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

Context: Fever is a common symptom in children that nurses and pediatricians treat. Although it is a common sign in clinical practice, fever instills irrational fears in parents that health professionals share. Objective: To investigate whether doctors’ and nurses’ knowledge, perceptions, and attitudes toward fever influence how this sign is managed. Furthermore, it intends to evaluate whether educational programs increase knowledge and change attitudes and/or perceptions of nurses about children’s fever. Data Sources: A systematic review with meta-analysis was conducted with PRISMA international standards and the Cochrane recommendations. Study selection: Articles examining health professionals’ (doctors and/or nurses) knowledge, perceptions, and/or attitudes toward fever in children and the use of antipyretics were selected for the study. Data extraction: The qualitative analysis was carried out by classifying the articles according to the applied educational programs for nurses related to fever care for children that evaluated different outcomes to determine their efficacies. Results: For the qualitative synthesis, 41 articles were included, and 5 of these were taken in meta-analysis, which measured the effectiveness of educational programs for fever management in nurses. Limitations: All of the included studies generally had a high risk of bias. Conclusion: According to the evidence reviewed, nurses’ and physicians’ perceptions and attitudes regarding fever management in children indicate an overtreatment of this sign. We can give a recommendation grade of D on the use of educational programs to modify attitudes, perceptions, and knowledge about fever in children and improve clinical practice in nurses.

GAMBARAN PENGETAHUAN IBU TENTANG PERTOLONGAN PERTAMA KEGAWATDARURATAN DEMAN PADA BALITA DI POSYANDU SOKARAJA KULON

Fever is when the body temperature rises by 38 celcius degree. Fever in children is one of the reasons parents seek medical help to treat it. Fever management is very important to reduce the negative impact caused by fever. The aims of this studi was to determine the description of parental knowledge in first aid for fever emergencies in children. This research was a descriptive study and using cross sectional approach. Sampling was done by accidental sampling and data collection using a knowledge questionnaire of fever management with 16 questions. It was analysed by univariate analysis. Out of 20 respondent, the average value of the respondent’s knowledge was 12,25, with minimum score of 8 and maximum value of 16. The result of this research shows that all respondents would measure a chlid’s temperature using a thermometer when he had a fever, take his child to seek medical help when he was sick, and do a compress with warm water on a child who has fever.

Cross-sectional study of parental knowledge, behaviour and anxiety in management of paediatric fever among German parents

ObjectivesFever is a common symptom among children. Parental lack of knowledge about fever could cause anxiety and lead to unnecessary measures to subside fever. There is little evidence about German parents’ knowledge and their fever management.DesignA cross-sectional study using a paper-based questionnaire.Setting16 kindergartens in Saarbrücken and Saarlouis regional association accepted to participate in the study. Parents from these kindergartens were requested during the pickup time to answer the questionnaire.Participants481 German parents participated in the study, 394 of them were women. Inclusion criteria were good understanding of German and being a parent of at least one child below the age of 7 years.Primary and secondary outcome measuresKnowledge and behaviour of parents on paediatric fever management and the factors influencing fever anxiety.ResultsThe older the parents were, the more anxiety they reported. Their definition of fever had a wide range of 30°C–41°C (mean 38.46, SD=0.67) and almost 90% (mean 3.05, SD=2.03) of participants reported fever as useful, whereby they felt more confident the more they found fever useful. 69% of parents felt calm when their child has fever (mean 4.47, SD=2.27). In case of fever, 55% of parents administer paracetamol, 72% ibuprofen and 32% of them would alternate between the two. Paracetamol and ibuprofen are used more by more anxious parents. In explorative factor analysis, reasons to reduce temperature were summarised in three main factors: damage prevention, illness control and well-being protection, whereby the first two were positively related to parental anxiety.ConclusionsBoth knowledge as well as level of confidence/anxiety vary largely. Taking antipyretics is related to higher level of anxiety, indicating the need for further education. Fever anxiety depends on multiple factors, which have to be further investigated.

Knowledge, Attitude and Practices of Mothers towards Fever and Its Home Management among Under Five Children in Kom Hamada City, Behira Governorate, Egypt

Background: Fever is one of the most common presenting complaint in pediatric age and is the cause of nearly 70% of all pediatric clinic visits. Fever isn’t a disease but a symptom of disease, so we need to do more to communicate the message to parents. Aim: To assess knowledge, attitude and practices of mothers towards fever and its management at home among under five children and to find-out some factors influencing maternal knowledge, attitude and practices. Subjects and Methods: A cross sectional study was carried out in Maternity and Child Health Care Center in Kom Hamada city, Behira Governorate. A sample of 384 mothers was included in the study. The study was done via a pre-designed questionnaire sheet filled through direct interview with target mothers to assess their knowledge, attitude and practice regarding fever management of their under five children. Results: Most of the studied mothers had good knowledge (62%) and positive attitude (59.9%). But (39.3% and 38.8%) of them had bad and fair practice respectively. Bad practice was common in the age group 25-30, those having three or four children, urban residence and with decreased family income. Conclusion: The results found that awareness was relatively good. The study highlights the numerous misconceptions regarding fever management. So health education of mothers is needed to improve mother’s practice.

WHO Fever Management Guidelines: Challenges in Harnessing the Benefits During Covid-19 Pandemic

Fever remains an integral part of the acute clinical diseases management, esp. viral, for which effective therapeutics remain desired. However, the presence of often confusing fever reduction recommendations for COVID-19 in the public domain during the pandemic, as late as 28 April 2021, seems to suggest the reduction of any ‘uncomfortable’ fever ranging from 37.8 - 39oC, as opposed to WHO fever reduction guidelines (≥39oC), urgently need attention. The confusion could percolate down into different agencies who look up to these agencies for guidance in framing their own, denying the benefits of fever to populations, and effectively undo whatever successive WHO’s guidelines have achieved in the last two decades. The existence of conflicting guidelines in public domains which are open to interpretations has consequences to public health and the healthcare infrastructure, on implementation. For controlling acute infectious diseases, esp. viral, the fever remains the most important enabler. Historically, our chief obstacles to harnessing the benefits of fever in acute clinical diseases with limited therapeutics had been: a) widespread myths about ‘fevers’ arising from a general misunderstanding of basic facts; b) presence of confusing guidelines by different agencies which are open to alternate interpretation. The article attempts to briefly indicate the benefits of fever in disease resolution, dispel myths, underline vagueness in illustrative national guidelines and the need to align them with evidence-based WHO guidelines, as it has the potential to perpetuate myths/confusion in masses leading to adverse impact on disease management – more morbidity and mortality from diseases including COVID-19.