Fatma Tuba YILDIRIM, Burcu ÖZKAN, Özgen HÜR, Mesut KOÇAK, Şanlıay ŞAHİN, Ali Osman KÖKSAL, Mehtap ACAR, Şerife YILMAZ, Osman ÖZDEMİR, Aslıhan YILMAZ ARASLI

Mother approaches to children with fever

Amaç: Çocukluk çağının en yaygın bulgularından biri olan ateş ailelerin en çok endişe duydukları ve nedenini bir an önce bilmek istedikleri bir yakınma olup acil servis başvurularının da önemli bir kısmını oluşturmaktadır. Bu çalışmada, çocuklarını ateş yakınması ile getiren ailelerin ateş konusundaki bilgileri, tutumları, ateş düşürücü ilaç kullanma durumları, verilen ateş düşürücü ilaç dozları ve bunları etkileyen faktörlerin incelenmesi amaçlanmıştır. Yöntem: Çalışmaya 1 31 Mart 2014 tarihleri, 08.00 16.00 saatleri arasında hastanemiz Çocuk Acil Servisine ateş yakınması ile getirilen, bilinen kronik hastalığı olmayan ve verilen anket formunu doldurmayı kabul eden 300 çocuğun annesi alınmıştır. Bulgular: Çalışmaya alınan 300 olgunun 127si (%42,3) kız, 173ü (%57,7) erkek ve %52si üç yaş ve altında idi. Annelerin %96sının ateşin çocuk için zararlı olduğunu düşündüğü ve %95inin ateşten en sık korkma nedeninin çocuğunun havale geçirme riski olduğu öğrenildi. Eğitim düzeyi arttıkça annelerin evde ateş ölçme oranının daha yüksek olduğu saptandı (p = 0,01). Annelerin yarısından fazlasının saatte bir ateş ölçtüğü, ancak ateş ölçüm sıklığının annelerin eğitim düzeylerinden bağımsız olduğu görüldü (p = 0,76). Doktor önerisi ile ateş düşürücü verme oranının annelerin eğitim düzeyi düştükçe istatistiksel olarak arttığı saptandı (p < 0,01). Doktor önerisi olmadan antibiyotik kullanım oranı erkek çocuğu olan annelerde, kız çocuk sahibi annelere göre anlamlı olarak yüksek bulundu (p = 0,02). Sonuç: Annelerde ateş korkusunun yaygın olduğu, bu endişe halinin ateşli çocuğa yaklaşımı olumsuz etkilediği, yanlış uygulamalar ve gereksiz acil servis başvurularını artırdığı saptanmıştır. Annelerin bilgi eksikliğinden kaynaklanan bu durumların düzeltilmesi için sağlık çalışanları ateşle ilgili bilgileri hastane başvuruları esnasında annelere birebir vermelidirler. Ayrıca kitle iletişim araçları kullanılarak düzenlenecek sağlık eğitim programları yardımıyla daha çok kişiye ulaşılarak annelerin ateşe yönelik korkuları azaltılabilir ve hatalı uygulamaların önlenmesine katkıda bulunulabilir. Ancak tüm bu bilgilendirme ve eğitimlerin ne şekilde yapılması gerektiği ve bu girişimlerin sonuçları hakkında daha fazla çalışmaya ihtiyaç vardır.

