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Çelik T, Güzel Y. Parents' Knowledge and Management of Fever: "Parents Versus Fever!". Turk Arch Pediatr 2024; 59:179-184. [PMID: 38454227 PMCID: PMC11059622 DOI: 10.5152/turkarchpediatr.2024.23152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/18/2023] [Indexed: 03/09/2024]
Abstract
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.
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Affiliation(s)
- Taylan Çelik
- Division of Pediatric Infectious Disease, Departmant of Pediatrics, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Yusuf Güzel
- Departmant of Pediatrics, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
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LIU D, ZHANG Y, YU T, LIU Z, JIAO Y, WANG H, XU Y, GUAN Q, CHEN L, HU H. Protective mechanisms of Tuina therapy against lipopolysaccharide-induced fever in young rabbits based on untargeted metabolomics analysis. J TRADIT CHIN MED 2023; 43:725-733. [PMID: 37454257 PMCID: PMC10320445 DOI: 10.19852/j.cnki.jtcm.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/15/2022] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To investigate the effect of Tuina on the plasma metabolites of lipopolysaccharide-induced febrile in infant rabbits. METHODS Twenty-four infant New Zealand rabbits were selected and randomly divided into three groups: saline, model, and Tuina. The fever model was established by injecting LPS intravenously through the ear margin vein in the model group and Tuina group, respectively. The modeling was considered successful when the anal temperature increased by 0.5℃ or above within 1 h. In the Tuina group, six Tuina techniques (i.e., opening Tianmen / the heaven gate, pushing Kangong / the superciliary arch, kneading Taiyang and the prominent bone behind the ears, clearing Tianheshui, spine pinching) that alleviate fever were performed on the young rabbits 1 h after the modeling, whereas the model and saline groups were not given Tuina treatment, with the real-time anal temperature monitored during the experiment. The plasma was taken 3 h after the modeling for liquid chromatography-mass spectrometry (LC-MS) untargeted metabolomics study. RESULTS Our results showed a fever-reducing effects of Tuina therapy on lipopolysaccharide-induced fever in young rabbits, as indicated by a significantly lower anal temperature, maximum rise in body temperature, and body response index at 2 and 3 h after modeling in the Tuina group compared to the model group, with reductions in the PGE2 expression observed in the blood and hypothalamus. The differential metabolites including riboflavin, nicotinamide N-oxide, porphobilinogen, 5-hydroxyindoleacetic acid, gamma-aminobutyric acid, and lysoPC (16:1 (9Z)/0:0) were found following the Tuina intervention. Tuina primarily involves glycine-serine-threonine, arginine-proline, porphyrin-chlorophyll, pyrimidine, primary bile acid biosynthesis, and cyanoamino acid metabolic pathways. CONCLUSION Tuina therapy has proven to be effective in reducing body temperature and down-regulating PGE2 expression in LPS-induced febrile young rabbits, with its mechanism of fever-reducing action possibly associated with the changes in plasma metabolites and metabolic pathways.
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Affiliation(s)
- Di LIU
- 1 School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 102401, China
| | - Yingqi ZHANG
- 1 School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 102401, China
| | - Tianyuan YU
- 1 School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 102401, China
| | - Zhifeng LIU
- 1 School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 102401, China
| | - Yi JIAO
- 1 School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 102401, China
| | - Hourong WANG
- 1 School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 102401, China
| | - Yajing XU
- 1 School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 102401, China
| | - Qian GUAN
- 1 School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 102401, China
| | - Lulu CHEN
- 2 Department of Acupuncture-Moxibustion, Beijing Massage Hospital, Beijing 100035, China
| | - Hui HU
- 3 Department of Acupuncture-Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
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Manion AB, Lubelchek A, Bensko L. Prolonged Fever: Kawasaki Disease in a Pediatric Patient With COVID-19. J Pediatr Health Care 2023; 37:208-212. [PMID: 36549986 PMCID: PMC9712069 DOI: 10.1016/j.pedhc.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/19/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022]
Abstract
Kawasaki disease (KD) is the leading cause of acquired heart disease. The cardiac clinical features seen with KD require diagnosis and treatment within 10 days of symptoms to decrease the risk of complications. This case report examines the complexity of prolonged fever in a pediatric patient with a positive test for severe acute respiratory coronavirus 2 and meets the KD criteria.
