Predictors of parents' intentions to reduce childhood fevers

Abstract

Background
Parents concerns about and immunological benefits of mild to moderate fevers have been reported for 25 years. Recent reports indicate practices of alternating antipyretics when fever has not reduced sufficiently.

Purpose
The purpose of this study was to explore the predictors of Australian parents’ intentions to reduce childhood fevers by non-pharmacological and pharmacological methods.

Method
A crossectional survey of 397 parents of children aged between 6-months and 5-years was undertaken. An instrument developed from literature, findings from focused discussions with 15 parents and existing instruments was used. Instrument face, content and construct validity were determined by an expert panel and readability by 10 parents. Predictors of intention to reduce fever, reduce fevers with antipyretics and reduce fevers of 38.0 degrees Celsius or below were determined through the Theory of Planned Behavior. Predictors explored were parents’ beliefs about benefits of reducing fever, normative influences on reducing fever and reducing fever with antipyretics and perceived control over fever management.

Results
Simultaneous regressions were conducted. Beliefs (β=.42) and norms relating to fever reduction (β=.16) were strongest predictors of intentions to reduce fever R2=.27, F[4,392]=36.11, p=<.001. Norms about reducing fevers with antipyretics (β=.47) and beliefs (β=.37) positively influenced intentions to reduce fevers with antipyretics R2=.34, F[4,392]=50.13, p=<001 and norms about fever reduction had a negative influence (β=-.20). Predictors of intentions to reduce fevers of 38.0°C or below were weaker R2=.14, F[4,392]=16.55, p=<.001, however, beliefs (β=.24) and norms about reducing fevers with antipyretics (β=.29) predicted this practice.

Conclusions
Negative beliefs about fever and fever management and normative influences were the strongest predictors of parents’ fever management intentions. These findings highlight the need to target all parents’ beliefs about fever and its benefits and correct norms relating to reducing fever and the dangers of unnecessary and/or overuse of antipyretics in children with a febrile illness.