{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T21:48:10Z","timestamp":1783288090148,"version":"3.54.6"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2016,5,13]],"date-time":"2016-05-13T00:00:00Z","timestamp":1463097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In order to evaluate the adherence of healthcare providers and parents to the current recommendations concerning fever and pain management, randomized samples of 500 healthcare providers caring for children and 500 families were asked to complete an anonymous questionnaire. The 378 health care providers (HCPs) responding to the survey (75.6%) included 144 primary care pediatricians (38.1%), 98 hospital pediatricians (25.9%), 62 pediatric residents (16.4%), and 71 pediatric nurses (19.6%); the 464 responding parents (92.8%) included 175 whose youngest (or only) child was \u22645 years old (37.7%), 175 whose youngest (or only) child was aged 6\u201310 years (37.7%), and 114 whose youngest (or only) child was aged 11\u201314 years (24.6%). There were gaps in the knowledge of both healthcare providers and parents. Global adherence to the guidelines was lower among the pediatric nurses than the other healthcare providers (odds ratio 0.875; 95% confidence interval 0.795\u20130.964). Among the parents, those of children aged 6\u201310 and 11\u201314 years old, those who were older, and those without a degree answered the questions correctly significantly less frequently than the others. These findings suggest that there is an urgent need to improve the dissemination of the current recommendations concerning fever and pain management among healthcare providers and parents in order to avoid mistaken and sometimes risky attitudes, common therapeutic errors, and the unnecessary overloading of emergency department resources. Pediatric nurses and parents with older children, those who are older, and those with a lower educational level should be the priority targets of educational programmes.<\/jats:p>","DOI":"10.3390\/ijerph13050499","type":"journal-article","created":{"date-parts":[[2016,5,13]],"date-time":"2016-05-13T11:53:16Z","timestamp":1463140396000},"page":"499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Fever and Pain Management in Childhood: Healthcare Providers\u2019 and Parents\u2019 Adherence to Current Recommendations"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9175-9394","authenticated-orcid":false,"given":"Genny","family":"Raffaeli","sequence":"first","affiliation":[{"name":"Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milano 20122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Orenti","sequence":"additional","affiliation":[{"name":"Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milano 20122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monia","family":"Gambino","sequence":"additional","affiliation":[{"name":"Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milano 20122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Peves Rios","sequence":"additional","affiliation":[{"name":"Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milano 20122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Bosis","sequence":"additional","affiliation":[{"name":"Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milano 20122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Bianchini","sequence":"additional","affiliation":[{"name":"Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milano 20122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Tagliabue","sequence":"additional","affiliation":[{"name":"Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milano 20122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-2837","authenticated-orcid":false,"given":"Susanna","family":"Esposito","sequence":"additional","affiliation":[{"name":"Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milano 20122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1542\/peds.2010-3852","article-title":"Fever and antipyretic use in children","volume":"127","author":"Sullivan","year":"2011","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Bertille, N., Fournier-Charri\u00e8re, E., Pons, G., and Chalumeau, M. (2013). Managing fever in children: a national survey of parents\u2019 knowledge and practices in France. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0083469"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1542\/peds.107.6.1241","article-title":"Fever phobia revisited: Have parental misconceptions about fever changed in 20 years?","volume":"107","author":"Crocetti","year":"2001","journal-title":"Pediatrics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1001\/archinte.160.4.449","article-title":"Antipyretic therapy: Physiologic rationale, diagnostic implications, and clinical consequences","volume":"160","author":"Plaisance","year":"2000","journal-title":"Arch. Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1001\/archpedi.1980.02130140050015","article-title":"Fever phobia: Misconceptions of parents about fevers","volume":"134","author":"Schmitt","year":"1980","journal-title":"Am. J. Dis. Chil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1177\/0009922809355312","article-title":"Fever phobia: A survey of caregivers of children seen in a pediatric emergency department","volume":"49","author":"Poirier","year":"2010","journal-title":"Clin. Pediatr. (Phila)"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1136\/bmj.39218.495255.AE","article-title":"NICE guidelines: Assessment and initial management of feverish illness in children younger than 5 years: Summary of NICE guidance","volume":"334","author":"Richardson","year":"2007","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1016\/j.clinthera.2009.08.006","article-title":"Management of fever in children: Summary of the Italian Pediatric Society guidelines","volume":"31","author":"Chiappini","year":"2009","journal-title":"Clin. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1016\/j.clinthera.2012.06.011","article-title":"Update of the 2009 Italian Pediatric Society Guidelines about management of fever in children","volume":"34","author":"Chiappini","year":"2012","journal-title":"Clin. