Abstract
BackgroundFever is one of the most common presenting complaints in paediatrics and general practice. In the majority of cases nothing harmful is diagnosed. However, the subjective meaning of fever often varies between doctors and parents. Knowledge of the parents' concept of fever may help tailor counselling to their needs.In this study we determine 1) the influence of socio-economic status and cultural background on two concepts of fever which we labelled "functional" and "fearful", each representing typical experiences of mothers, and 2) the actions taken by the mothers related to these concepts.MethodsA standardized interview study was conducted among German and Turkish mothers in Germany in 2009. The questionnaire consisted of 36 questions and 205 items. Interviews were conducted in 16 private practices of paediatricians and 2 paediatric emergency departments in an urban region of Germany. The two fever concepts were represented in 6 statements that could be rated with a six-point Likert scale. The association of the socio-economic status and the cultural background with one of the fever concepts was determined by a multiple logistic regression.ResultsA total of 338 mothers (49% with a Turkish background) completed the interview (response rate 92%). The average age of mothers with a German background was higher (34.1 years vs. 32.0 years, p = 0.0001). Mothers with a Turkish background were more likely to relate to the concept "fearful" [adjusted Odds Ratio (AOR) 1.99; confidence interval (CI) 1.16-3.44]. Mothers with a middle or high socio-economic status were more likely to respond to the concept "functional" [middle: AOR, 0.53; CI, 0.30-0.92; high: AOR, 0.44; CI, 0.21-0.95].Mothers adhering to the concept "fearful" more often gave acetaminophen before the recommended interval of 6 hours (46.8% vs. 31.3%, p = 0.005) and visited out-of-hours services more frequently in the preceding 9 months than the other group (0.7 vs. 0.4, p = 0.001).ConclusionsA Turkish migrant background and a low socio-economic status are associated with the fever concept "fearful". Mothers with these attributes seem to require specific and reassuring counselling as they use antipyretic drugs extensively and out-of-hours services frequently.
Highlights
Fever is one of the most common presenting complaints in paediatrics and general practice
In total 369 mothers were invited to participate in the study
The total score for the socio-economic status (SES) was 4.7 out of 21 points lower in the Turkish compared to the German group (p = 0.000) (Table 2)
Summary
Fever is one of the most common presenting complaints in paediatrics and general practice. The subjective meaning of fever often varies between doctors and parents. The subjective meaning a symptom or a disease has for a person often varies between doctors and patients. Differences between professional and common-sense knowledge as well as cultural orientations, family traditions, and socio-economic status play an important role in the way a pathophysiological process is interpreted [1,2]. The way in which health professionals deal with the differences in the meaning of a symptom is an important factor in paediatric practice and for the quality of care [5]. In a study conducted in the UK, 68-74% of the interviewed parents reported episodes of high temperature at least once every 6 months in the age range of 6-56 months [6]
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