Parental Knowledge, Concerns, and Management of Childhood Fever in Taiwan

台灣父母對兒童發燒的知識、擔憂與處置

10.1097/JNR.0000000000000007

張麗娟(Li-Chuan Chang)；劉清泉(Ching-Chuan Liu)；黃美智(Mei-Chih Huang)

發燒 ； 發燒恐懼症 ； 健康照護 ； 父母 ； fever ； fever phobia ； healthcare ； parents

The Journal of Nursing Research

21卷4期（2013 / 12 / 01）

252 - 260

英文

背景　發燒是父母帶兒童就醫常會出現的狀況，國際許多研究指出父母有發燒恐懼症。然而在台灣有關父母對兒童發燒訊息的實證研究仍不足。目的　本研究旨在探究父母對兒童發燒的概念、擔憂與處置與其相關。方法　採用橫斷式調查研究法，自填問卷的方式，於台灣台南地區的小兒科診所及幼稚園共收集649位父母的問卷。結果　部份的父母（47.2%）對醫護人員所提供的發燒資訊不完全了解，41.6%對醫護人員所提供的發燒資訊不滿意。發燒知識總分23分，父母得分中位數為10分（四分位數間距 =〔8, 12〕），父母性別、宗教信仰、教育程度、職業等影響父母的發燒知識分數。不會擔心或是有時擔心孩子發燒的父母，其知識得分顯著高於總是擔憂的父母（知識分數中位數11分，四分位數間距 =〔9, 13〕相對於10分，四分位數間距 =〔8, 11〕）。大多數的父母對發燒處置遵循西方醫學建議，但仍有31.1%併用傳統民俗方式。86.6%的父母經常或總是擔憂孩子的發燒，68.8%的父母表示因發燒而焦慮。結論／實務應用　父母對發燒相關知識的誤解，部分原因是因為不了解或不滿意現有的兒童發燒相關訊息，與其他國家比較擔憂程度較高。本研究顯示，台灣父母需要適切的發燒處置資訊，以減輕父母的擔憂並引導他們居家照護發燒的孩子。

Background: Childhood fever is a commonly treated condition in medical settings. Many studies around the world have reported on the phenomenon of parental fever phobia. Studies of parental knowledge regarding childhood fever are lacking in Taiwan.Purpose: This study explores parental knowledge, concerns, and management of childhood fever and their correlates in Taiwan.Methods: This study used a cross-sectional survey and self-administered questionnaire. Six hundred forty-nine parents were recruited as participants from pediatric clinics and kindergartens in southern Taiwan.Results: Nearly half (47.2%) of participants incompletely understood the healthcare information about childhood fever provided by physicians and nurses. Furthermore, 41.6% of parents were dissatisfied with the information provided. The median score of parental knowledge was 10 (interquartile range [IQR] = [8, 12] out of a maximum of 23). Parent gender, religion, education level, and occupation were independent predictors of knowledge scores. Parents who were never or sometimes concerned about childhood fever had significantly higher knowledge scores than those who were always concerned about childhood fever (median knowledge score: 11, IQR = [9, 13] vs. 10, IQR = [8, 11]). Most parents followed Western medical advice to manage childhood fever; however, 31.1% of parents combined this with traditional folk treatments. Levels of concern among parents included 86.6% of parents who frequently or always worried about their children's fever. Fever-induced anxiety was reported by 68.8% of the parents.Conclusions/Implications for Practice: Participants' lack of fever-related knowledge was because, in part, of either their not understanding or their dissatisfaction with provided information. The higher level of concern compared with other countries and studies indicates that parents in Taiwan need appropriate information about fever management to alleviate their concerns and guide them in caring for their febrile children.

