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Development and evaluation of a hospital discharge information package to empower parents in caring for a child with a fever
  1. Josephine S van de Maat1,
  2. Daphne van Klink1,
  3. Anine den Hartogh-Griffioen1,
  4. Eva Schmidt-Cnossen2,
  5. Hester Rippen2,
  6. Amber Hoek3,
  7. Sarah Neill4,
  8. Monica Lakhanpaul5,
  9. Henriette A Moll1,
  10. Rianne Oostenbrink1
  1. 1 Department of General Paediatrics, Erasmus Medical Centre – Sophia Children’s Hospital, Rotterdam, The Netherlands
  2. 2 Stichting Kind en Ziekenhuis, Utrecht, The Netherlands
  3. 3 Emergency Department, Erasmus Medical Centre, Rotterdam, The Netherlands
  4. 4 Faculty of Health and Society, University of Northampton, Northampton, UK
  5. 5 UCL Great Ormond Street Institute of Child Health, London, UK
  1. Correspondence to Dr Rianne Oostenbrink; r.oostenbrink{at}


Objectives First, to explore parents’ views on and experiences of managing their febrile child and to assess their behaviour and needs when in search of information about fever; second, to develop and evaluate a hospital discharge information package about fever in children.

Design Mixed methods: (A) qualitative study with semistructured interviews and a focus group discussion (FGD) and (B) quantitative survey.

Setting Emergency department, non-acute hospital setting and day nursery in Rotterdam, The Netherlands.

Participants Parents of children <18 years (interviews, n=22) parents of children under 5 years (FGD (n=14), survey (n=38)).

Intervention Information package about fever in children (leaflet and website including videos).

Outcome measures quantitative survey Knowledge of fever and confidence in caring for a febrile child (Likert scale 0–5).

Results Parents found fever mostly alarming, especially high fever. Help-seeking behaviour was based on either specific symptoms or on an undefined intuition. When parents did not feel recognised in their concern or felt criticised, anxiety increased as well as the threshold to seek healthcare for future illnesses. Information was needed, especially for situations when the general practitioner or social network were less easily available. This information should be reliable, consistent, available in multiple formats and include advice on management of fever at home and precise referral to medical services. Parents reported improved knowledge about fever (p<0.05) and mentioned improved confidence in caring for a child with fever at home after consulting the information package.

Conclusion Parents of children with a fever visiting the hospital are concerned about specific symptoms or based on an undefined intuition. Rather than telling parents that they should manage their child’s illness at home, healthcare professionals should recognise parental intuition and provide clear information on alarming signs and potential diagnoses to empower parents in the management of their febrile child.

  • paediatrics
  • qualitative research
  • infectious diseases

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  • Contributors JSvdM supervised the interviews, conducted the focus group discussion (FGD), was responsible for the analyses and the main author of the paper. DvK conducted the interviews, assisted in the focus group discussion, transcribed all interviews and the FGD and assisted in analyses of the qualitative data and writing of the paper. AdH-G was responsible for the data collection and analyses of the quantitative survey. ES-C and HR were responsible for protocol development, preparation and conduction of the FGD. AH was responsible for the production of the website and videos of the information package and editing of the paper. SN had a main contribution to the interpretation of the results and the editing of the paper. ML was responsible for protocol development interpretation of the results and editing of the paper. HAM supervised the protocol development, analyses and writing of the paper. RO was responsible for protocol development and supervised the data collection, analyses and writing of the paper.

  • Funding This work was supported by Stichting Coolsingel, grant number 485, and by The Netherlands Organization for Health Research and Development (ZonMW), grant number836041001 .

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Ethics approval The Erasmus Medical Centre review board (Rotterdam) considered the study not subject to the Medical Research Involving Human Subjects Act (WMO).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.