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Qualitative interview study of parents' perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care.

ABSTRACT: OBJECTIVE:To explore parents' perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care. DESIGN:Qualitative semistructured interview study. SETTING:UK primary care. PARTICIPANTS:23 parents of children aged 6?months to 10 years presenting with LRTI in primary care. METHOD:Thematic analysis of semistructured interviews (either in person or by telephone) conducted with parents to explore their experiences and views on their children being prescribed antibiotics for LRTI. RESULTS:Four major themes were identified and these are perspectives on: (1) infection, (2) antibiotic use, (3) the general practitioner (GP) appointment and (4) decision making around prescribing. Symptomatic relief was a key concern: the most troublesome symptoms were cough, breathing difficulty, fever and malaise. Many parents were reluctant to use self-care medication, tended to support antibiotic use and believed they are effective for symptoms, illness duration and for preventing complications. However, parental expectations varied from a desire for reassurance and advice to an explicit preference for an antibiotic prescription. These preferences were shaped by: (1) the age of the child, with younger children perceived as more vulnerable because of their greater difficulty in communicating, and concerns about rapid deterioration; (2) the perceived severity of the illness; and (3) disruption to daily routine. When there was disagreement with the GP, parents described feeling dismissed, and they were critical of inconsistent prescribing when they reconsult. When agreement between the parent and the doctor featured, parents described a feeling of relief and legitimation for consulting, feeling reassured that the illness did indeed warrant a doctor's attention. CONCLUSION:Symptomatic relief is a major concern for parents. Careful exploration of expectations, and eliciting worries about key symptoms and impact on daily life will be needed to help parents understand when a no antibiotic recommendation or delayed antibiotic recommendation is made.

SUBMITTER: Halls A

PROVIDER: S-EPMC5640115 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Qualitative interview study of parents' perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care.

Halls Amy A Van't Hoff Catherine C Little Paul P Verheij Theo T Leydon Geraldine M GM

BMJ open 20170915 9

<h4>Objective</h4>To explore parents' perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care.<h4>Design</h4>Qualitative semistructured interview study.<h4>Setting</h4>UK primary care.<h4>Participants</h4>23 parents of children aged 6 months to 10 years presenting with LRTI in primary care.<h4>Method</h4>Thematic analysis of semistructured interviews (either in person or by telephone) conducted with parents to explore the ...[more]

PMID: 28918409

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Project description:BACKGROUND:Antibiotics are not recommended for treating uncomplicated respiratory tract infections (RTIs), despite this, antibiotic prescribing for this is widespread. General practitioners (GPs) report parental pressure and fear of losing patients if they do not prescribe antibiotics, however, parental views on antibiotics for RTIs are unclear. Therefore, this study examined GPs' and parents' perceptions regarding antibiotic prescribing for RTIs in young children. METHODS:We conducted semi-structured interviews with 20 GPs, and a survey and focus groups with 50 parents and carers of children under the age of five between June 2014 and July 2015 in Melbourne, Australia. Qualitative data were thematically analysed using NVivo and quantitative data were analysed using SPSS. RESULTS:GPs believed that parents expect antibiotics for RTIs and were more likely to prescribe them if parents were insistent. They believed parents would go elsewhere if they did not prescribe antibiotics. GPs suggested that there would be less conflict if parents were better educated on appropriate antibiotics use. In contrast, parents demonstrated good knowledge of RTIs and appropriate antibiotic use. Their main expectation from GPs was to obtain a diagnosis, discuss management, and receive reassurance that the illness was not serious. Parental satisfaction with GPs was not dependent on receiving antibiotics (r = 0.658, p < 0.001), and they would not seek another GP if antibiotics were not prescribed (r = 0.655, p < 0.001). CONCLUSION:GPs and parents have dissonant views on antibiotic prescribing for RTI in young children. GPs perceived parents wanting a diagnosis and reassurance that their child is not severely ill as pressure to prescribe antibiotic. To overcome these barriers, targeted training for both GPs and parents to improve communication and reassurance that satisfaction is not related to receiving antibiotics may reduce unnecessary antibiotic prescribing for RTI in young children.

Dataset Information

Qualitative interview study of parents' perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care.

Publications

Qualitative interview study of parents' perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care.

Similar Datasets

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