Discursive Analysis of Pediatrician’s Therapeutic Approach towards Childhood Fever and Its Contextual Differences: An Ethnomethodological Study

Children Pub Date : 2024-03-07 DOI:10.3390/children11030316
Francisco Vicens-Blanes, Rosa Miró-Bonet, Jesús Molina-Mula
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Abstract

Introduction: Fever stands out as the predominant clinical indicator in infancy. Pediatricians encounter fever routinely in their daily practice, playing a crucial role in their interactions with children and families. Objective: The aim is to examine pediatricians’ viewpoints, understanding, and approaches regarding childhood fever in two healthcare settings: pediatric hospitalization (emergency and inpatient ward) and primary care. Methods: A qualitative study was conducted using an ethnomethodological approach. Pediatricians working in the specified pediatric settings participated in in-depth interviews where theoretical clinical cases were presented for analysis. Results: Following the examination of the discourses, the codes were organized into eight categories: Understanding of fever, Significance ascribed to fever, Therapeutic strategies, Engagement with the evidence, Family apprehensions regarding fever, Influence of the COVID-19 Pandemic, Inter- and intra-professional relationships, and Suggestions for change: Conclusions: Pediatricians acknowledge the importance of addressing discomfort in the treatment of fever, but express challenges in implementing these recommendations. Pediatricians in inpatient settings emphasize the need for enhanced parental education from primary care, while those in primary care recognize the potential for improvement. Inpatient pediatricians are open to implementing changes in their daily practices, particularly concerning the administration of antipyretics.
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儿科医生对儿童发烧的治疗方法及其语境差异的话语分析:人种学研究
导言发热是婴儿期最主要的临床指标。儿科医生在日常工作中经常会遇到发热,这在他们与儿童和家庭的互动中起着至关重要的作用。研究目的目的:研究儿科医生在儿科住院(急诊和住院病房)和初级保健两种医疗环境中对儿童发热的观点、理解和方法。研究方法采用人种学方法进行定性研究。在指定儿科医疗机构工作的儿科医生参与了深入访谈,并在访谈中提供了理论临床案例以供分析。研究结果在对论述进行检查后,将代码归纳为八个类别:对发热的理解、发热的重要性、治疗策略、证据参与、家庭对发热的担忧、COVID-19 大流行的影响、专业间和专业内关系以及变革建议:结论:儿科医生认识到在治疗发烧时消除不适感的重要性,但在实施这些建议时遇到了挑战。住院环境中的儿科医生强调基层医疗机构需要加强对家长的教育,而基层医疗机构的儿科医生则认识到改进的潜力。住院儿科医生愿意在日常工作中实施改变,尤其是在退烧药的使用方面。
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