Fever Phobia: A Survey of Caregivers of Children Seen in a Pediatric Emergency Department

This study, from the Children's Hospital of the King's Daughters in Norfolk, VA, sought to document the incidence of caregivers' misconceptions about fever and its harmful effects (termed “fever phobia”) in a pediatric emergency department (PED). Two hundred thirty caregivers of children seen in a PED answered a 28-question survey pertaining to their perceptions, attitudes, and behaviors regarding fever in children. The authors found widespread misconceptions about fever and its harmful effects, as well as improper home treatment of fever. The median temperature considered a fever was 37.8° (range 36.1°–40.6°), whereas the median temperature at which antipyretics were administered was also 37.8°. Forty percent of caregivers administered ibuprofen more frequently than every 6 h, but only 8% gave acetaminophen more often than every 4 h. The authors found statistically significant differences in the perception of fever and the mean temperature at which a caregiver would take the child to the PED between caregivers of different educational levels and ethnicities. Specifically, the level of education was directly proportional to the mean fever that triggered a PED visit—38.9° for caregivers who had “at least some high school,” 39.1° for “at least some college,” and 39.7° for “at least some postgraduate.” Education level was inversely proportional to level of concern about a fever, with caregivers of higher education levels showing less concern about the potential harmful consequences of a high fever. Black caregivers were more likely than their white counterparts to take a child to the PED at a lower mean temperature—38.8° vs. 39.6° (p=0.023)—and were more concerned about the potential harmful effects of a fever (p<0.001). There were no statistically significant differences in responses between male and female caregivers. The authors find their results to be consistent with prior studies that noted widespread “fever phobia” in caregivers who presented to both pediatrician offices and PED.