아동의 발열관리: 현황 및 과학적 근거 = Childhood Fever Management: Current Practice vs Evidence

다국어 초록 (Multilingual Abstract)

Purpose: The purposes of this review were to address misconceptions of childhood fever and fever management practice among parents and health care providers, and to identify the scientific evidences against such misconceptions and practices. Methods: Journal databases and clinical guidelines from 2000 to 2015 were searched. The search terms were fever, fever management, misconception, myth, fiction, fact, fever phobia, child, antipyretics, tepid bath, alternating use/combined use of antipyretics, and physical cooling method. Results: There are significant gaps between current concepts and practices, and the scientific evidence. Misconceptions and unrealistic concerns about childhood fever still exist among parents and even health care providers, worldwide. The evidences suggest that antipyretics should be given carefully with the aim of relieving discomfort or pain rather than decreasing the temperature itself. Alternating use of antipyretics should be discouraged due to the risk of confusion and error. Antipyretics do not prevent febrile convulsions. Moreover, the scientific evidence does not support tepid sponge massage. Conclusion: Evidence-based childhood fever management interventions should be targeted toward parents and health care providers. By adopting an evidence-based approach to nursing interventions, pediatric nurses can ensure children receive appropriate and safe fever management.

참고문헌 (Reference)

1 정민진, "응급실 내원 발열 소아환자의 열관리를 위한 근거중심 간호실무 가이드라인 개발" 한국아동간호학회 18 (18): 214-221, 2012

2 정용선, "아동의 발열과 발열관리: 문헌고찰" 한국아동간호학회 16 (16): 30-40, 2010

3 정용선, "아동발열관리에 대한 부모의 인식, 지식과 자기효능감에 관한 연구" 한국아동간호학회 16 (16): 324-333, 2010

4 최애란, "소아청소년과 외래를 방문한 부모들의 발열공포와 관련 요인" 한국아동간호학회 20 (20): 113-122, 2014

5 강태신, "발열이 있는 3세 미만 소아환자에서 응급실 혈액배양 검사의 유용성" 대한응급의학회 24 (24): 77-82, 2013

6 El-Radhi AS, "The role of fever in the past and present" 19 (19): 9-14, 2011

7 J. T. McBride, "The Association of Acetaminophen and Asthma Prevalence and Severity" American Academy of Pediatrics (AAP) 128 (128): 1181-1185, 2011

8 Offringa M, "Prophylactic drug management for febrile seizures in children" 4 : 003031-, 2012

9 Elena Chiappini, "Parental and medical knowledge and management of fever in Italian pre-school children" Springer Nature 12 (12): 2012

10 Siba Paul, "Paracetamol use in children: is it as safe as we think?" Wiley-Blackwell 22 (22): 16-20, 2011

11 McCarthy PL, "Observation scales to identify serious illness in febrile children" 70 (70): 802-809, 1982

12 L. Emmerton, "Management of children's fever by parents and caregivers: Practical measurement of functional health literacy" SAGE Publications 18 (18): 302-313, 2014

13 Figen Demir, "Knowledge, attitudes and misconceptions of primary care physicians regarding fever in children: a cross sectional study" Springer Nature 38 (38): 40-, 2012

14 National Institute for Health and Clinical Excellence, "Feverish illness in children: Assessment and initial management in children younger than 5 years" RCOG Press

15 Schmitt BD, "Fever phobia: Misconceptions of parents about phobia" 134 (134): 176-181, 1980

16 A Sahib Mehdi El-Radhi, "Fever management: Evidence vs current practice" Baishideng Publishing Group Inc. 1 (1): 29-, 2012

17 Penny McDougall, "Fever and feverish illness in children under five years" RCN Publishing Ltd. 28 (28): 49-59, 2014

18 J. E. Sullivan, "Fever and Antipyretic Use in Children" American Academy of Pediatrics (AAP) 127 (127): 580-587, 2011

19 곽영호, "Fever Phobia in Korean Caregivers and Its Clinical Implications" 대한의학회 28 (28): 1639-1644, 2013

20 M. B. Wallenstein, "Fever Literacy and Fever Phobia" SAGE Publications 52 (52): 254-259, 2013

21 Clarke Patricia, "Evidence-Based Management of Childhood Fever: What Pediatric Nurses Need to Know" Elsevier BV 29 (29): 372-375, 2014

22 Joy Monsma, "Empowering parents for evidence-based fever management: An integrative review" Wiley-Blackwell 27 (27): 222-229, 2015

23 Ehud Rosenbloom, "Do antipyretics prevent the recurrence of febrile seizures in children? A systematic review of randomized controlled trials and meta-analysis" Elsevier BV 17 (17): 585-588, 2013

24 Thomas S, "Comparative effectiveness of tepid sponging and antipyretic drug versus only antipyretic drug in the management of fever among children : A randomized controlled trial" 46 (46): 133-136, 2009

25 Wong T, "Combined and alternating paracetamol and ibuprofen therapy for febrile children" 10 : 009572-, 2013

26 Andrea K. Morrison, "Caregiver Low Health Literacy and Nonurgent Use of the Pediatric Emergency Department for Febrile Illness" Elsevier BV 14 (14): 505-509, 2014

27 E. Simons, "Association Between Paracetamol Use in Infancy and Childhood, and Risk of Asthma, Rhinoconjunctivitis, and Eczema in Children Aged 6-7 Years: Analysis From Phase Three of the ISAAC Programme" American Academy of Pediatrics (AAP) 124 (124): S110-S110, 2009

28 Wright AD, "Alternating antipyretics for fever reduction in children: An unfounded practice passed down to parents from pediatricians" 46 (46): 146-150, 2007

29 Elena Chiappini, "Adherence among Italian paediatricians to the Italian guidelines for the management of fever in children: a cross sectional survey" Springer Nature 13 (13): 2013

30 Meltem Polat, "A current analysis of caregivers’ approaches to fever and antipyretic usage" Journal of Infection in Developing Countries 8 (8): 2014