Fever Phobia as a Reason for Pediatric Emergency Department Visits: Does the Primary Care Physician Make a Difference?

BACKGROUND Fever is a source of considerable parental anxiety. Numerous studies have also confirmed similar anxiety among health care workers. This study analyzed caregiver knowledge of fever, and beliefs concerning children with a febrile illness, with an emphasis on the referring physician. METHODS This was a cross-sectional study of 100 caregivers of children 3 months to 12 years old, treated at an urban tertiary care pediatric emergency department for fever. Caregiver knowledge was assessed with a questionnaire. RESULTS Most caregivers correctly defined the threshold for fever as >38.0-38.3°C. Caregivers commonly believed that fever can cause brain damage and epilepsy; the frequency of this belief was not affected by whether they were referred to the emergency department by their pediatrician/family physician or by another physician or arrived without a referral. For a comfortable-appearing child with a temperature not above 38.0°C, both groups reported that they would give antipyretics in similar proportions (mean 31%). The majority of parents in both groups believed that teething could cause fever (mean 74%). CONCLUSION Caregivers in this study had limited knowledge of fever and its management in children, even if referred by their primary care physician. We suggest that there is a need for aggressive educational interventions to reduce parents' fever phobia, in clinics as well as in pediatric emergency departments, and that this need may extend to the education of medical personnel as well.