Parental management of childhood complaints: over-the-counter medicine use and advice-seeking behaviours
Misel Trajanovska
Authors: Misel Trajanovska , BSc (Psych), BBioMed (Hons), PhD Candidate, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC; Elizabeth Manias , RN, MPharm, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Noel Cranswick , MBBS, BMedSc, FRACP, Associate Professor, Department of Paediatrics, Royal Children’s Hospital, Parkville, Melbourne, VC and Australian Paediatric Pharmacology Research Unit, Murdoch Childrens Research Institute & Royal Children’s Hospital, Parkville, Melbourne, VC; Linda Johnston , RN, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Department of Neonatology, Royal Children’s Hospital, Parkville, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC, Australia
Search for more papers by this authorElizabeth Manias
Authors: Misel Trajanovska , BSc (Psych), BBioMed (Hons), PhD Candidate, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC; Elizabeth Manias , RN, MPharm, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Noel Cranswick , MBBS, BMedSc, FRACP, Associate Professor, Department of Paediatrics, Royal Children’s Hospital, Parkville, Melbourne, VC and Australian Paediatric Pharmacology Research Unit, Murdoch Childrens Research Institute & Royal Children’s Hospital, Parkville, Melbourne, VC; Linda Johnston , RN, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Department of Neonatology, Royal Children’s Hospital, Parkville, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC, Australia
Search for more papers by this authorNoel Cranswick
Authors: Misel Trajanovska , BSc (Psych), BBioMed (Hons), PhD Candidate, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC; Elizabeth Manias , RN, MPharm, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Noel Cranswick , MBBS, BMedSc, FRACP, Associate Professor, Department of Paediatrics, Royal Children’s Hospital, Parkville, Melbourne, VC and Australian Paediatric Pharmacology Research Unit, Murdoch Childrens Research Institute & Royal Children’s Hospital, Parkville, Melbourne, VC; Linda Johnston , RN, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Department of Neonatology, Royal Children’s Hospital, Parkville, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC, Australia
Search for more papers by this authorLinda Johnston
Authors: Misel Trajanovska , BSc (Psych), BBioMed (Hons), PhD Candidate, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC; Elizabeth Manias , RN, MPharm, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Noel Cranswick , MBBS, BMedSc, FRACP, Associate Professor, Department of Paediatrics, Royal Children’s Hospital, Parkville, Melbourne, VC and Australian Paediatric Pharmacology Research Unit, Murdoch Childrens Research Institute & Royal Children’s Hospital, Parkville, Melbourne, VC; Linda Johnston , RN, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Department of Neonatology, Royal Children’s Hospital, Parkville, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC, Australia
Search for more papers by this authorMisel Trajanovska
Authors: Misel Trajanovska , BSc (Psych), BBioMed (Hons), PhD Candidate, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC; Elizabeth Manias , RN, MPharm, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Noel Cranswick , MBBS, BMedSc, FRACP, Associate Professor, Department of Paediatrics, Royal Children’s Hospital, Parkville, Melbourne, VC and Australian Paediatric Pharmacology Research Unit, Murdoch Childrens Research Institute & Royal Children’s Hospital, Parkville, Melbourne, VC; Linda Johnston , RN, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Department of Neonatology, Royal Children’s Hospital, Parkville, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC, Australia
Search for more papers by this authorElizabeth Manias
Authors: Misel Trajanovska , BSc (Psych), BBioMed (Hons), PhD Candidate, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC; Elizabeth Manias , RN, MPharm, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Noel Cranswick , MBBS, BMedSc, FRACP, Associate Professor, Department of Paediatrics, Royal Children’s Hospital, Parkville, Melbourne, VC and Australian Paediatric Pharmacology Research Unit, Murdoch Childrens Research Institute & Royal Children’s Hospital, Parkville, Melbourne, VC; Linda Johnston , RN, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Department of Neonatology, Royal Children’s Hospital, Parkville, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC, Australia
Search for more papers by this authorNoel Cranswick
Authors: Misel Trajanovska , BSc (Psych), BBioMed (Hons), PhD Candidate, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC; Elizabeth Manias , RN, MPharm, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Noel Cranswick , MBBS, BMedSc, FRACP, Associate Professor, Department of Paediatrics, Royal Children’s Hospital, Parkville, Melbourne, VC and Australian Paediatric Pharmacology Research Unit, Murdoch Childrens Research Institute & Royal Children’s Hospital, Parkville, Melbourne, VC; Linda Johnston , RN, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Department of Neonatology, Royal Children’s Hospital, Parkville, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC, Australia
Search for more papers by this authorLinda Johnston
Authors: Misel Trajanovska , BSc (Psych), BBioMed (Hons), PhD Candidate, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC; Elizabeth Manias , RN, MPharm, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Noel Cranswick , MBBS, BMedSc, FRACP, Associate Professor, Department of Paediatrics, Royal Children’s Hospital, Parkville, Melbourne, VC and Australian Paediatric Pharmacology Research Unit, Murdoch Childrens Research Institute & Royal Children’s Hospital, Parkville, Melbourne, VC; Linda Johnston , RN, PhD, Professor, School of Nursing & Social Work, The University of Melbourne, Melbourne, VC; Department of Neonatology, Royal Children’s Hospital, Parkville, Melbourne, VC and Critical Care & Neurosciences, Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Melbourne, VC, Australia
Search for more papers by this authorAbstract
Aims and objectives. To explore parental management of childhood complaints with respect to factors associated with the purchase of over-the-counter medicines and sources of information accessed by parents.