Ateşi olan çocuklarda anne yaklaşımları

Objective: Fever, one of the most common symptoms of childhood, is a complaint that the families worried about the most. The families want to know its reason, and it constitutes a significant part of visits to emergency department. In this study, it has been aimed to investigate the knowledge, attitude, antipyretic drug status of the families who bring their children with the complaint of fever, the doses of antipyretic drug and the factors affecting them. Methods: The mothers of 300 children without known chronic disease, who were brought to the Children's Emergency Department of our hospital with complaints of fever between 1-31 March and between the hours of 08:00 to 16:00 and who agreed to complete a questionnaire, were included in the study. Results: One hundred and twenty-seven (42.3%), 173 (57.7%) and 52% of 300 patients enrolled in the study were female, male and under the age of three, respectively. It has been determined that 96% of mothers thought that fever was harmful to children and the cause of the most common fear due to fever for 95% of them was the risk of febrile convulsion. As the level of education of mothers was increasing, the rate of measuring the temperature at home was found to be higher (p = 0.01). It has been observed that more than half of the mothers measured the temperature once an hour, but the frequency of temperature measurement was independent of mothers' education level (p = 0.76). It has been determined that the statistical rate of giving antipyretic with the recommendation of a doctor significantly increased as the maternal education level decreased (p < 0.01). The rate of usingantibiotics without a doctor's recommendation was significantly higher in mothers having sons than mothers having daughters (p = 0.02). Conclusion: It has been determined that the fear of fever was common in mothers; this concern has negatively affected the state of children with fever, increased unnecessary visits and unnecessary treatments of the emergency department. Health workers should inform the mothers one to one about fever during hospital admission in order to rectify this situation caused by the mothers lack of knowledge. In addition, the fear of mothers about fever may be reduced by using the mass media with the help of health education programs, which will be organized, by reaching more people and this contributes to the prevention of erroneous procedures. However, more studies are needed to be conducted on how all of these information and training should be done and the effectiveness of these initiatives.

