommendations for its treatment and risks associated with improper management.

RESULTS

188 final-year medical students (median age of 26 years, 67% females) were enrolled. Relevant improvements in the criterion for treating fever and conceptions about the beneficial effects of fever were observed at T1 and T2. Similar data were found for the reduction of physical methods advice to decrease body temperature and concerns for brain damage from fever.

CONCLUSION

This study shows for the first time that an educational intervention is effective in changing students' conceptions and attitudes toward fever both in the short and medium term.

Approach to fever in children among final-year nursing students: a multicenter survey

BACKGROUND

Unfounded concerns regarding fever are increasingly observed among nurses worldwide. However, no study has so far explored the preferred approach towards pediatric fever among nursing students. Therefore, we aimed to investigate the attitude towards pediatric fever among final-year nursing students.

METHODS

Between February and June 2022, final-year nursing students of 5 Italian university hospitals were asked to answer an online survey on their approach to fever in children. Both quantitative and qualitative methods were utilized. Multiple regression models were employed to explore the existence of moderators on fever conceptions.

RESULTS

The survey was filled in by 121 nursing students (response rate 50%). Although most students (98%) do not consider discomfort to treat fever in children, only a minority would administer a second dose of the same antipyretic in nonresponsive cases (5.8%) or would alternate antipyretic drugs (13%). Most students would use physical methods to decrease fever (84%) and do not think that fever has mainly beneficial effects in children (72%). The own know-how adequacy on fever was inversely associated (OR 0.33, 95% CI 0.13-0.81) with the beliefs that high fever might lead to brain damage. No further predictive variable was significantly associated with the concern that fever might be associated with brain damage, the advice of physical methods use, and the assumption that fever has mostly positive effects.

DISCUSSION

This study shows for the first time that misconceptions and inappropriate attitudes towards fever in children are common among final-year nursing students. Nursing students could potentially be ideal candidates for improving fever management within clinical practice and amongst caregivers.

Perception, knowledge and attitude towards childhood fever: A survey among final-year medical students

AIMS

Undue concerns about the consequences of fever and its inappropriate management have been documented worldwide among physicians. However, no data exist on medical students. We investigated the perception, knowledge and attitude towards childhood fever among final-year medical students.

METHODS

Between June and September 2021, final-year medical students of six Italian universities were invited to complete an online survey on their conceptions and attitude towards pharmacological and non-pharmacological management of childhood fever. History of relevant personal or second-hand experience with childhood fever was also addressed. Both quantitative and qualitative approaches were used.

RESULTS

Of 1095 (69%) final-year medical students, 756 completed the survey. Many students believe that high fever might cause brain damage, would recommend physical methods and alternate two drugs for fever. Most students do not think that fever has mainly beneficial effects. In Northern Italy, students are less likely to believe that fever might lead to brain damage (OR 0.55, 95% CI 0.33-0.94), and in Southern Italy students are more likely to advise physical methods (OR 1.77, 95% CI 1.22-2.57) and less likely to believe that fever has mainly beneficial effects (OR 0.55, 95% CI 0.39-0.77). History of a relevant personal episode of fever during childhood was not associated with these outcomes.

CONCLUSIONS

Misconceptions about fever are common among final-year medical students in Italy. Cultural factors rather than individually learned traits might underlie these beliefs. Medical students are a promising target for educational interventions to improve childhood fever management.