Management Of Fever In Children Research Articles

Educational interventions on fever management in children: A scoping review.

BackgroundNumerous studies have been conducted specifically to target “fever phobia” and inappropriate fever management skills. However, despite educational intervention, caregivers continue to adopt inappropriate and non‐evidence‐based practices.AimsTo collect and examine peer‐reviewed literature for active educational interventions aimed at improving fever management in children and profile them based on: who provided the training, training location, how the intervention was delivered, outcomes of training, and how it was measured.DesignScoping Review.MethodsMEDLINE, EMBASE, CINAHL, PubMED, PsycINFO, and IPA were searched from January 1980–December 2016. Study location, type of intervention, intervention target, study aim(s), sample size, instruments, outcome measures, and results were extracted.ResultsThirty‐seven studies met the inclusion criteria. Most targeted parents with the remainder focused on healthcare professionals. The interventions and their outcome measures varied significantly from structured group training sessions to video interventions and many using a combination of methods. Most interventions reported a positive impact in outcomes such as knowledge, health service use, or fever management skills.ConclusionMore standardized educational platforms targeted at both caregivers and healthcare professionals with appropriate evaluation methods should be developed and made widely available.

Childhood Fever Knowledge and Management: A Case of Mothers with Children under Five Years

Childhood Fever Knowledge and Management: A Case of Mothers with Children under Five Years

Operationalising integrated community case management of childhood illnesses by community health workers in rural Haryana.

To conduct implementation research in integrated community case management (ICCM) of childhood pneumonia, diarrhoea and fever by promoting accredited social health activists as treatment providers and generate lessons for upscaling this approach. In this one-sample study, 49 Accredited Social Health Activists were trained in ICCM. Community awareness and demand generation activities undertaken included announcements, pamphlets and posters. Supplies of medicines and supervision of activists were maintained throughout the 10-month implementation period. Three cross-sectional surveys were conducted in households with children aged 2-59months for documenting two-week prevalence of illnesses and care-seeking practices. Focus group discussions and in-depth interviews were carried out with mothers/grandmothers and activists for documenting perceptions about health activists as treatment providers. One third of pneumonia (113/334) and one quarter of diarrhoea (102/408) cases at end-line were treated by Accredited Social Health Activists. Proportion of households seeking care from private providers (mostly unqualified) reduced significantly from baseline to endline (81-56% for diarrhoea, p<0.01; 78-48% for pneumonia, p<0.01). At endline, activists were considered an acceptable and attractive source for treatment near home. Trained Accredited Social Health Activists can treat uncomplicated childhood illnesses and are accepted by the community in this role.

EFFECT OF HEALTH EDUCATION USING VIDEO AND BROCHURE ON MATERNAL HEALTH LITERACY

Background: Fever is manifestation of acute disease on children and contributes to incidence of severe malnutrition and morbidity and the most common reason for parents to deliver children on hospital. Currently, parents still lack knowledge of determination and proper management of fever although intervention of health education has been widely practiced. One obstacle to widespread success of educational intervention is inadequacy of health literacy. Utilization of media with simple and completed information with picture can be developed in communities with low levels of health literacy.&#x0D; Objective: To understanding the effect of health education using video and brochure on maternal health literacy in the working area of Saptosari Public Health Center, Gunungkidul Yogyakarta, Indonesia.&#x0D; Methods: This was a quasi-experimental study with pretest and posttest nonequivalent control group design conducted on 15 – 27 May 2017. The questionnaire used was HLS-Asia Q which had been modified. Health education intervention was done using a five minute-duration video about fever management in children preceded by discussion about the content of the video. Cluster sampling technique was applied with mothers who have under five children as the respondent involving 45 respondents for intervention group and 42 respondents in control group. Data analysis used independent sample t-test.&#x0D; Results: There was an increase in average maternal health literacy provided with video and brochure media compared to the maternal health literacy given with standard treatment. Intervention group mean difference value was 6.6444 ± 9.6086 and value of difference of control group mean equals to -2.4762 ± 12.0674 (p value &lt;0.001).&#x0D; Conclusion: Health education intervention using video has a higher impact in the development of maternal health literacy compared with the standard intervention using brochure.