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Affiliation(s)
- Amy Becker Manion
- Amy Becker Manion, Associate Professor, College of Nursing, Rush University, Chicago, IL.
| | - Alison Lubelchek
- Alison Lubelchek, DNP Candidate, College of Nursing, Rush University, Chicago, IL
| | - Leanne Bensko
- Leanne Bensko, Attending Physician, Northwestern Children's Practice, Chicago, IL
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Merlo F, Falvo I, Caiata-Zufferey M, Schulz PJ, Milani GP, Simonetti GD, Bianchetti MG, Fadda M. New insights into fever phobia: a pilot qualitative study with caregivers and their healthcare providers. Eur J Pediatr 2023; 182:651-659. [PMID: 36443503 PMCID: PMC9899170 DOI: 10.1007/s00431-022-04704-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 10/25/2022] [Accepted: 11/07/2022] [Indexed: 11/30/2022]
Abstract
UNLABELLED Despite the availability of clinical guidelines on the correct symptomatic management of fever in children, several studies have reported inaccurate knowledge about this symptom and inappropriate management behaviours among caregivers. There is evidence that caregivers' management of fever is largely influenced by unrealistic and unwarranted concerns about the potential harm that elevated body temperature can cause, a phenomenon commonly referred to as fever phobia. Research on fever phobia has predominantly focused on the role of fever misconceptions in triggering anxiety and impeding a proper fever management, in terms of both concept and operationalization, with little attention to the influence of the relationship between caregivers and the healthcare team. The aim of this pilot study was to explore and describe fever-related knowledge, experience and behaviour among a sample of caregivers, paediatricians and their medical assistants in the Canton of Ticino, Switzerland. We used a qualitative study design with semi-structured, one-to-one interviews with paediatricians employed in private healthcare facilities, their medical assistants and caregivers with at least one child between the ages of 0 and 3 years. We conducted individual interviews either in person or by phone, according to participants' preferences, between October 2020 and February 2021. We performed an inductive-deductive analysis of the transcripts to identify the most meaningful themes from participants' reports. The analysis of the transcripts yielded three main themes. The first theme refers to participants' awareness of the emotional component in managing the child's fever and the challenges this component presents. The second theme refers to the risk of overtreating when the child's right to be sick is not recognized and respected. The third theme refers to the importance of the relational component, showing how a solid therapeutic alliance with the healthcare team helps caregivers develop self-confidence in managing the child's fever. This study contributes to advance our understanding of fever phobia and to a better conceptualization and operationalization of this phenomenon. CONCLUSION Our results point out to the importance of going beyond a knowledge gap paradigm and recognizing both the emotional and the relational component of fever phobia, the former being entrenched in latter, that is, the unique relationship caregivers establish with their child's paediatrician and the medical assistant. WHAT IS KNOWN • Research on fever phobia has predominantly focused on the role of fever misconceptions in triggering anxiety and impeding a proper fever management, in terms of both concept and operationalization, with little attention to the relational component of this phenomenon. WHAT IS NEW • Our results point out to the importance of recognizing the emotional component of fever phobia, beyond its declarative and procedural knowledge dimensions. They also suggest that overtreating is not necessarily and not only the result of a phobia but also of a particular conception of health and the relational component of this phenomenon, which is entrenched in the unique relationship caregivers establish with their child's paediatrician and the medical assistant.
