{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T01:29:19Z","timestamp":1793669359512,"version":"4.5.1"},"reference-count":26,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2021,2,28]],"date-time":"2021-02-28T00:00:00Z","timestamp":1614470400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,1,21]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore how parents judge disease severity of their febrile child and to identify symptoms they associate with serious illness, minor illness or health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Semistructured interviews were conducted. Interviews were audio taped, transcribed verbatim and analysed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Parents of children aged 0\u20135 years with a febrile illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Participants were recruited at the paediatric ward and the emergency department.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-six interviews were conducted, in which 37 parents participated. Parents described disease severity of their child mainly in terms of changes in their child\u2019s normal characteristics (behaviour and physical features). They found it harder to describe specific disease symptoms such as dyspnoea or dehydration. Their child being active, eating and drinking well, and smiling were perceived as reassuring, whereas high fever, moving very little and uncertainty about the type of infections were mentioned as alarming symptoms. Previous experience with febrile illnesses in their children was of great influence on the number and accuracy of symptoms they reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Parents used the normal behaviour and physical features of their child as a reference frame for judging disease severity. With a larger deviation from the child\u2019s normal characteristics, parents considered the illness more serious. They were less able to describe specific symptoms of disease such as dyspnoea or dehydration. This knowledge is important for clinicians in their communication with parents of children with febrile illness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-042609","type":"journal-article","created":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T11:17:22Z","timestamp":1614597442000},"page":"e042609","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Parental assessment of disease severity in febrile children under 5 years of age: a qualitative study"],"prefix":"10.1136","volume":"11","author":[{"given":"Dora L","family":"Kuijpers","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Juliana Children\u2019s Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3110-9434","authenticated-orcid":false,"given":"Daphne","family":"Peeters","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Juliana Children\u2019s Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina C","family":"Boom","sequence":"additional","affiliation":[{"name":"Department of Paediatric Intensive Care, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7351-4596","authenticated-orcid":false,"given":"Josephine","family":"van de Maat","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Global Health, Radboudumc, Nijmegen, The Netherlands"},{"name":"General Paediatrics, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7919-8934","authenticated-orcid":false,"given":"Rianne","family":"Oostenbrink","sequence":"additional","affiliation":[{"name":"General Paediatrics, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gertjan J A","family":"Driessen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Juliana Children\u2019s Hospital, The Hague, The Netherlands"},{"name":"Department of Paediatrics, Maastricht University Medical Center+, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,1]]},"reference":[{"key":"2025121219461018000_11.3.e042609.1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-7-23"},{"key":"2025121219461018000_11.3.e042609.2","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmi035"},{"key":"2025121219461018000_11.3.e042609.3","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1093\/fampra\/cmy079","article-title":"Most preschool children with fever and common infection symptoms do not consult the family physician","volume":"36","author":"Peetoom","year":"2019","journal-title":"Fam Pract"},{"key":"2025121219461018000_11.3.e042609.4","first-page":"1847","article-title":"Geringe etnische verschillen in spoedeisende problemen bij kinderen: 10 jaar acute hulp in Het Sophia Kinderziekenhuis te Rotterdam","volume":"145","author":"Bouwhuis","year":"2001","journal-title":"Ned Tijdschr Geneeskd"},{"key":"2025121219461018000_11.3.e042609.5","doi-asserted-by":"publisher","DOI":"10.1197\/jamia.M2164"},{"key":"2025121219461018000_11.3.e042609.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)62000-6"},{"key":"2025121219461018000_11.3.e042609.7","unstructured":"Oostenbrink R , Nijman RG , Tuut MK . 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