Assessment of knowledge and practices of parents regarding childhood fever management in Kuala Lumpur, Malaysia

Nearly every child will develop a fever at some point. The challenge for parents is to know when to be concerned. This study used the parent fever management scale (PFMS) to assess the knowledge and practices of Malaysian parents regarding management of childhood fever. A community-based survey was carried out in 12 different public places. A four-part questionnaire was used to collect data from 430 parents of children aged ≤ 6 years. Logistic regression analysis was performed to determine which factors might significantly predict fever burden. Usual practices targeted temperature reduction, antipyretic administration (81.4%), and temperature monitoring (86.0%). Moreover, medical advice was sought for illness symptoms (69.8%). The source of medication was either doctor prescription, leftover medicine, or a pharmacist. Parents recorded high PFMS total scores. Standard regression analysis demonstrated that ethnicity, followed by sex, accounted for the greatest variance in the PFMS total score when the variance explained by all other demographic variables in the model was controlled for. Our results revealed improper practice in managing childhood fever among parents in Malaysia and suggested that the care of febrile children was motivated by fever phobia. Parents need consistent evidence-based information about the management of childhood fever.

The challenge of rapid management of fever in children under 5 in Guinea.

In 2013, the Guinean health authority had to reorganise and run a national response against malaria as a priority. The review of the National Strategic Plan to fight malaria in Guinea was carried out and one of its critical components was the prevention and rapid management of fever (RMF) attributable to malaria in children. The study reports on the demographic and health determinants of this rapid management in children under 5. The participants were 4786 children from 2874 representative households. RMF was defined in terms of recourse to primary care. The recourse was defined by child's reference for the treatment of fever which led or not to treatment of malaria. We found that 1491 children (31.2%) had a bout of fever within the 2 weeks that preceded the survey. The prevalence of malaria was 45.4% among those children who have a bout of fever. The recourse to traditional healers was estimated at 9.6% and the use of health facilities was estimated at 71.5%. Overall, 74.9% of children with fever received treatment within the recommended timeliness (24 h), with regional disparity in this rapid response. The high proportion of recourse to traditional healers is still a matter of concern. New control and prevention strategies should be extended to traditional healers for their training and involvement in directing febrile children to health facilities.

Fever awareness, management practices and their correlates among parents of under five children in urban India.

Awareness regarding fever is reportedly low among Indian urban parents, leading to its over- management among under five children. We attempted to study the awareness and fever management practices of South Indian urban parents. The objectives were to find the awareness of parents regarding childhood fever management, and correlates of practices. One hundred parents of under-five children with history of fever in past three months were randomly selected and interviewed using a predesigned tool. Children's weight and height was measured. Awareness scores for causes of fever and fever management were constructed. Logistic regression was done to identify correlates of incorrect practices. 95% parents were aware about correct temperature above which fever became harmful. Awareness score for causes of fever was poor (<1) among 41% parents. Mothers' complications awareness scores were better than fathers (p<0.05). 81% parents used antibiotics; only 18% consulted a doctor before doing so. 17% parents using antibiotics did not complete the prescribed course. The independent correlates of poor fever management practices were working parents (OR: 6.28; 95%CI: 1.7-23.16), lesser number of children (OR: 3.08; 95%CI: 1.01-9.37), poor compliance for antipyretics (OR: 9.20; 95%CI: 1.64-51.52) and giving antipyretics without consulting doctors (OR: 5.43; 95%CI: 1.69-17.47). Poor knowledge of available pediatric antipyretic preparations was negatively correlated (OR: 0.13; 95%CI: 0.02-0.64). Fever awareness was fair among urban parents. Mothers had better awareness than fathers. Increased awareness for correct fever management of under-five children is desirable among urban parents to reduce misuse of antibiotics and antipyretics.

Knowledge, attitudes and misconceptions of Italian healthcare professionals regarding fever management in children

BackgroundFever phobia is still a major issue in paediatrics. We report knowledge of a sample of Italian paediatricians performed six years after the release of the Italian guidelines for the management of fever in children (IFG).MethodsA questionnaire, developed following the IFG recommendations and previously administered to 300 paediatricians in 2012, was proposed to all the paediatricians attending the 2015 National Congress of Practice Paediatrics, held in Florence, Italy. Changes in answers over time were analyzed.Results70.2% (562/800) paediatricians returned the questionnaire. The recommended site and device for body temperature measurement in children > 1 year was correctly chosen by 89.3% of participants (vs. 80.7% of 2012 participants; P < 0.001), but with children aged less than 1 year the correct answer was selected only by the 50.3% (vs. 39.3% of 2012 participants: P < 0.001).Use of physical methods was still incorrectly recommended by 51.6% of paediatricians (vs. 63.6% in 2012; P < 0.001). Use of antipyretics according to discomfort was adopted only by 38.2% of participants, while 12.2% of them recommended alternate use of antipyretics. These proportions were substantially stable since 2012 (45 and 11% respectively), rectal administration of antipyretics only in case of vomiting was correctly recommended by 86.8% of paediatricians vs. 74.7% in 2012 (P < 0.001).ConclusionImprovements in some pediatricians’ misconceptions were observed over time. However, some incorrect habits persist. Further studies are needed to better understand the “weak points” of the communication between Scientific Societies and paediatricians in order to impact everyday clinical practice.

