{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:47:00Z","timestamp":1782319620706,"version":"3.54.5"},"reference-count":32,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"unspecified","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Elisabeth von Freyburg Stichting","award":["Haga-JKZ 22-01"],"award-info":[{"award-number":["Haga-JKZ 22-01"]}]},{"name":"Haga Hospital"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,5,29]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore which factor or combination of factors is perceived by parents as most distinctive in prompting them to seek medical care for children aged 0\u20135 years who were admitted to the hospital with fever due to a serious bacterial infection (SBI), in order to inform further development of an e-health tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative study was conducted using semi-structured interviews with a purposive sampling strategy. Interviews were conducted by a medical intern and supervised by a clinician researcher. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis to identify key themes in parental decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Paediatric ward of the Juliana Children\u2019s Hospital in The Hague, an urban teaching hospital in the Netherlands, between April and June 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Parents of children aged 0\u20135 years admitted with a suspected SBI were eligible. Of the 17 parents approached, 15 agreed to participate in 13 interviews (ie, in two interviews both parents participated).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>13 interviews with 15 parents revealed five themes. Parents sought medical attention when they perceived a shift in their child\u2019s illness state, based on three themes: perceived abnormal illness presentation through either single alarming symptoms (altered consciousness, breathing difficulties, skin changes) or symptom combination, symptom recognition based on previous experiences or prolonged fever and respiratory complaints. Many parents demonstrated awareness of symptoms aligning with professional red flag indicators. The fourth and fifth themes, work constraints and limited general practitioner access, highlighted external barriers that sometimes delayed help-seeking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights key factors influencing parents\u2019 decisions to seek medical care for febrile children with an SBI, emphasising the importance of both parental perceptions and clinical symptoms. The findings may inform parent-centred resources including an e-health tool, which support parents in assessing illness severity and deciding when to seek medical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-115270","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T15:55:25Z","timestamp":1782316525000},"page":"e115270","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding parents\u2019 decisions to seek care for children with serious bacterial infections: a qualitative study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7416-795X","authenticated-orcid":false,"given":"Evelien B","family":"van Kempen","sequence":"first","affiliation":[{"name":"Department of General Pediatrics, Erasmus MC Sophia, Rotterdam, The Netherlands"},{"name":"Department of Pediatrics, Juliana Children\u2019s Hospital, Haga Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Willemsen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Juliana Children\u2019s Hospital, Haga Hospital, The Hague, 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":"Department of General Pediatrics, Erasmus MC Sophia, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"van Veen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Juliana Children\u2019s Hospital, Haga Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"2026062408551001000_16.6.e115270.1","first-page":"1847","article-title":"Few ethnic differences in acute pediatric problems: 10 years of acute care in the Sophia Children\u2019s Hospital in Rotterdam","volume":"145","author":"Bouwhuis","year":"2001","journal-title":"Ned Tijdschr Geneeskd"},{"key":"2026062408551001000_16.6.e115270.2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.84.5.390"},{"key":"2026062408551001000_16.6.e115270.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.f2866","article-title":"on behalf of the Guideline Development Group and technical team. 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