A qualitative interview study of parents’ perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care
A qualitative interview study of parents’ perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care
Abstract
Objective: To explore parents’ perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care.
Design: Qualitative semi-structured interview study.
Setting: UK primary care
Participants: 23 parents of children aged from six months to ten years presenting with LRTI in primary care.
Method: Thematic analysis of semi-structured interviews (either in person or by telephone) conducted with parents to explore their experiences and views on their children being prescribed antibiotics for LRTI.
Results: Four major themes were identified and these are perspectives on: 1) infection, 2) antibiotic use, 3) the GP appointment, and 4) decision-making around prescribing. Symptomatic relief was a key concern: the most troublesome symptoms were cough, breathing difficulty, fever and malaise. Many parents were reluctant to use self-care medication, tended to support antibiotic use, and believed they are effective for symptoms, illness duration and for preventing complications. However, parental expectations varied from a desire for reassurance and advice to an explicit preference for an antibiotic prescription. These preferences were shaped by: 1) the age of the child, with younger children perceived as more vulnerable because of their greater difficulty in communicating, and concerns about rapid deterioration; 2) the perceived severity of the illness; and 3) disruption to daily routine. When there was disagreement with the GP parents described feeling dismissed, and they were critical of inconsistent prescribing when they re-consult. When agreement between the parent and doctor featured, parents described a feeling of relief and legitimation for consulting, feeling reassured that the illness did indeed warrant a doctor’s attention.
Conclusion: Symptomatic relief is a major concern for parents. Careful exploration of expectations, and eliciting worries about key symptoms and impact on daily life will be needed to help parents understand when a no antibiotic recommendation or delayed antibiotic recommendation is made.
Halls, A.V.
75f2a817-41cf-4283-8276-2088d7d27429
Van't Hoff, C.I.
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Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, T.J.M.
cc355b92-ba85-4102-98a0-cee55f0504f6
Leydon, G.M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
September 2017
Halls, A.V.
75f2a817-41cf-4283-8276-2088d7d27429
Van't Hoff, C.I.
6b3af0b9-67b0-4398-9273-4533344acda7
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, T.J.M.
cc355b92-ba85-4102-98a0-cee55f0504f6
Leydon, G.M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Halls, A.V., Van't Hoff, C.I., Little, P., Verheij, T.J.M. and Leydon, G.M.
(2017)
A qualitative interview study of parents’ perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care.
BMJ Open, 7, [e015701].
(doi:10.1136/bmjopen-2016-015701).
Abstract
Abstract
Objective: To explore parents’ perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care.
Design: Qualitative semi-structured interview study.
Setting: UK primary care
Participants: 23 parents of children aged from six months to ten years presenting with LRTI in primary care.
Method: Thematic analysis of semi-structured interviews (either in person or by telephone) conducted with parents to explore their experiences and views on their children being prescribed antibiotics for LRTI.
Results: Four major themes were identified and these are perspectives on: 1) infection, 2) antibiotic use, 3) the GP appointment, and 4) decision-making around prescribing. Symptomatic relief was a key concern: the most troublesome symptoms were cough, breathing difficulty, fever and malaise. Many parents were reluctant to use self-care medication, tended to support antibiotic use, and believed they are effective for symptoms, illness duration and for preventing complications. However, parental expectations varied from a desire for reassurance and advice to an explicit preference for an antibiotic prescription. These preferences were shaped by: 1) the age of the child, with younger children perceived as more vulnerable because of their greater difficulty in communicating, and concerns about rapid deterioration; 2) the perceived severity of the illness; and 3) disruption to daily routine. When there was disagreement with the GP parents described feeling dismissed, and they were critical of inconsistent prescribing when they re-consult. When agreement between the parent and doctor featured, parents described a feeling of relief and legitimation for consulting, feeling reassured that the illness did indeed warrant a doctor’s attention.
Conclusion: Symptomatic relief is a major concern for parents. Careful exploration of expectations, and eliciting worries about key symptoms and impact on daily life will be needed to help parents understand when a no antibiotic recommendation or delayed antibiotic recommendation is made.
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Accepted/In Press date: 19 July 2017
e-pub ahead of print date: 15 September 2017
Published date: September 2017
Identifiers
Local EPrints ID: 412788
URI: http://eprints.soton.ac.uk/id/eprint/412788
ISSN: 2044-6055
PURE UUID: d8c845c0-8003-4fa1-af0c-811b2cb08fca
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Date deposited: 01 Aug 2017 16:31
Last modified: 16 Mar 2024 05:34
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Author:
C.I. Van't Hoff
Author:
T.J.M. Verheij
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