Fever is a frequent reason for parents to seek medical advice for their children. A significant source of parental anxiety stems from the misconception that fever is a disease itself, rather than a symptom indicating an underlying illness. Two decades ago, Dr. Barton Schmitt identified prevalent misconceptions among parents, coining the term “fever phobia” to describe these unfounded fears. More recently, concerns about occult bacteremia in febrile children have led to increased diagnostic testing and treatment approaches. This study aimed to investigate current parental attitudes towards fever, compare them with findings from Schmitt’s 1980 research, and assess whether heightened medical interventions for potential occult bacteremia correlate with increased parental worry regarding fever.
This research employed a cross-sectional 29-item questionnaire, administered between June and September 1999 to caregivers of children attending two urban, hospital-affiliated pediatric clinics in Baltimore, Maryland. The questionnaires were given before both routine check-ups and urgent care visits. Adapted from Schmitt’s earlier work, the questionnaire explored aspects such as the definition of fever, concerns associated with fever, and methods of fever management. Additional data gathered included common home-based fever reduction techniques, frequency of temperature monitoring, and parents’ recollection of past laboratory tests and treatments their children received during fever-related healthcare visits.
The study involved 340 caregivers. A significant 56% expressed considerable worry about the potential dangers of fever in their children, and 44% considered a temperature of 102°F (38.9°C) to be a “high” fever. Alarmingly, 7% believed that an untreated fever could escalate to 110°F (≥43.4°C). A substantial 91% of caregivers believed fever could cause harm, with 21% specifically mentioning brain damage and 14% citing death as possible consequences. Remarkably, 52% stated they would check their child’s temperature every hour or more frequently when a fever was present. Overzealous fever management was also evident, as 25% administered antipyretics for temperatures below 100°F (<37.8°C), and 85% would wake their child to give fever-reducing medication. In terms of medication dosing, 14% gave acetaminophen and 44% administered ibuprofen at intervals that were too frequent. Among the 73% who used sponging to manage fever, 24% initiated sponging even at temperatures of 100°F (≤37.8°C), and 18% used alcohol for sponging. When seeking information about fever, 46% of caregivers identified doctors as their primary source. Interestingly, caregivers who reported high levels of worry about fever were more likely to have previously had a child evaluated for fever, to have experienced blood work being performed on their child during a febrile illness, and to perceive their doctors as highly concerned about fever. Compared to the attitudes observed 20 years prior, a greater proportion of caregivers now listed seizures as a potential harm of fever, woke their children more often to check temperatures during febrile episodes, and more frequently administered antipyretics or started sponging even for potentially normal temperatures.
The study’s findings confirm that fever phobia remains a significant issue. Pediatric healthcare providers are in a crucial position to positively influence parental understanding of fever and its role in illness. Future research should focus on evaluating the effectiveness of educational interventions and identifying specific medical care practices that may inadvertently contribute to fever phobia. Addressing parental misconceptions about fever is essential for improving child healthcare and reducing unnecessary anxiety and medical interventions.