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Affiliation(s)
- Federica Merlo
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland ,Sasso Corbaro Foundation, Bellinzona, Switzerland
| | - Ilaria Falvo
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Maria Caiata-Zufferey
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Peter J. Schulz
- Faculty of Communication, Culture and Society, Università della Svizzera Italiana, Lugano, Switzerland ,Department of Communication & Media, Ewha Womans University, Seoul, Korea
| | - Gregorio P. Milani
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy ,Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Giacomo D. Simonetti
- Pediatric Institute of Southern Switzerland, Ente Ospedaliero Cantonale, EOC, Bellinzona, Switzerland ,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Mario G. Bianchetti
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Marta Fadda
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
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Gulcan MK, Sahiner NC. Determining the fever-related knowledge and practices of mothers with children aged 1-5 years presenting to a child emergency service with fever complaints in Turkiye. J Pediatr Nurs 2022; 69:e13-e20. [PMID: 36494236 DOI: 10.1016/j.pedn.2022.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 11/19/2022] [Accepted: 11/19/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE This study aimed to evaluate and determine the knowledge and practices of mothers with children aged between 1 and 5 years presenting to a pediatric emergency service with fever complaints regarding fever management. DESIGN AND METHODS This study was descriptive and correlational study was conducted between March and May 2019 with mothers over the age of 18 who brought their children aged 1-5 years to the XX State Hospital Pediatric Emergency Department with fever complaints. To evaluate the descriptive characteristics of the mothers and their practices when their children had a fever, data were collected with a questionnaire form consisting of 36 open-ended questions and the Parents' Fever Management Scale-Turkish Version (PFMS-TR). The data were analyzed using the SPSS 21 software with frequency, percentage, mean, standard deviation, min-max values, chi-squared, Cronbach's alpha, ANOVA, t-test, Kruskal- Wallis test, post hoc analysis with Bonferroni correction and correlation analysis, where p < 0.05, was considered statistically significant. RESULTS Of the mothers included in the study, 36.9% (n = 118) were between the ages of 33 and 39, 33.4% (n = 107) were graduates of higher education and 57.2% (n = 183) were homemakers. The mean number of people living at the homes of the participants was 4.26 ± 1.24 (min = 3, max = 8), the mean number of their children was 2.0 ±,97 (min = 1, max = 6), and the mean age of their children was 2.90 ± 1. 37 (min = 1, max = 5). The most common practices of the mothers when their children had fever were taking off their clothes and giving them antipyretic drugs. Moreover, the inappropriate practices of the mothers included rubbing the child with a vinegar and water mixture (11.9%) and cold application (8%). While 55.9% of the mothers were worried that the child would suffer post-fever convulsions 25.9% of them were worried that the child would suffer brain damage. A significant relationship was found between the mean scores of the mothers on PFMS-TR and their educational and economic statuses (p < 0.05). CONCLUSIONS Fears of fever are common in mothers, but their knowledge and practices about fever are inaccurate / incomplete. PRACTICE IMPLICATIONS Parents should be informed about fever with up-to-date information by nurses, and the appropriate attitude should be established on this issue. Efficient educational activities can reduce fears of mothers and prevent ill-advised practices.
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Affiliation(s)
| | - Nejla Canbulat Sahiner
- Karamanoglu Mehmetbey University, Health Science Faculty, Pediatric Nursing Department, 70200 Karaman, Turkey.
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Kombate G, Cakpo GE, Azianu KA, Labité MA, van der Sande MAB. Care-seeking behaviour among febrile children under five in Togo. BMC Public Health 2022; 22:2107. [PMCID: PMC9670432 DOI: 10.1186/s12889-022-14550-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
Fever is one of the warning signs of poor health in children. Care-seeking in febrile children is importance in reducing child deaths and morbidity. This care-seeking by parents in children with fever is however relatively low in sub-Sahara Africa. The aim of this study is to improve understanding of the behaviour of caregivers in seeking care for children under five with fever and to identify associated modifiable risk factors in Togo.
Methods
Data from a 2013–2014 cross-sectional nationally representative malaria indicator survey was used. Advice or care-seeking is defined as any child under 5 years of age with fever in the two weeks prior to the interview for whom advice or treatment was sought in a public medical area, private medical area, store, market, or from an itinerant medicine seller. Univariate and multivariate logistic regression analysis were performed using Generalized Linear Models.
Results
A total of 1359 febrile children out of 6529 children under five were enrolled. Care had been sought in 38.9% of cases. In multivariate analysis, independent risk factors associated with formal care seeking were accessibility to the nearest health center (aOR = 1.52, 95% CI [1.18–1.95], mother's education level secondary and above (aOR = 1.85, 95% [1.32–2.59]), mothers who identified as belonging to animist/traditionalist religions compared to mothers who belonged to a formal religion (catholic (aOR = 2. 28, 95% [1.55–3.37]), Muslim (aOR = 2.41, 95% [1.67–3.47]), and Protestant (aOR = 1.9, 95% [1.37–2.65]), Maritime region (aOR = 0.49, 95% [0.29–0.82]) compared to Lome commune.
Conclusion
Interventions should specifically target women with limited education, not identifying as part of an official church and at longer distance from health center.
