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Childhood fever: a qualitative study on GPs' experiences during out-of-hours care

Childhood fever: a qualitative study on GPs' experiences during out-of-hours care
Childhood fever: a qualitative study on GPs' experiences during out-of-hours care
Background. Fever in children is common and mostly caused by self-limiting infections. However, parents of febrile children often consult in general practice, in particular during out-of-hours care. To improve management, it is important to understand experiences of GPs managing these consultations.

Objective. To describe GPs? experiences regarding management of childhood fever during out-of-hours care.

Methods. A descriptive qualitative study using purposeful sampling, five focus group discussions were held among 37 GPs. Analysis was based on constant comparative technique using open and axial coding.

Results. Main categories were: (i) Workload and general experience; (ii) GPs? perceptions of determinants of consulting behaviour; (iii) Parents? expectations from the GP?s point of view; (iv) Antibiotic prescribing decisions; (v) Uncertainty of GPs versus uncertainty of parents and (vi) Information exchange during the consultation. GPs felt management of childhood fever imposes a considerable workload. They perceived a mismatch between parental concerns and their own impression of illness severity, which combined with time?pressure can lead to frustration. Diagnostic uncertainty is driven by low incidences of serious infections and dealing with parental demand for antibiotics is still challenging.

Conclusion. Children with a fever account for a high workload during out-of-hours GP care which provides a diagnostic challenge due to the low incidence of serious illnesses and lacking long-term relationship. This can lead to frustration and drives antibiotics prescription rates. Improving information exchange during consultations and in the general public to young parents, could help provide a safety net thereby enhancing self-management, reducing consultations and workload, and subsequent antibiotic prescriptions.
Antibiotics, child, family
0263-2136
449-455
Bont, Eefje G P M de
5d2d1ae1-f78c-4773-8581-f374ea2a314e
Peetoom, Kirsten K B
b2b45683-0e4f-4fc5-b5ae-35e44c66e1bd
Moser, Albine
a2f6f19e-2cd4-40b0-8665-c5522a4bfb13
Francis, Nicholas
9b610883-605c-4fee-871d-defaa86ccf8e
Dinant, Geert-Jan
7d19eddd-8d85-4095-a68a-07e6babfb84e
Cals, Jochen W L
ec7f8605-c306-4ce0-a833-a290c963c1cf
Bont, Eefje G P M de
5d2d1ae1-f78c-4773-8581-f374ea2a314e
Peetoom, Kirsten K B
b2b45683-0e4f-4fc5-b5ae-35e44c66e1bd
Moser, Albine
a2f6f19e-2cd4-40b0-8665-c5522a4bfb13
Francis, Nicholas
9b610883-605c-4fee-871d-defaa86ccf8e
Dinant, Geert-Jan
7d19eddd-8d85-4095-a68a-07e6babfb84e
Cals, Jochen W L
ec7f8605-c306-4ce0-a833-a290c963c1cf

Bont, Eefje G P M de, Peetoom, Kirsten K B, Moser, Albine, Francis, Nicholas, Dinant, Geert-Jan and Cals, Jochen W L (2015) Childhood fever: a qualitative study on GPs' experiences during out-of-hours care. Family Practice, 32 (4), 449-455. (doi:10.1093/fampra/cmv029).

Record type: Article

Abstract

Background. Fever in children is common and mostly caused by self-limiting infections. However, parents of febrile children often consult in general practice, in particular during out-of-hours care. To improve management, it is important to understand experiences of GPs managing these consultations.

Objective. To describe GPs? experiences regarding management of childhood fever during out-of-hours care.

Methods. A descriptive qualitative study using purposeful sampling, five focus group discussions were held among 37 GPs. Analysis was based on constant comparative technique using open and axial coding.

Results. Main categories were: (i) Workload and general experience; (ii) GPs? perceptions of determinants of consulting behaviour; (iii) Parents? expectations from the GP?s point of view; (iv) Antibiotic prescribing decisions; (v) Uncertainty of GPs versus uncertainty of parents and (vi) Information exchange during the consultation. GPs felt management of childhood fever imposes a considerable workload. They perceived a mismatch between parental concerns and their own impression of illness severity, which combined with time?pressure can lead to frustration. Diagnostic uncertainty is driven by low incidences of serious infections and dealing with parental demand for antibiotics is still challenging.

Conclusion. Children with a fever account for a high workload during out-of-hours GP care which provides a diagnostic challenge due to the low incidence of serious illnesses and lacking long-term relationship. This can lead to frustration and drives antibiotics prescription rates. Improving information exchange during consultations and in the general public to young parents, could help provide a safety net thereby enhancing self-management, reducing consultations and workload, and subsequent antibiotic prescriptions.

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More information

Published date: 25 April 2015
Keywords: Antibiotics, child, family

Identifiers

Local EPrints ID: 436489
URI: http://eprints.soton.ac.uk/id/eprint/436489
ISSN: 0263-2136
PURE UUID: 7b901230-d348-4d78-a3ab-fb13ddc45773
ORCID for Nicholas Francis: ORCID iD orcid.org/0000-0001-8939-7312

Catalogue record

Date deposited: 11 Dec 2019 17:30
Last modified: 09 Jan 2022 04:08

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Contributors

Author: Eefje G P M de Bont
Author: Kirsten K B Peetoom
Author: Albine Moser
Author: Geert-Jan Dinant
Author: Jochen W L Cals

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