父母對發燒概念與處置受醫師之影響過程

Parental Concept and Management to Fever: What are the Influences by Physicians?

發燒是兒科最常見的醫療問題，亦是父母最常帶小兒求診的理由。在求醫過程中，醫師對發燒的認知與處置，以及對父母提供的發燒資訊和指導可能會影響父母對發燒的概念形成，進而影響其發燒的處置，但卻少有實證性研究探討此現象所隱藏的行為意義。本研究以敘事訪談法，實地訪談20位於半年內曾經歷其6歲以下小孩發燒的父母，藉由分析其對發燒概念的主觀陳述，探討父母主觀感受醫師對發燒的作法對他們的影響。結果顯示，父母會依據醫師所提供的資訊與處理方法，發展自己對孩子發燒的概念及處理模式，經判斷後，再實際對孩子做發燒的居家處置。父母亦會評價醫師對孩子發燒的作法，而產生符合或不符合期望的結果。符合期望時，父母會信任醫療專業且把醫師的處理方法當成是依據、準繩；不符合期望時，父母會再尋找其他醫師，或轉而尋求宗教、偏方。由研究結果可知，雖看似是醫療人員主導發燒診斷與治療，然父母對孩子發燒的概念及處置，才是實際處理孩子發燒的方式》此現象顯示醫師對父母之發燒概念與處置具重要影響力，故護理人員應再省思及調整與父母之互動方式，並主動協助父母提升其對小兒發燒之判斷與處理的能力。Fever is the most primary complaint of children seen by pediatricians. In counseling, physicians, concept and management of fever and the information they provided may intentionally or unconsciously influence parents’ perceptions and practices towards their children’s fever. However, rare studies were conducted to explore this process and meanings of this issue. This study aimed to explore what and how parental concepts and management towards childhood fevers were influenced by pediatricians. Twenty parents who had experienced their child’s fever at least once within six months were recruited by snowball method. A narrative interview was used to collect parents, information about their child’s fever. Results showed parents framed their own concept and management patterns towards fever based on the physicians’ advice and behavior. They concurrently judged physicians’ concept and management and evaluated whether the treatment procedures met their expectations or not. If so, parents would trust the pediatrician and recognize as the physician as standard. Otherwise, they would consult other physicians or turn to religion and folk remedies. Although it seemed the professionals guided the treatment process of fever, actually, parents played the crucial role in practice. In conclusion, physicians significantly influenced parental perceptions and practices of fever. Healthcare professionals should be aware and adjust the interaction patterns with parents. Finally, healthcare professionals ought to be responsible in empowering parents to improve their ability to manage childhood fevers.