Use of the Theoretical Domains Framework to explore factors influencing paediatric fever management practices and antipyretic use in New Zealand emergency departments.

Autor: Tan E; Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.; Emergency Department, Middlemore Hospital, Auckland, New Zealand., Haskell L; Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.; Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand., Beck S; Emergency Department, Dunedin Hospital, Dunedin, New Zealand.; Department of Medicine, University of Otago, Dunedin, New Zealand., MacLean A; Emergency Department, Tauranga Hospital, Tauranga, New Zealand., Rogan A; Emergency Department, Wellington Regional Hospital, Wellington, New Zealand.; Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand., Than M; Emergency Department, Christchurch Hospital, Christchurch, New Zealand., Venning B; Emergency Department, Middlemore Hospital, Auckland, New Zealand.; School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand., White C; Emergency Department, Taranaki Base Hospital, New Plymouth, New Zealand., Yates K; Emergency Departments, North Shore and Waitakere Hospitals, Auckland, New Zealand.; Centre for Medical and Health Science Education, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand., McKinlay CJ; Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.; Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand., Dalziel SR; Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.; Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.; Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Jazyk: angličtina
Zdroj: Journal of paediatrics and child health [J Paediatr Child Health] 2022 Oct; Vol. 58 (10), pp. 1847-1854. Date of Electronic Publication: 2022 Jul 23.
DOI: 10.1111/jpc.16127
Abstrakt: Aim: To explore factors influencing fever management practices and antipyretic use among New Zealand Emergency Department (ED) doctors and nurses using the Theoretical Domains Framework (TDF).
Methods: Cross-sectional survey of doctors and nurses across 11 New Zealand EDs. The questionnaire examined eight of 12 TDF domains, based on a generic questionnaire validated to assess TDF-based determinants of health-care professional behaviour. Relevant domains were identified by the frequency of beliefs; the presence of conflicting beliefs within a domain; and the likely strength of impact of a belief on paediatric fever management in the ED.
Results: About 602 participants (243 doctors, 353 nurses and 6 unknown) completed the survey (response rate 47.5%). Over half (351/591, 59.6%, 95% confidence interval (CI) 55.5-63.5%) knew the content of clinical practice guidelines regarding antipyretic use in febrile children (TDF Domain Knowledge), or had been trained to ensure antipyretics are given to febrile children only if they appear distressed (347/592, 58.6%, 95% CI 54.5-62.6%) (Skills). Over 40% (246/590, 95% CI 37.7-45.8%) aim to reduce the fever before discharge (Goals). Most (444/591, 75.1%, 95% CI 71.4-78.6%) participants felt capable of explaining appropriate antipyretic use to parents/care givers (Beliefs about Capabilities). Only a minority (155/584, 26.5%, 95% CI 23.0-30.3%) thought that they can ensure antipyretics are given to febrile children only if they appear distressed when the ED is busy (Environmental Context and Resources).
Conclusions: Using the TDF, we identified factors influencing fever management practices and antipyretic use in the ED. These factors can guide the design of targeted, theory-informed knowledge translation strategies.
(© 2022 The Authors. Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)
Databáze: MEDLINE
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