Parental Expectations When Consulting Out-Of-Hours With A Child With Symptoms Of Respiratory Tract Infection

Kallestrup P and Bro F.
University of Aarhus. Aarhus (Denmark).
Aims and objectives. In Denmark the out-of-hours consultation is most often a meeting between a patient and a GP unknown to each other. The purpose of this study was to investigate factors influencing this meeting from a parental point of view. The main variables being: reason for encounter, parental expectations to the consultation, the doctors' diagnosis and treatment.
Methods. Prior to the consultation parents presenting with a child with any symptoms of respiratory tract infection were interviewed. The doctors' diagnosis and treatment were recorded. In 152 consecutive consultations the child and parent(s) seen by 32 different doctors were interviewed. 134 were eligible for the study: exclusion because of acute referral to hospital, another focus of infection diagnosed, language problems.
Results. The symptoms presented were fever (80%), coughing (48%), ear pain (24%), sore throat (12%), difficulty in breathing (8%). The diagnosis were upper respiratory tract infection (61%), otitis media (22%), bronchitis (7%), pneumonia (5%), sore throat (4%), other (2%). When asked openly: “What do you expect from the consultation?" the parents answered: examination (99%), explanation (49%), diagnosis (43%), advice and guidance (19%), medication (7%), referral to hospital (1%). When asked directly: "Do you expect a prescription of an antibiotic?" 25 (19%) answered "yes". 9 (36%) of these did in fact receive a prescription while 16% of the total study population did.
Conclusions. Our study shows that GP's in the out-of-hours service seldom prescribe antibiotics to children and that most parents do not expect it either. It illustrates that it is mainly with clinical and communicative skills rather than with the prescription forms that our patients' expectations are met.
Parental expectations when consulting out-of-hours with a child with symptoms of respiratory tract infection