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Acorda DE, Engebretson J, DesOrmeaux C, Cuccaro P, Rozmus C. Exploring Latino Perspectives in Childhood Fever: Beliefs, Practices, and Needs. J Transcult Nurs 2022; 33:695-703. [PMID: 35942871 DOI: 10.1177/10436596221114149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Latino parents have significant knowledge gaps and misconceptions about fever. In this study, we explored Latino beliefs and practices around fever and its impact on their care decisions. METHODS A qualitative-focused ethnography was conducted with 21 Latino parents. Semi-structured interviews were completed, and inductive thematic analysis was used to identify themes and subthemes. RESULTS Three major themes emerged: (a) the meaning of fever; (b) seeking guidance; and (c) navigating fever. Subthemes included: a sign of folk illness, a sign of infection, trust in health care providers, watchful waiting, and barriers and needs. DISCUSSION Latino parents have significant knowledge gaps about the role of fever in illness. They engage multiple systems of care but rarely share their fears with health care providers. Culturally-sensitive interventions incorporating traditional and biomedical approaches are needed. Findings can help inform future interventions targeting knowledge gaps in this population.
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Affiliation(s)
- Darlene E Acorda
- The University of Texas Health Science Center, Houston, USA.,Texas Children's Hospital, Houston, USA
| | | | | | - Paula Cuccaro
- The University of Texas Health Science Center, Houston, USA
| | - Cathy Rozmus
- The University of Texas Health Science Center, Houston, USA
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Luo S, She R, Lau MMC, Lau JTF. Would Illness Representations of COVID-19 and COVID-19 Fears During Clinic Visits Promote or Reduce Behavioral Intention to Seek Medical Consultations for Flu Symptoms? A Random Telephone Survey in Hong Kong, China. Front Public Health 2022; 10:903290. [PMID: 35757650 PMCID: PMC9226407 DOI: 10.3389/fpubh.2022.903290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background The study investigated the level of behavioral intention to consult doctors for flu symptoms (BICDFS) during the Coronavirus Disease 2019 (COVID-19) pandemic and examined its associations with illness representations of COVID-19 and fear of COVID-19 during clinic visits in a general Chinese adult population. Methods A random telephone survey was conducted among 300 residents in Hong Kong, China in April 2020 when the second wave of COVID-19 was just ended in the region. The participants were asked about their intention to consult doctors if they had mild or severe flu symptoms in the next week (from 1 = definitely no to 5 = definitely yes). Illness representations of COVID-19 were measured by the Chinese version of the Brief Illness Perception Questionnaire (BIPQ). The fear of COVID-19 during clinic visits were assessed by two single items. Linear regression adjusted for background variables and hierarchical strategies were employed. Results Of the participants, 52.3 and 92.0% showed an intention to consult doctors for mild and severe flu symptoms, respectively. Adjusted for background factors, COVID-19-related cognitive representations (consequences: standardized b = 0.15, p = 0.010; understanding: standardized b = 0.21, p = 0.001) and emotional representations (concern: standardized b = 0.17, p = 0.001; negative emotions: standardized b = 0.19, p = 0.001) were positively associated with BICDFS. In the hierarchical model, independent significant factors of BICDFS included understanding (standardized b = 0.16, p = 0.013) and negative emotions (standardized b = 0.17, p = 0.008). The fear-related variables showed non-significant associations with the BICDFS. Conclusions Promotion of care-seeking behaviors for flu symptoms during the COVID-19 pandemic should consider improving people's understanding of COVID-19 and providing advice on related coping strategies for emotional responses to COVID-19.
