Parents’ childhood fever management: community survey and instrument development

Aim: This paper is a report of a study to explore Australian parents’ knowledge, beliefs, practices and information sources about fever management and develop a scale to measure parents’ fever management practices. Background: Parental fever phobia and overuse of antipyretics to reduce fever continue. No scales to measure parents’ fever management practices are available. Method: A community-based, postal survey was carried out in 2005 with 401 Australian parents of well children aged 6 months to 5 years. Respondents were recruited through advertising (48.4%), face-to-face (26.4%) and snowball (24.4%) methods. A 33-item instrument was developed; construct and content validity were determined by an expert panel and item reliability by test-retest. Results: Moderate fever (40.0ºC±1.0ºC) was reported to be harmful (88%), causing febrile convulsions (77.7%). Usual practices targeted temperature reduction, antipyretic administration (87.8%), temperature monitoring (52.5%). Fewer evidence-based practices, such as encouraging fluids (49.0%) and light clothing (43.8%), were reported. Positive changes over time (36.4%) included less concern and delayed or reduced antipyretic use. Negative practice changes (22.7%) included greater concern and increased antipyretic use. Medical advice was sought for illness symptoms (48.7%) and high (37.4%) or persistent (41.5%) fevers. Fever management was learnt from doctors, family and friends and experience, while receiving conflicting information (41.9%) increased concerns and created uncertainty about best practice. Conclusion: Parents need consistent evidence-based information about childhood fever management. The Parental Fever Management Scale requires further testing with difference populations and in different cultures and healthcare systems to evaluate its usefulness in nursing practice and research

A Practical Approach to the Treatment of Low-Risk Childhood Fever

Fever is a common symptom of childhood infections that in itself does not require treatment. The UK’s National Institute for Health and Care Excellence (NICE) advises home-based antipyretic treatment for low-risk feverish children only if the child appears distressed. The recommended antipyretics are ibuprofen or paracetamol (acetaminophen). They are equally recommended for the distressed, feverish child; therefore, healthcare professionals, parents and caregivers need to decide which of these agents to administer if the child is distressed. This narrative literature review examines recent data on ibuprofen and paracetamol in feverish children to determine any clinically relevant differences between these agents. The data suggest that these agents have similar safety profiles in this setting and in the absence of underlying health issues, ibuprofen seems to be more effective than paracetamol at reducing NICE’s treatment criterion, ‘distress’ (as assessed by discomfort levels, symptom relief, and general behavior)