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Chiappini, E., Parretti, A., Becherucci, P., Pierattelli, M., Bonsignori, F., Galli, L., and de Martino, M. (2012). Parental and medical knowledge and management of fever in Italian pre-school children. BMC Pediatr., 12.","DOI":"10.1186\/1471-2431-12-97"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Chiappini, E., D\u2019Elios, S., Mazzantini, R., Becherucci, P., Pierattelli, M., Galli, L., and de Martino, M. (2013). Adherence among Italian paediatricians to the Italian guidelines for the management of fever in children: A cross sectional survey. BMC Pediatr., 13.","DOI":"10.1186\/1471-2431-13-210"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/1824-7288-39-51","article-title":"Symptomatic fever management among 3 different groups of pediatricians in Northern Lombardy (Italy): Results of an explorative cross-sectional survey","volume":"39","author":"Bettinelli","year":"2013","journal-title":"Ital. J. Pediatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/01376517-200210000-00002","article-title":"Adverse effects of pain on the nervous systems of newborns and young children: A review of the literature","volume":"34","author":"Mitchell","year":"2002","journal-title":"J. Neurosc. Nurs."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.siny.2006.02.007","article-title":"Long-term consequences of pain in human neonates","volume":"11","author":"Grunau","year":"2006","journal-title":"Semin. Fetal Neonatal Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.pain.2006.08.014","article-title":"Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years","volume":"127","author":"Spagrud","year":"2007","journal-title":"Pain"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1542\/peds.2013-2744","article-title":"Pediatric clinical practice guidelines for acute procedural pain: A systematic review","volume":"133","author":"Lee","year":"2014","journal-title":"Pediatrics"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ferrante, P., Cuttini, M., Zangardi, T., Tomasello, C., Messi, G., Pirozzi, N., Losacco, V., Piga, S., and Benini, F. (2013). PIPER Study Group. Pain management policies and practices in pediatric emergency care: A nationwide survey of Italian hospitals. BMC Pediatr., 13.","DOI":"10.1186\/1471-2431-13-139"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1136\/bmj.328.7451.1312","article-title":"Selecting, designing, and developing your questionnaire","volume":"328","author":"Boynton","year":"2004","journal-title":"BMJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1080\/03610920600974419","article-title":"Modeling association between two or more categorical variables that allow for multiple category choices","volume":"36","author":"Bilder","year":"2007","journal-title":"Commun. Stat. Theory Methods"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/j.1365-2125.2012.04311.x","article-title":"Regional differences in symptomatic fever management among paediatricians in Switzerland: The results of a cross-sectional Web-based survey","volume":"75","author":"Lava","year":"2013","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1136\/archdischild-2014-307483","article-title":"Who\u2019s afraid of fever?","volume":"100","author":"Richardson","year":"2015","journal-title":"Arch. Dis. Child."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00431-013-2239-5","article-title":"Paracetamol: A focus for the general pediatrician","volume":"173","author":"Marzuillo","year":"2014","journal-title":"Eur. J. Pediatr."},{"key":"ref_23","first-page":"146","article-title":"Recent advances in pediatric use of oral paracetamol in fever and pain management","volume":"4","author":"Chiarugi","year":"2015","journal-title":"Pain Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/ijcp.12056","article-title":"Optimising the management of fever and pain in children","volume":"67","year":"2013","journal-title":"Int. J. Clin. Pract."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.clinthera.2006.05.010","article-title":"Determinants of antipyretic misuse in children up to 5 years of age: A cross-sectional study","volume":"28","author":"Bilenko","year":"2006","journal-title":"Clin. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1111\/j.1365-2125.2011.03993.x","article-title":"Paracetamol prescribing in primary care: Too little and too much?","volume":"72","author":"Kazouini","year":"2011","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.amepre.2009.05.018","article-title":"Medication overdoses leading to emergency department visits among children","volume":"37","author":"Schillie","year":"2009","journal-title":"Am. J. Prev. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.phrs.2011.08.010","article-title":"The role of nonsteroidal anti-inflammatory drugs in pediatric patients","volume":"65","author":"Dills","year":"2012","journal-title":"Pharmacol. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1002\/ebch.1978","article-title":"Combined and alternating paracetamol and ibuprofen therapy for febrile children","volume":"9","author":"Wong","year":"2014","journal-title":"Evid. Based Child. Health"},{"key":"ref_30","first-page":"CD009572","article-title":"Combined and alternating paracetamol and ibuprofen therapy for febrile children","volume":"10","author":"Wong","year":"2013","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1155\/2008\/478102","article-title":"Pain in hospitalized children: A prospective cross-sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital","volume":"13","author":"Taylor","year":"2008","journal-title":"Pain Res. Manag."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/13\/5\/499\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:23:49Z","timestamp":1760210629000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/13\/5\/499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5,13]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2016,5]]}},"alternative-id":["ijerph13050499"],"URL":"https:\/\/doi.org\/10.3390\/ijerph13050499","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5,13]]}}}