FEBRE INFANTIL E SEU MANEJO PELOS PAIS: ANÁLISE QUANTITATIVA

Objetivo: verificar o conhecimento, crenças, fontes de informação, práticas e atitudes dos pais/cuidadores no manejo da febre infantil. Material e Métodos: estudo descritivo transversal, de caráter quantitativo. A amostra composta por 286 pais/cuidadores que procuraram o serviço de urgência de um Hospital Infantil em Minas Gerais com relato de febre na criança. Resultados: 45,6% dos pais possuíam o ensino médio, 54% ganhavam até um salário mínimo e 42% tinham um filho. 70% possuíam termômetro, 48,4% não observaram o tempo adequado para retirada do termômetro de mercúrio e 29,4% verificavam pela palpação. 34,3% conceituaram febre a partir de 37,5°C. 96,3% administravam antitérmicos, 50,5% dipirona e 39,3% paracetamol. 83,3% desconheciam os efeitos adversos. 14% administravam antibióticos. 70% consideravam que a febre trazia malefícios e que o pior dano é a convulsão. Para detectar a febre os entrevistados utilizaram o termômetro e a palpação. Consideram a febre perigosa por acreditarem provocar convulsão, sonolência, prostração, desidratação e danos cerebrais. Para controle da febre utilizavam métodos farmacológicos e não farmacológicos. Como fontes de informação, acessam a internet, livros, televisão, jornais, profissionais de saúde, amigos e parentes. Conclusão: Os participantes possuíam perfil socioeconômico, medos, crenças e práticas de manejo da febre similares. Em algumas situações demonstraram conhecimento e percepções limitadas ocasionando em atitudes errôneas frente à febre. As concepções direcionam as condutas e práticas no manejo da febre. A febre fobia persiste, pais/cuidadores demonstram insegurança para cuidar da criança febril.&#x0D; &#x0D; DESCRITORES&#x0D; Febre.Conhecimento.Criança.Percepção.Atitude.

Assessment of Knowledge and Performance of the Parents at the Management of Fever in Children

Background When a child’s body temperature rises, most parents become very worried that high fever may harm the child; in this study, knowledge and performance of the parents at the time of fever in children and how they act when encountering children’s fever were studied. Materials and Methods In this cross-sectional descriptive study, samples (300 parents of children under 10 years) were selected using the convenience sampling method among the children admitted to Children's Hospital of Tabriz, Iran, and these parents completed the research made questionnaire of parental knowledge and performance at the time of fever in children. Data were analyzed using SPSS version 20.0. Results The most common complication of high fever from the parents’ views was febrile seizure in 141 cases (47%). The use of corticosteroids for the treatment of fever in this study was observed in 23 cases (7.7%), and 40.7% of mothers had received their information about fever and how to manage it in children from doctors and nurses. In this study 87 (29%) of mothers had used thermometer to check for the child’s fever. In total, 53% of mothers knew the correct definition of standard fever temperature. Results showed that 161 (53.7%) of mothers believed in feeding the child more fluids than usual, 21 (7%) believed in feeding the child less fluids than usual, and 118 (39.3%) believed in feeding the child the same amount of fluids as before. In total, 25.7% of mothers had used antibiotics to treat their child’s fever. Conclusion Fever phobia continues to be common among parents. Parents have low level of awareness about children’s fever. Such low awareness and parents’ wrong perception of fever and their excessive fear and anxiety cause them fail to act properly.