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Affiliation(s)
- Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Rui She
- Centre for Health Behaviors Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Mason M C Lau
- Centre for Health Behaviors Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Joseph T F Lau
- Centre for Health Behaviors Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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Tavan A, Monemi E, Keshavarz F, Kazemi B, Nematollahi M. The effect of simulation-based education on parental management of fever in children: a quasi-experimental study. BMC Nurs 2022; 21:168. [PMID: 35764950 PMCID: PMC9238067 DOI: 10.1186/s12912-022-00938-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fever is a sign of illness in children and parents should receive educational interventions based on their needs to provide effective care for children. Simulation-based education provided by nurses for managing children's fever can help improve the quality of parental care. Accordingly, this study aimed to explore the effectiveness of simulation-based education in the management of children's fever by parents. METHODS This quasi-experimental study was conducted using a pretest-posttest design with two groups on 90 parents of children with fever who visited Afzalipour Teaching Hospital in Kerman, Iran. The participants were randomly divided into two groups. The members of the intervention group received simulation-based fever management education and the parents in the control group received routine interventions. A demographic information form and the Parental Fever Management Knowledge and Practice Scale were completed by the participants in both groups before and after the intervention. The collected data were analyzed with SPSS 21 at a significant level of 0.05 (P = 0.05). RESULTS The results of the study showed that there was a statistically significant difference between the mean scores of fever management knowledge in the intervention group before and after the intervention (30.51 ± 1.50 vs. 54.79 ± 2.55) (p < 0.05), while the control group showed no statistically significant difference before and after the intervention (29.81 ± 4.1 vs. 29.95 ± 2.80) (p > 0.05). Furthermore, there was a significant difference between the mean scores of fever management practice in the intervention group before and after the intervention (24.32 ± 0.89 vs. 37.51 ± 1.09) (p < 0.05). In contrast, the control group showed no statistically significant difference before and after the intervention (23.03 ± 0.90 vs. 21.98 ± 0.02) in terms of fever management practice (p > 0.05). The results of the independent samples t-test also showed that the mean scores of fever management knowledge and practice were not significantly different between the two groups before the intervention (p > 0.05) while there were significant intergroup differences after the intervention (p < 0.05). CONCLUSION The results of the study showed that simulation-based education was effective in improving the parents' child fever management knowledge and practice. Accordingly, professional care teams can prepare simulation-based education packages to improve parental care at home for children's fever management.
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Affiliation(s)
- Asghar Tavan
- Health in Disasters and Emergencies Research Center, Institue for futures Studies in Health, Kerman University of Medical science, Kerman, Iran
| | - Elnaz Monemi
- Pediatric and neonatal intensive care nursing department, Razi school of nursing and midwifery, Kerman University of Medical Sciences, Kerman, Iran.,Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Fateme Keshavarz
- Pediatric and neonatal intensive care nursing department, Razi school of nursing and midwifery, Kerman University of Medical Sciences, Kerman, Iran.,Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Behrooz Kazemi
- Pediatric and neonatal intensive care nursing department, Razi school of nursing and midwifery, Kerman University of Medical Sciences, Kerman, Iran.,Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Monirsadat Nematollahi
- Pediatric and neonatal intensive care nursing department, Razi school of nursing and midwifery, Kerman University of Medical Sciences, Kerman, Iran. .,Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran. .,Student Research Committee, Kerman University of Medical Science, Kerman, Iran.
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10
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Zhao Y, Hu J, Gu Y, Wan Y, Liu F, Ye C, Zhang X. Development and Implementation of a Pediatric Nursing-Clinical Decision Support System for Hyperthermia: A Pre- and Post-test. Comput Inform Nurs 2021; 40:131-137. [PMID: 34347639 PMCID: PMC8820773 DOI: 10.1097/cin.0000000000000812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This article describes the development process and application of the Pediatric Nursing-Clinical Decision Support System for Hyperthermia. Firstly, we formed the Pediatric Nursing-Knowledge Base for Hyperthermia, which combines publicly available clinical practice guidelines and nursing routines of hyperthermia management. Then, following the nursing process framework, the system was developed using clinical decision support technology. Finally, a pre- and post-test were adopted to examine the effectiveness, usability, and feasibility before (1st to 31st of August 2018) and after (1st to 31st of December 2019) using the system. Its effectiveness was examined by analysis of nursing records' quality, including completeness of nursing assessment, timeliness of nursing diagnosis, individualization of nursing interventions, and timeliness of nursing evaluation. Its usability and feasibility were assessed using the Clinical Nursing Information System Effectiveness Evaluation Scale. There was a significant difference between the two groups in effectiveness, usability, and feasibility. Although the system was developed specifically for our hospital workflow and processes, the Pediatric Nursing-Knowledge Base for Hyperthermia and workflow for hyperthermia management in this study can be used as a reference to other hospitals.