PDF

___

1. Lopez JA, McMillin KJ, Tobias-Merrill EA, Chop WM Jr. Managing fever in infants and toddlers: toward a standard of care. Postgrad Med 1997; 101: 241-2, 245-52.
2. Yiğit R, Esenay F, Şen E, Serinol Z. Mothers information and applications about high fever [Turkish article]. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi 2003; 6: 48-56.
3. Esenay FI, İşler A, Kurugöl Z, Conk Z, Koturoğlu G. Mothers approach to feverish child and fever phobia [Turkish article]. Turk Arch Ped 2007; 42: 57-60.
4. Crocetti M, Moghbeli N, Serwint J. Fever phobia revisited: have parental misconceptions about fever changed in 20 years? Pediatrics 2001; 107: 1241-6.
5. Cuzzolin L, Zaffani S, Murgia V, Gangemi M, Meneghelli G, Chiamenti G, Benoni G. Patterns and perceptions of complementary/alternative medicine among paediatricians and patients' mothers: a review of the literature. Eur J Pediatr 2003; 162: 820-7.
6. Karwowska A, Nijssen-Jordan C, Johnson D, Davies HD. Parental and health care provider understanding of childhood fever: a Canadian perspective. CJEM 2002; 4: 394-400.
7. Betz MG, Grunfeld AF. Fever phobia in the emergency department: a survey of childrens caregivers. Eur J Emerg Med 2006; 13: 129-33.
8. Luszczak M. Evaluation and management of infants and young children with fever. Am Fam Physician 2001; 64: 1219-26.
9. Kramer MS, Shapiro ED. Management of the young febrile child: a commentary on recent practice guidelines. Pediatrics 1997; 100: 128-34.
10. McErlean M, Bartfield JM, Kennedy DA, Gilman EA, Stram RL, Raccio- Robak N. Home antipyretic use in children brought to the emergency department. Pediatr Emerg Care 2001; 17: 249-51.
11. Demir M, Bayat M. 0-5 Age Group Infants Brought in to Tokat Karşıyaka Maternity and Infant Hospital Emergency Service owing to high temperature ailments and their mothers attitude and knowledge about high temperature [Turkish article]. Journal of Health Sciences 2005; 14: 22-9.
12. Devrim I, Kara A, Ceyhan M, Tezer H, Uludağ AK, Cengiz AB, Yiğitkanl I, Seçmeer G. Measurement accuracy of fever by tympanic and axillary thermometry. Pediatr Emerg Care 2007; 23: 16-9.
13. Schmitt BD. Fever phobia: Misconceptions of parents about fevers. Am J Dis Child 1980; 134: 176-81.
14. ONeill-Murphy K, Liebman M, Barnsteiner JH. Fever education: does it reduce parent fever anxiety? Pediatr Emerg Care 2001; 17: 47-51.
15. Halıcıoğlu O, Koç F, Aşık Akman S, Teyin A. In feverish children; mothers' knowledge and home management about fever and its relationship with sociodemographical characteristics. Behcet Uz Cocuk Hast Derg 2011; 1: 13-9.
16. Arıkan Z, Tekşam Ö, Kara A, Kale G. Determining causes and frequency of misdosing of antipyretics in patients presenting with fever to pediatric emergency [Turkish article]. Turk Arch Ped 2012; 47: 114-8.
17. Section on Clinical Pharmacology andTherapeutics; Committee on Drugs, Sullivan JE, Farrar HC. Fever and antipyretic use in children. Pediatrics 2011; 127: 580-7.
18. van Stuijvenberg M, de Vos S, Tjiang GC, Steyerberg EW, Derksen-Lubsen G, Moll HA. Parents fear regarding fever and febrile seizures. Acta Paediatr 1999; 88: 618-22.
19. Eliaçık K, Kanık A, Oyman G, Rastgel H, Güngör S, Anıl M, Helvacı M, Bakiler AR. Knowledge, belief and misconceptions of the parents about fever [Turkish article]. Journal of ADU Medical Faculty 2012; 13: 5-7.
20. Demir F, Torun SD, Cebe E, Aydın Y, Gümüşlü B. Knowledge, attitudes and beliefs concerning fever in Kazim Karabekir a district area of Umraniye [Turkish article]. TAF Prev Med Bull 2007; 6: 69-76.
21. Çöl Araz N. Parents approach to fever in childhood: knowledge, attitudes and applications [Turkish article]. Turkish J Pediatr Dis 2013; 1: 27-32.
22. Özkan H, Öztürk S. The applications made by mothers applying to two family health centres in Eastern Anatolia region when their children had fever [Turkish article]. Behcet Uz Cocuk Hast Derg 2013; 3: 121-6.
23. Şen Celasin N, Ergin D, Atman Ü. Attitudes and knowledge concerning high temperature of mothers have 0-6 age group infants who are hospitalized due to high temperature ailments [Turkish article]. F.Ü. Sağ Bil Derg 2008; 22: 315-22.
24. Çiftdoğan DY, Gönülal DA, İkizoğlu HT, Onağ A. Efficacy of ibuprofen use after paracetamol on fever control in febrile children [Turkish article]. Ege Pediatri Bülteni 2008; 15: 69-74.
25. Vernacchio L, Kelly JP, Kaufman DW, Mitchell AA. Medication use among children _____12 years of age in the United States: results from the Sloane Survey. Pediatrics 2009; 124: 446-54.
26. de Vires F, Setakis E, van Staa TP. Concomitant use of ibuprofen and paracetamol and the risk of major clinical safety outcomes. Br J Clin Pharmacol 2010; 70: 429-38.
27. Martens ME, Lee CP. Reye's syndrome: salicylates and mitochondrial functions. Biochem Pharmacol 1984; 33: 2869-76.
28. Saz EU, Koturoğlu G, Duyu M, Ozananar Y, Kurugöl Z, Sever M. Fears of fever and fever management in Turkish families [Turkish article]. J Pediatr Inf 2009; 3: 161-4.
29. Matziou V, Brokalaki H, Kyritsi H, Perdikaris P, Gymnopoulou E, Merkouris A. What Grek mothers know about evaluation and treatment of fever in children: an interview study. Int J Nurs Stud 2008; 45: 829-36.
30. Hixson R, Franke U, Mittal R, Hamilton M. Parental calculation of pediatric paracetamol dose: a randomized trial comparing the Parental Analgesia Slide with product information leaflets. Paediatr Anaesth 2010; 20: 612-9.
31. Yin HS, Mendelsohn AL, Fierman A, van Schaick L, Bazan IS, Dreyer BP. Use of a pictographic diagram to decrease parent dosing errors with infant acetaminophen: a health literacy perspective. Acad Pediatr 2011; 11: 50-7.