Assessing effective methods to educate caregivers on fever in children aimed at reducing input to the paediatric emergency department

Introduction: Many paediatric emergency departments face a significant proportion of non-urgent attendances, leading to problems for both patients and healthcare systems. Our primary aim was to compare the effectiveness of pamphlet versus video in educating caregivers regarding fever management in children. Our secondary aim was to assess caregivers’ sentiments towards these methods. Methods: A randomized controlled trial was conducted with 50 participants over a four-week period (May–June 2015) in the KK Hospital Paediatric Emergency Department. The control group was exposed to the standard pamphlet available in the KK Hospital Paediatric Emergency Department, which provided basic information on fever management. The intervention group watched a video produced by our team, containing similar content. The same five-question questionnaire assessing fever management knowledge was issued to participants before and immediately following exposure to intervention. Results: The pamphlet group had a mean pre-intervention score=2.8 (out of five), post-intervention score=3.84, amounting to an improvement of 1.04. The video group had a mean pre-intervention score=2.56, post-intervention score=4.12, giving an improvement of 1.36. The study was powered at 80%, with calculated p-value=0.111, hence the results were statistically insignificant. Both groups had increased self-reported awareness post-exposure, found the intervention useful, would rely on it for future management and would recommend it to others. Conclusion: While the sample size was limited, this study demonstrates the potential that both pamphlet and video interventions have in educating caregivers, as participants reported favourable sentiments towards the methods. It would be worthwhile to conduct the study on a larger scale to yield statistically significant results.

Guidelines for the symptomatic management of fever in children: systematic review of the literature and quality appraisal with AGREE II

IntroductionSeveral societies have produced and disseminated clinical practice guidelines (CPGs) for the symptomatic management of fever in children. However, to date, the quality of such guidelines has not been appraised.ObjectiveTo...

Level of parental anxiety and use of antipyretics in childhood fever

Objective: The aim of the study was to analyse parental fever management (degree of temperature when parents start to administrate antipyretics) in relationship with the level of parental anxiety. Methods: Parental fever management was assessed by a questionnaire; the anxiety was determined by Spielberger-Hanin State-Trait Anxiety Inventory. There were surveyed 246 parents (median age 28,5 ± 5,7 years) of children, aged 3 months to 5 years, admitted to hospital with fever, without coexisting serious illness. Results: We have found that parents with a high level of anxiety (both – state and trait), administrate antipyretics at low degree of child’s temperature – 37.0 – 37.5 C in comparison with the parents with normal level of anxiety which administrate antipyretics at 38.5-39.0 C (trait anxiety- p<0,005, state anxiety- p<0,005). The most frequent fears about fever were that it can generate serious health complications, loss of consciousness, stroke, coma, choke. Conclusion: Childhood fever management – antipyretic administration – depends on the level of parental anxiety which is generated by misconceptions about the harmful effects of fever. Early antipyretic administration can reduce the beneficial effects of fever for child recovery.

Knowledge and Practice of Fever Management by Mothers of Preschool Children at Home

Purpose: This study was done to identify the level and correlation of knowledge and practice of fever management at home and provide data for the development of an intervention program to improve the fever management ability of mothers of preschool age children. Methods: Participants were 112 mothers with children between 1 and 6 years of age and attending one of three daycare centers located in J city. The participants had a history of using medication and tepid massage. Data were collected during April, 2016. Results: The mean scores were 27.55 (correct answer rate 70.64%) of 39 for knowledge, and 75.93 of 92 for fever management practice. There were significant differences in scores for knowledge according to the number of children and number of visits to doctors for treatment of a fever. There were no differences in scores for practice. There was a positive correlation between knowledge and practice. Conclusion: Results indicate that mothers’ knowledge and practice of childhood fever management were insufficient to provide accurate management of childhood fevers. Therefore, to improve the mothers’ ability to provide appropriate fever management, educational strategies that focus on increasing knowledge need to be developed.

Fever: A Literature Review of Perceptions, Perspectives and Practices

Previous and extant studies on home management of childhood fever among caregivers in most contexts have shown that the perceptions, perspectives and common practices associated with fever have not changed significantly. Generally, caregivers in all contexts are still managing childhood fever aggressively due to fever phobia. In particular, caregivers in resource poor countries such as sub-Saharan Africa still have cultural believes about fever which often underscores the pervasive hybrid of traditional and inadequate orthodox approaches to home management of fever. There is thus need for culturally sensitive and competent health literacy interventions to mitigate deleterious impacts of perceptions, perspectives and common practices related to home management of fever universally.