1. Taiwan Pediatric Association, Taiwan, ROC. (2011). Recommendations for the management of childhood fever. Retrieved from http://www.pediatr.org.tw/people/edu_info.asp?id=15 (Original work published in Chinese)
2. Al-Eissa, Y. A.,Al-Zaben, A. A.,Al-Wakeel, A. S.,Al-Alola, S. A.,Al-Shaalant, M. A.,Al-Amire, A. A.,Al-Shamsant, L. A.(2001).Physician's perceptions of fever in children: Facts and myths.Saudi Medical Journal,22(2),124-128.
3. Betz, M. G.,Grunfeld, A. F.(2006)."Fever phobia" in the emergency department: A survey of children's caregivers.European Journal of Emergency Medicine,13(3),129-133.
4. Blumenthal, I.(1997).Fever- Concepts old and new.Journal of the Royal Society of Medicine,90(7),391-394.
5. Broom, M.(2007).Physiology of fever.Paediatric Nursing,19(6),40-45.
6. Broome, M. E.,Dokken, D. L.,Broome, C. D.,Woodring, B.,Stegelman, M. F.(2003).A study of parent/grandparent education formanaging a febrile illness using the CALM approach.Journal of Pediatric Health Care,17(4),176-183.
7. Crocetti, M.,Moghbeli, N.,Serwint, J.(2001).Fever phobia revisited: Have parental misconceptions about fever changed in 20 years?.Pediatrics,107(6),1241-1246.
8. El-Radhi, A. S.(2008).Why is the evidence not affecting the practice of fever management?.Archives of Disease in Childhood,93(11),918-920.
9. Huang, M. C.、Shih, C. J.(2004)。Effects of fever education on changing parental concepts and management of fever in childhood。The Journal of Nursing，51(6)，34-38。
10. Jensen, J. F.,Tønnesen, L. L.,Söderström, M.,Thorsen, H.,Siersma, V.(2010).Paracetamol for feverish children: Parental motives and experiences.Scandinavian Journal of Primary Health Care,28(2),115-120.
11. Karwowska, A.,Nijssen-Jordan, C.,Johnson, D.,Davies, H. D.(2002).Parental and health care provider understanding of childhood fever: A Canadian perspective.Canadian Journal of Emergency Medicine,4(6),394-400.
12. Krantz, C.(2001).Childhood fevers: Developing an evidence-based anticipatory guidance tool for parents.Pediatric Nursing,27(6),567-573.
13. O''Neill-Murphy, K.,Liebman, M.,Barnsteiner, J. H.(2001).Fever education: Does it reduce parent fever anxiety?.Pediatric Emergency Care,17(1),47-51.
14. Poirier, M. P.,Collins, E. P.,McGuire, E.(2010).Fever phobia: A survey of caregivers of children seen in a pediatric emergency department.Clinical Pediatrics (Phildelphia),49(6),530-534.
15. Poirier, M. P.,Davis, P. H.,Gonzalez-del Rey, J. A.,Monroe, K. W.(2000).Pediatric emergency department nurses' perspectives on fever in children.Pediatric Emergency Care,16(1),9-12.
16. Purssell, E.(2009).Parental fever phobia and its evolutionary correlates.Journal of Clinical Nursing,18(2),210-218.
17. Rupe, A.,Ahlers-Schmidt, C. R.,Wittler, R.(2010).A comparison of perceptions of fever and fever phobia by ethnicity.Clinical Pediatrics (Philadelphia),49(2),172-176.
18. Sarrell, M.,Cohen, H. A.,Kahan, E.(2002).Physicians', nurses', and parents' attitudes to and knowledge about fever in early childhood.Patient Education and Counseling,46(1),61-65.
19. Sarrell, M.,Kahan, E.(2003).Impact of a single-session education program on parental knowledge of and approach to childhood fever.Patient Education and Counseling,51(1),59-63.
20. Schmitt, B. D.(1984).Fever in childhood.Pediatrics,74(5, Pt. 2),929-936.
21. Schmitt, B. D.(1980).Fever phobia: Misconceptions of parents about fevers.American Journal of Diseases of Children,134(2),176-181.
22. Soon, W. S.,Cheong, S. K.,Hong, C. Y.(2003).Fever phobia in a primary healthcare setting: A Singapore perspective.Annals of the Academy of Medicine, Singapore,32(5, Suppl),S26-S27.
23. Su, L. Y.(1978)。Survey of fevermanagement in Taichung County。The Journal of Hung Kuang University，6，181-209。
24. Tessler, H.,Gorodischer, R.,Press, J.,Bilenko, N.(2008).Unrealistic concerns about fever in children: The influence of culturalethnic and sociodemographic factors.The Israel Medical Association Journal,10(5),346-349.
25. Walsh, A. M.,Edwards, H.,Fraser, J.(2008).Parents' childhood fevermanagement: Community survey and instrument development.Journal of Advanced Nursing,63(4),376-388.
26. Walsh, A.,Edwards, H.,Courtney, M.,Wilson, J.,Monaghan, S.(2006).Paediatric fever management: Continuing education for clinical nurses.Nurse Education Today,26(1),71-77.
27. Walsh, A.,Edwards, H.,Fraser, J.(2007).Influences on parents' fevermanagement: Beliefs, experiences and information sources.Journal of Clinical Nursing,16(12),2331-2340.
28. Wang, Y. M.、Huang, M. C.(2008)。Using evidence-based nursing to explore the management of child fever。The Journal of Nursing，55(2)，10-15。
29. Yuan, C. J.(2010)。Taiwan, ROC，Nursing and Health Science, National Taipei University。

1. 李佳玲,吳映厲(2017)。照顧一位因蒙迪尼發育不良引起復發性腦膜炎病童之照護經驗。志為護理-慈濟護理雜誌，16(6)，127-136。