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Green R, Webb D, Jeena PM, Wells M, Butt N, Hangoma JM, Moodley R(S, Maimin J, Wibbelink M, Mustafa F. Management of acute fever in children: Consensus recommendations for community and primary healthcare providers in sub-Saharan Africa. Afr J Emerg Med 2021; 11:283-296. [PMID: 33912381 PMCID: PMC8063696 DOI: 10.1016/j.afjem.2020.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 11/08/2020] [Accepted: 11/15/2020] [Indexed: 12/24/2022] Open
Abstract
Fever is one of the most common reasons for unwell children presenting to pharmacists and primary healthcare practitioners. Currently there are no guidelines for assessment and management of fever specifically for community and primary healthcare workers in the sub-Saharan Africa region. This multidisciplinary consensus guide was developed to assist pharmacists and primary healthcare workers in sub-Saharan Africa to risk stratify and manage children who present with fever, decide when to refer, and how to advise parents and caregivers. Fever is defined as body temperature ≥ 37.5 °C and is a normal physiological response to illness that facilitates and accelerates recovery. Although it is often associated with self-limiting illness, it causes significant concern to both parents and attending healthcare workers. Clinical signs may be used by pharmacy staff and primary healthcare workers to determine level of distress and to distinguish between a child with fever who is at high risk of serious illness and who requires specific treatment, hospitalisation or specialist care, and those at low risk who could be managed conservatively at home. In children with warning signs, serious causes of fever that may need to be excluded include infections (including malaria), non-infective inflammatory conditions and malignancy. Simple febrile convulsions are not in themselves harmful, and are not necessarily indicative of serious infection. In the absence of illness requiring specific treatment, relief from distress is the primary indication for prescribing pharmacotherapy, and antipyretics should not be administered with the sole intention of reducing body temperature. Care must be taken not to overdose medications and clear instructions should be given to parents/caregivers on managing the child at home and when to seek further medical care.
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Affiliation(s)
- Robin Green
- Department Paediatrics and Child Health, University of Pretoria, South Africa
| | - David Webb
- Houghton House Group, Johannesburg, South Africa
| | - Prakash Mohan Jeena
- Department of Paediatrics & Child Health, University of KwaZulu Natal, Durban, South Africa
| | - Mike Wells
- Division of Emergency Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | | | - Jackie Maimin
- South African Pharmacy Council, Johannesburg, South Africa
| | | | - Fatima Mustafa
- Steve Biko Academic Hospital, Department of Paediatrics and Child Health, University of Pretoria, South Africa
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12
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Stars I, Smane L, Pucuka Z, Roge I, Pavare J. Impact of Pediatric COVID-19 on Family Health-Related Quality of Life: A Qualitative Study from Latvia. Glob Pediatr Health 2021; 8:2333794X211012394. [PMID: 33997124 PMCID: PMC8072840 DOI: 10.1177/2333794x211012394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/15/2021] [Accepted: 03/31/2021] [Indexed: 11/15/2022] Open
Abstract
Information on family health-related quality of life (FHRQoL) among families of children with the coronavirus disease 2019 (COVID-19) is limited. This qualitative study explores the impact of pediatric COVID-19 on FHRQoL from the parents' perspective. Semi-structured interviews were conducted with parents (n = 20) whose children had tested positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Inductive thematic analysis revealed the following 10 themes that represented parents' perception of FHRQoL while taking care of a child with COVID-19: pediatric COVID-19 as a disease with many unknowns; emotional saturation; internal family relationships in the context of "a new experience"; routine household activities and daily regimen while family is in lockdown; plenty of free time; a wide social support network; social stigma associated with COVID-19; different options for work; savings and debts; challenges with family housing and transport availability. Our results show that parents experience multiple effects of pediatric COVID-19 with regard to FHRQoL.
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Affiliation(s)
| | - Liene Smane
- Riga Stradins University, Riga, Latvia.,Children's Clinical University Hospital, Riga, Latvia
| | - Zanda Pucuka
- Riga Stradins University, Riga, Latvia.,Children's Clinical University Hospital, Riga, Latvia
| | - Ieva Roge
- Children's Clinical University Hospital, Riga, Latvia
| | - Jana Pavare
- Riga Stradins University, Riga, Latvia.,Children's Clinical University Hospital, Riga, Latvia
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13
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Dubey P, Das A, Priyamvada K, Bindroo J, Mahapatra T, Mishra PK, Kumar A, Franco AO, Rooj B, Sinha B, Pradhan S, Banerjee I, Kumar M, Bano N, Kumar C, Prasad C, Chakraborty P, Kumar R, Kumar N, Kumar A, Singh AK, Kundan K, Babu S, Shah H, Karthick M, Roy N, Gill NK, Dwivedi S, Chaudhuri I, Hightower AW, Chapman LAC, Singh C, Sharma MP, Dhingra N, Bern C, Srikantiah S. Development and Evaluation of Active Case Detection Methods to Support Visceral Leishmaniasis Elimination in India. Front Cell Infect Microbiol 2021; 11:648903. [PMID: 33842396 PMCID: PMC8024686 DOI: 10.3389/fcimb.2021.648903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