Development and Effects of A Parent Education Program for Childhood Fever Management

Development and Effects of A Parent Education Program for Childhood Fever Management

Factors Affecting Daycare Center Teachers’ Management of Childhood Fever

Purpose The purposes of this study were to investigate daycare teachers’ knowledge, anxiety and management of childhood fever and to identify factors affecting their management of childhood fever. Methods A descriptive correlation study was conducted. Participants were 109 daycare center teachers from G metropolitan city. A self-administered questionnaire was used for data collection. Results The mean percent of correct answers for knowledge about childhood fever was 42.9%. Levels of anxiety related to children’s fever were high among day care teachers in this study. Many daycare center teachers used management practices which were not recommended for childhood fever management. There was a statistically significant difference in participants’ knowledge about childhood fever by marital status and having a child. Moreover, there were statistically significant positive correlation between daycare center teachers’ knowledge and management and negative correlation between daycare center teachers’ anxiety and management of childhood fever. Knowledge and anxiety related to childhood fever accounted for 15.2% of variance for fever management. Conclusion Results show that day care teachers’ knowledge and anxiety related to fever are important factors in predicting their fever management. Development and evaluation of educational interventions to improve daycare teachers’ childhood fever management are recommended. Key words: 어린이집; 교사; 아동; 발열; 근거기반실무 Key words: Child daycare centers; Teachers; Child; Fever; Evidence-based practice

2016 Update of the Italian Pediatric Society Guidelines for Management of Fever in Children

To review new scientific evidence to update the Italian guidelines for managing fever in children as drafted by the panel of the Italian Pediatric Society. Relevant publications in English and Italian were identified through search of MEDLINE and the Cochrane Database of Systematic Reviews from May 2012 to November 2015. Previous recommendations are substantially reaffirmed. Antipyretics should be administered with the purpose to control the child's discomfort. Antipyretics should be administered orally; rectal administration is discouraged except in the setting of vomiting. Combined use of paracetamol and ibuprofen is discouraged, considering risk and benefit. Antipyretics are not recommended preemptively to reduce the incidence of fever and local reactions in children undergoing vaccination, or in attempt to prevent febrile convulsions in children. Ibuprofen and paracetamol are not contraindicated in children who are febrile with asthma, with the exception of known cases of paracetamol- or nonsteroidal anti-inflammatory drug-induced asthma. Recent medical literature leads to reaffirmation of previous recommendations for use of antipyretics in children who are febrile.

National modulators of symptomatic fever management in children: comparative analysis of survey data

In symptomatic fever management of children, cultural differences have been detected. We aimed at investigating the presence of national modulators of symptomatic fever management. We analyzed the data collected in the context of the Swiss national survey on symptomatic fever management in children and of an adapted version of that survey performed in Lombardy (Northern Italy). Ibuprofen (P<0.001) and an alternation regimen with 2 drugs (P<0.001) are more often prescribed in Switzerland than in Lombardy. In front of a comfortable child whose fever has not responded to the first antipyretic, Swiss pediatricians are more aggressive than Italian colleagues (P<0.001). In an 18-month-old child, the rectal administration route of paracetamol is less often chosen in Lombardy than in Switzerland (P<0.025). Additionally, some previously identified cultural differences among linguistically different regions of Switzerland (role of reduced general appearance and perceived frequency of fever phobia) held true also beyond national borders. Several significant differences between Northern Italy and the different speaking regions of Switzerland were detected. This suggests the existence of national modulators of symptomatic fever management in children.

Fever management in the emergency department of the Children's Hospital of Fudan University: a best practice implementation project.

Febrile illness in young children usually indicates an underlying infection and is a cause of concern for parents and carers. It is very important that healthcare professionals know how to recognize fever, assess children with fever, treat children with fever and role of nurses and parents. This paper outlines a best practice implementation project on the management of fever in children in an emergency department. To audit current practice of fever management for children in an emergency department and to implement strategies to standardize pediatric fever management based on evidence-based practice guidelines. We used the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice to examine compliance with fever management criteria based on the best available evidence before and after the implementation of strategies to spread the use of evidence-based practice protocols. We found significant improvements in pediatric fever management as measured by the knowledge scores of parents (54.5-83.7) and nurses (67.6-90.3). This suggested a need for continuous education. We found a noticeable improvement in compliance across all the five criteria; using correct methods to measure temperature (86-98%), staff education (0-100%), parents education (0-100%), using assessment tools (0-100%) and observed management (0-98%). This best practice implementation project demonstrated the use of effective strategies to standardize the protocol for fever management, implement assessment tool, develop multimedia materials, deliver continuous staff education and update nursing documentation and patient education pamphlets to ensure best practice is delivered by nurses to improve patient outcomes.