Study highlights parents’ motivations and expectations for children with gastroenteritis

Findings from a qualitative study of parents who contacted primary care after hours for their child’s acute gastroenteritis provide an overview of parents’ motivations and expectations for seeking additional medical care.

Parents seeking out-of-hours primary care contact for unusual behaviour, anuria, persistent vomiting and/or diarrhoea, reduced or no fluid intake and expect the GP to conduct a thorough physical examination, provide information and Perform follow-up inspections. making plans.¹

“Understanding parents’ motivations, expectations and experiences could improve (general practitioner) care and increase parent satisfaction with (out-of-hours primary care) contact, treatment and outcomes, while providing opportunities to enhance parental self-management,” the investigators wrote road.¹

Gastroenteritis can affect people of all ages, although young children may be particularly vulnerable because their immune systems are not yet mature. For children with gastroenteritis who develop fever, tiredness, bloody diarrhea, or dehydration, it is recommended to see a healthcare provider.²

Anouk Weghorst, MD, Department of General and Geriatric Care Medicine, University of Groningen, The Netherlands, explores the motivations, expectations, and experiences of parents of children with acute gastroenteritis in out-of-hours primary care contacts, a team of investigators in Assen, Groningen, The Netherlands Semi-structured interviews were conducted with parents contacting out-of-hours primary care services in the Zwolle region. To participate in the study, parents had to contact an out-of-hours primary care facility for children under 6 years old with acute gastroenteritis, speak Dutch and provide written informed consent.¹

Investigators used purposive sampling to obtain representativeness of children’s exposure type, gender, and age. After inclusion, parents’ gender and age, parents’ working status, education level, family composition, and number of children were also assessed.¹

The investigators interviewed a total of 14 parents, including 11 mothers (78.6%) and 3 fathers (21.4%), with an average age of 32 years (22-46 years). Most children were <1 year old (35.7%) and were the first child (71.4%) or only child (50%). Interviews, which lasted 30 to 45 minutes, were recorded, transcribed and analyzed by investigators between January and March 2021.¹

During the interviews, the investigators addressed parents’ motivations, expectations, and experiences through open-ended questions, conducting the interviews until thematic saturation appeared to be achieved through iterative data analysis. The researcher completed 4 additional interviews in which no new codes were discovered, and the data were analyzed using a constant comparison method, in which each code was continuously compared to other codes.¹

After analysis, the results indicate that parents should seek immediate out-of-hours primary care contact to address 3 main symptoms: changes in their child’s behavior, insufficient urination, persistent vomiting and/or diarrhea with reduced or no fluid intake. Parental feelings of uncertainty, helplessness and panic were also motivations for out-of-hours primary care contact.¹

Investigators noted that parents expressed concerns about dehydration, duration of fever, changes in their children’s behavior, and perceived pain. Notably, family type and children’s age appear to influence parents’ level of concern, with younger children and parents’ inexperience associated with greater concern.¹

Most participants said they contacted out-of-hours primary care because they felt a sense of urgency or because they felt their views were not adequately listened to by their GP. They want to receive information about the different aspects of the disease, the symptoms to look out for and what to do in certain circumstances, so that their children can have a medical check-up and get reassurance from their GP. Parents rated the contact as satisfactory if their expectations were met and they felt that the GP cooperated and acknowledged their feelings. This includes receiving information and advice on how to improve fluid intake, alarm symptoms, what to expect during the disease process and when and who to call.¹

Further analysis revealed that participants expressed dissatisfaction if they did not receive information about the disease or follow-up, if the GP did not conduct a physical examination, showed bias towards the parents, or was uninterested in the parents’ concerns.¹

“The results of this study suggest that GPs must remember that some children are not seriously ill or dehydrated, but parents may be concerned and want to prevent serious illness. As well as reassurance, parents also need information about the natural course of the disease, alarm symptoms and what Clear, practical information to contact you again,” the investigators concluded.¹

refer to:

1. Weghorst A, van den Brink M, Bonvanie I, et al. Acute gastroenteritis: a qualitative study of parent motivations, expectations and experiences during out-of-hours primary care. Annals of Family Medicine. Published online in 2023. doi: https://doi.org/10.1370/afm.3021
2. Mayo Clinic. Viral gastroenteritis (stomach flu). Diseases and Conditions. Accessed: September 25, 2023. https://www.mayoclinic.org/diseases-conditions/viral-gastroenteritis/symptoms-causes/syc-20378847