Thesis (M.S.P.H.)--University of Michigan, 1942.

Thesis (M.S.P.H.)--University of Michigan, 1942.

Caregivers often associate fevers with permanent harm and bring children to emergency departments (EDs) unnecessarily. However, families using EDs for nonurgent complaints often have difficulty accessing quality primary care. Mutual misconceptions among caregivers and healthcare providers regarding nonurgent ED use are a barrier to implementing meaningful interventions. The purpose of this project was to identify dominant themes in caregivers’ narratives about bringing children to the ED for nonurgent fevers. Thirty caregivers were recruited in a pediatric ED for participation in qualitative semi-structured interview from August to November 2014. Interview transcripts were coded and analyzed for themes. Caregivers’ decisions to come to the ED revolved around their need for reassurance that children were not in danger. Several major themes emerged: caregivers came to the ED when they felt they had no other options; parents feared that fevers would result in seizures; caregivers frequently drew on family members and the internet for health information; and many families struggled to access their PCPs for sick care due to challenging family logistics. Reducing nonurgent ED utilization requires interventions at the individual and structural level. Individual-level interventions should empower caregivers to manage fevers and other common illnesses at home. However, such interventions may have limited impact on utilization outcomes among families with poor access to primary care. Afterhours primary care should be expanded to accommodate families with rigid work schedules and limited transportation resources.

Bakgrund: Hos barn i åldern noll till fem år är feber ett vanligt symtom vid sjukdom. Det är därför viktigt att vårdnadshavare förstår betydelsen av egenvård för att kunna ta hand om sitt barn i sin hemmiljö. Syfte: Syftet var att belysa barnhälsovårdssjuksköterskans preventiva arbete för barn med feber. Metod: Vald metod var kvalitativ design med induktiv ansats. Intervjuer av 11 specialistutbildade sjuksköterskor innefattande distriktssköterskor samt sjuksköterskor med specialistutbildning inom hälso- och sjukvård av barn och ungdomar. Barnhälsovårdssjuksköterskor (BHV-sjuksköterskor) i både privat samt regional regi deltog från två Halländska kommuner. Resultat: Tre kategorier: Information till vårdnadshavare, stöd till vårdnadshavare och egenvårdsrådgivning utgjorde resultatet. Därefter tillkom underkategorier. Likvärdigt resultat har kunnat ses hos deltagande BHV-sjuksköterskor. Konklusion: Slutsatsen var att majoriteten av BHV-sjuksköterskorna ansåg att det fanns ett stort behov av egenvårdsutbildning om barn med feber för vårdnadshavare. Goda kunskaper om egenvård av barn med feber kan troligtvis förhindra en del besök till akutmottagning. / Background: In children aged zero to five years, fever is a common symptom of illness. It is therefore essential that the caregiver understands the importance of self-care to effectively care for their child at home. Aim: The aim was to illuminate the preventive efforts of the child health care nurse for children with fever. Method: The chosen method was qualitative design with an inductive approach. Interviews of 11 specialist nurses including district nurses and nurses with specialist training in health care of children and adolescents. Child health Care nurses (CHC nurses) in both private and regional management participated from two municipalities in Halland. Results: Three categories: Information to guardians, support to guardians and self-care counselling constituted the result. Subcategories were then added. Similar results have been seen in participating child health nurses. Conclusion: The conclusion was that the majority of the child health care nurses felt there was a significant need for self-care education regarding children with fever for caregivers. Good knowledge of self-care of children with fever can probably prevent some visits to the emergency department.