As India moves toward the elimination of visceral leishmaniasis (VL) as a public health problem, comprehensive timely case detection has become increasingly important, in order to reduce the period of infectivity and control outbreaks. During the 2000s, localized research studies suggested that a large percentage of VL cases were never reported in government data. However, assessments conducted from 2013 to 2015 indicated that 85% or more of confirmed cases were eventually captured and reported in surveillance data, albeit with significant delays before diagnosis. Based on methods developed during these assessments, the CARE India team evolved new strategies for active case detection (ACD), applicable at large scale while being sufficiently effective in reducing time to diagnosis. Active case searches are triggered by the report of a confirmed VL case, and comprise two major search mechanisms: 1) case identification based on the index case's knowledge of other known VL cases and searches in nearby houses (snowballing); and 2) sustained contact over time with a range of private providers, both formal and informal. Simultaneously, house-to-house searches were conducted in 142 villages of 47 blocks during this period. We analyzed data from 5030 VL patients reported in Bihar from January 2018 through July 2019. Of these 3033 were detected passively and 1997 via ACD (15 (0.8%) via house-to-house and 1982 (99.2%) by light touch ACD methods). We constructed multinomial logistic regression models comparing time intervals to diagnosis (30-59, 60-89 and ≥90 days with <30 days as the referent). ACD and younger age were associated with shorter time to diagnosis, while male sex and HIV infection were associated with longer illness durations. The advantage of ACD over PCD was more marked for longer illness durations: the adjusted odds ratios for having illness durations of 30-59, 60-89 and >=90 days compared to the referent of <30 days for ACD vs PCD were 0.88, 0.56 and 0.42 respectively. These ACD strategies not only reduce time to diagnosis, and thus risk of transmission, but also ensure that there is a double check on the proportion of cases actually getting captured. Such a process can supplement passive case detection efforts that must go on, possibly perpetually, even after elimination as a public health problem is achieved.
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Affiliation(s)
- Pushkar Dubey
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Aritra Das
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Khushbu Priyamvada
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Joy Bindroo
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Tanmay Mahapatra
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Prabhas Kumar Mishra
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Ankur Kumar
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Ana O. Franco
- Institute for Global Health Sciences, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - Basab Rooj
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Bikas Sinha
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Sreya Pradhan
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Indranath Banerjee
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Manash Kumar
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Nasreen Bano
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Chandan Kumar
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Chandan Prasad
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Parna Chakraborty
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Rakesh Kumar
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Niraj Kumar
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Aditya Kumar
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Abhishek Kumar Singh
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Kumar Kundan
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Sunil Babu
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Hemant Shah
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Morchan Karthick
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Nupur Roy
- National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Naresh Kumar Gill
- National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Shweta Dwivedi
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Indrajit Chaudhuri
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | | | - Lloyd A C. Chapman
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chandramani Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | | | - Neeraj Dhingra
- National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Caryn Bern
- Institute for Global Health Sciences, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - Sridhar Srikantiah
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
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14
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Lai R, Tan L, Lai X, Zhang X, Zhou Q. Help-Seeking Behavior of Returning to Work in Healthcare Workers and its Influencing Factors During COVID-19 Subsiding. J Occup Environ Med 2020; 62:898-903. [PMID: 32649650 DOI: 10.1097/jom.0000000000001959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To explore the level and influencing factors of help-seeking behavior of returning to work in healthcare workers (HCWs). METHODS A total of 861 HCWs were surveyed. A structured self-administered questionnaire was used to collect data. Multivariable logistic regression was performed to examine the influencing factors of help-seeking behavior. RESULTS HCWs sought help with respect to COVID-19-diagnosized problem most. Help-seeking intention, problems encountered after return, test for return, work condition during COVID-19, relatives or friends diagnosed or suspected as COVID-19, and socio-demographic characteristics such as occupation, education, title, and marriage status are predictors of help-seeking behavior. CONCLUSIONS Education and intervention should lay particular stress on HCWs featured rest at home before return, doctor, lower education and lower title to ensure the safety, accuracy, and quality of work after they return to work for a better occupational environment.
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Affiliation(s)
- Ruying Lai
- Tongji Hospital, Tongji Medical College (Mr Lai, Dr Tan, Mr Lai); and School of Medicine and Health Management, Tongji Medical School (Dr Zhang, Dr Zhou), Huazhong University of Science and Technology, Wuhan, Hubei, China
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