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"My Child Can't Keep Anything Down!": Interviewing Parents Who Bring Their Preschoolers to the Emergency Department for Diarrhea, Vomiting, and Dehydration

Graham, Jennifer M. MSc, MD; Fitzpatrick, Eleanor A. MN(c), RN, ENC(C); Black, Karen J.L. MD, MSc, FRCPC

doi: 10.1097/PEC.0b013e3181d6d9de
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Introduction: Viral gastroenteritis with dehydration is one of the most frequent reasons for visits to pediatric emergency departments (ED). Parental intervention before presentation to the ED can make a significant difference in the course of a child's illness. There is a discrepancy between medical knowledge of dehydration and parental fears and understanding. This project is part of a larger program of research developing an educational tool for parents of preschoolers with diarrhea, vomiting, and dehydration. The primary objective was to develop an interview guide. From initial data, the researchers explored parental motivations for bringing their children to the ED.

Methods: Ten families were recruited after their visit to a pediatric ED in the fall of 2007. Included were families of children younger than 4 years who experienced vomiting, diarrhea, and dehydration. Interviews were conducted over the telephone and were transcribed. The interview guide was edited in an iterative process.

Results: Thematic analysis focused on parents' decision to take their child to the ED. Making the decision to take a child to the ED is a complex process for parents. This decision involves expectations developed from community-level, family-level, and child factors. Issues of access to care affect parents' decision, including perceived level of urgency, travel time, and modes of transport available.

Conclusions: A framework is proposed, which outlines the most important factors our sample of parents reported when deciding whether to take their ill child to the ED. The interview guide developed will facilitate collection of further information.

From the IWK Health Centre, Halifax, Nova Scotia, Canada.

Reprints: Jennifer M. Graham, MSc, MD, IWK Health Centre, 5850/5980 University Ave, PO Box 9700, Halifax, Nova Scotia, Canada B3K 6R8 (e-mail: jennifer.graham@dal.ca).

This study was supported by IWK Category A grant (IWK Health Centre).

© 2010 Lippincott Williams & Wilkins, Inc.