Parents’ concerns and beliefs about temperature measurement in children: a qualitative study

Abstract Background Nearly 40% of parents with children aged 6 to 17 months consult a healthcare professional when their child has a high temperature. Clinical guidelines recommend temperature measurement in these children, but little is known about parents’ experiences of and beliefs about temperature measurement. This study aimed to explore parents’ concerns and beliefs about temperature measurement in children. Methods Semi-structured qualitative interviews were conducted from May 2017 to June 2018 with 21 parents of children aged 4 months to 5.5 years, who were purposively sampled from the METRIC study (a method comparison study comparing non-contact infrared thermometers to axillary and tympanic thermometers in acutely ill children). Data analysis followed a thematic approach. Results Parents described the importance of being able to detect fever, in particular high fevers, and how this then influenced their actions. The concept of “accuracy” was valued by parents but the aspects of performance which were felt to reflect accuracy varied. Parents used numerical values of temperature in four main ways: determining precision of the thermometer on repeat measures, detecting a “bad” fever, as an indication to administer antipyretics, or monitoring response to treatment. Family and social networks, the internet, and medical professionals and resources, were all key sources of advice for parents regarding fever, and guiding thermometer choice. Conclusions Temperature measurement in children has diagnostic value but can either empower, or cause anxiety and practical challenges for parents. This represents an opportunity for both improved communication between parents and healthcare professionals, and technological development, to support parents to manage febrile illness with greater confidence in the home.

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Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability

British Journal of General Practice ◽

10.3399/bjgp20x708845 ◽

2020 ◽

Vol 70 (693) ◽

pp. e236-e244 ◽

Cited By ~ 2

Author(s):

Gail Hayward ◽

Jan Y Verbakel ◽

Fatene Abakar Ismail ◽

George Edwards ◽

Kay Wang ◽

...

Keyword(s):

Primary Care ◽

Qualitative Interviews ◽

Method Comparison ◽

Paediatric Population ◽

Temperature Measurements ◽

Poor Agreement ◽

Willingness To Adopt ◽

Qualitative Component ◽

Method Comparison Study ◽

Parents Experiences

BackgroundGuidelines recommend measuring temperature in children presenting with fever using electronic axillary or tympanic thermometers. Non-contact thermometry offers advantages, yet has not been tested against recommended methods in primary care.AimTo compare two different non-contact infrared thermometers (NCITs) to axillary and tympanic thermometers in children aged ≤5 years visiting their GP with an acute illness.Design and settingMethod comparison study with nested qualitative component.MethodTemperature measurements were taken with electronic axillary (Welch Allyn SureTemp®), electronic tympanic (Braun Thermoscan®), NCIT Thermofocus® 0800, and NCIT Firhealth Forehead. Parents rated acceptability and discomfort. Qualitative interviews explored parents’ experiences of the thermometers.ResultsIn total, 401 children were recruited (median age 1.6 years, 50.62% male). Mean difference between the Thermofocus NCIT and axillary thermometer was −0.14°C (95% confidence interval [CI] = −0.21 to −0.06°C); lower limit of agreement was −1.57°C (95% CI = −1.69 to −1.44°C) and upper limit 1.29°C (95% CI = 1.16 to 1.42°C). A second NCIT (Firhealth) had similar levels of agreement; however, the limits of agreement between tympanic and axillary thermometers were also wide. Parents expressed a preference for the practicality and comfort of NCITs, and were mostly negative about their child’s experience of axillary thermometers. But there was willingness to adopt whichever device was medically recommended.ConclusionIn a primary care paediatric population, temperature measurements with NCITs varied by >1°C compared with axillary and tympanic approaches. But there was also poor agreement between tympanic and axillary thermometers. Since clinical guidelines often rely on specific fever thresholds, clinicians should interpret peripheral thermometer readings with caution and in the context of a holistic assessment of the child.

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Preview Rapid Strep A Test Method Comparison Study

Case Medical Research ◽

10.31525/ct1-nct03907449 ◽

2019 ◽

Author(s):

Keyword(s):

Method Comparison ◽

Test Method ◽

Comparison Study ◽

Method Comparison Study

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Evaluation of point‐of‐care testing device for anemia detection: A cross‐sectional method comparison study from Thailand

Journal of Clinical Laboratory Analysis ◽

10.1002/jcla.23976 ◽

2021 ◽

Author(s):

Wittawat Chantkran ◽

Pitipat Jamnarnwej ◽

Pipat Sritanabutr ◽

Pasra Arnutti

Keyword(s):

Point Of Care ◽

Method Comparison ◽

Testing Device ◽

Comparison Study ◽

Point Of Care Testing ◽

Cross Sectional ◽

Method Comparison Study

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Diagnostic Value of Clinical Features to Distinguish Enteric Fever From Other Febrile Illnesses in Bangladesh, Nepal, and Pakistan

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1297 ◽

2020 ◽

Vol 71 (Supplement_3) ◽

pp. S257-S265 ◽

Cited By ~ 3

Author(s):

Kristen Aiemjoy ◽

Dipesh Tamrakar ◽

Shampa Saha ◽

Shiva R Naga ◽

Alexander T Yu ◽

...

Keyword(s):

Blood Culture ◽

Clinical Features ◽

Diagnostic Performance ◽

Enteric Fever ◽

Random Effect ◽

Clinical Signs ◽

Febrile Illness ◽

Diagnostic Value ◽

Case Definition ◽

Mixed Effect

Abstract Background Enteric fever, a bacterial infection caused by Salmonella enterica serotypes Typhi and Paratyphi A, frequently presents as a nonlocalizing febrile illness that is difficult to distinguish from other infectious causes of fever. Blood culture is not widely available in endemic settings and, even when available, results can take up to 5 days. We evaluated the diagnostic performance of clinical features, including both reported symptoms and clinical signs, of enteric fever among patients participating in the Surveillance for Enteric Fever in Asia Project (SEAP), a 3-year surveillance study in Bangladesh, Nepal, and Pakistan. Methods Outpatients presenting with ≥3 consecutive days of reported fever and inpatients with clinically suspected enteric fever from all 6 SEAP study hospitals were eligible to participate. We evaluated the diagnostic performance of select clinical features against blood culture results among outpatients using mixed-effect regression models with a random effect for study site hospital. We also compared the clinical features of S. Typhi to S. Paratyphi A among both outpatients and inpatients. Results We enrolled 20 899 outpatients, of whom 2116 (10.1%) had positive blood cultures for S. Typhi and 297 (1.4%) had positive cultures for S. Paratyphi A. The sensitivity of absence of cough was the highest among all evaluated features, at 65.5% (95% confidence interval [CI], 55.0–74.7), followed by measured fever at presentation at 59.0% (95% CI, 51.6–65.9) and being unable to complete normal activities for 3 or more days at 51.0% (95% CI, 23.8–77.6). A combined case definition of 3 or more consecutive days of reported fever and 1 or more of the following (a) either the absence of cough, (b) fever at presentation, or (c) 3 or more consecutive days of being unable to conduct usual activity--yielded a sensitivity of 94.6% (95% CI, 93.4–95.5) and specificity of 13.6% (95% CI, 9.8–17.5). Conclusions Clinical features do not accurately distinguish blood culture–confirmed enteric fever from other febrile syndromes. Rapid, affordable, and accurate diagnostics are urgently needed, particularly in settings with limited or no blood culture capacity.

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