Background. The use of over-the-counter medicines is extensive, but this practice is not without risks. To ensure safe use, nurses and other healthcare providers need to understand parental reasons for purchase and sources of information they access regarding management practices.
Design. A cross-sectional survey.
Method. Three-hundred and twenty-five parents of children (aged birth to 24 months) were recruited between September 2006–June 2007 from three recruitment sites across Melbourne, Australia. These included the following: outpatient clinics at a major paediatric hospital, maternal and child health centres and a childcare service of a tertiary education institution. Data were collected using a self-administered questionnaire.
Result. Most parents (82%) purchased over-the-counter medicines if suggested by the doctor and if it had been effective in the past. Doctors were the most frequently cited source of advice for management of complaints such as an ear ache (95%), wheeziness (90%) and rash (77%). Advice from maternal and child health nurses was frequently sought for sleep difficulties (60%), while family or friends were sought for advice on irritability or crankiness (47%) and teething pain (44%).
Conclusions. The findings revealed the impact of healthcare provider recommendations on parental purchase of over-the-counter medicines. Parents mainly sought information and advice from doctors, followed by maternal and child health nurses and family or friends, which appeared to be dependent on the type of childhood complaint.
Relevance to clinical practice. The use of over-the-counter medicines for symptom management is likely to increase with enhanced focus on self-care. It is important for all healthcare providers to proactively provide accurate, consistent and evidence-based information to parents regarding appropriate management of symptomatic and behavioural complaints.
References
- Agran PF, Anderson C, Winn D, Trent R, Walton-Haynes L & Thayer S (2003) Rates of pediatric injuries by 3-month intervals for children 0 to 3 years of age. Pediatrics 111, e683–e692.
- Allen J, Dyas J & Jones M (2002) Minor illness in children: parents’ views and use of health services. British Journal of Community Nursing 7, 462–468.
- Allotey P, Reidpath DD & Elisha D (2004) ‘Social medication’ and the control of children: a qualitative study of over-the-counter medication among Australian children. Pediatrics 114, e378–e383.
- Australian Bureau of Statistics (2001) Community Profile Series – Local government areas: 2001 Census. Available at: http://www.censusdata.abs.gov.au (accessed 20 January 2006).
- Balit CR, Isbister GK, Peat J, Dawson AH & Whyte IM (2002) Paracetamol recall: a natural experiment influencing analgesic poisoning. Medical Journal of Australia 176, 162–165.
- Bernhardt JM & Felter EM (2004) Online pediatric information seeking among mothers of young children: results from a qualitative study using focus groups. Journal of Medical Internet Research 6, e7.
- Bilenko N, Tessler H, Okbe R, Press J & Gorodischer R (2006) Determinants of antipyretic misuse in children up to 5 years of age: a cross-sectional study. Clinical Therapeutics 28, 783–793.
- Birchley N & Conroy S (2002) Parental management of over-the-counter medicines. Paediatric Nursing 14, 24–28.
- Bouche G & Migeot V (2008) Parental use of the Internet to seek health information and primary care utilisation for their child: a cross-sectional study. BMC Public Health 8, 300.
- Cantrill JA, Johannesson B, Nicolson M & Noyce PR (1996) Management of minor ailments in primary school children in rural and urban areas. Child: Care, Health and Development 22, 167–174.
- Cardol M, Schellevis FG, Spreeuwenberg P & Van De Lisdonk EH (2005) Changes in patients’ attitudes towards the management of minor ailments. British Journal of General Practice 55, 516–521.
- Conroy S, Collier J, Birchley N, Neil K, Rodgers S, McIntyre J, Choonara I & Avery A (2003) An examination of the risk management issues in the handling at home of over-the-counter medicines purchased for children. The Pharmaceutical Journal 271, 209–213.
- Crocetti M, Moghbeli N & Serwint J (2001) Fever phobia revisited: have parental misconceptions about fever changed in 20 years? Pediatrics 107, 1241–1246.
- D’Alessandro DM, Kreiter CD, Kinzer SL & Peterson MW (2004) A randomized controlled trial of an information prescription for pediatric patient education on the Internet. Archives of Pediatrics & Adolescent Medicine 158, 857–862.
- Easton KL, Chapman CB & Brien JA (2004) Frequency and characteristics of hospital admissions associated with drug-related problems in paediatrics. British Journal of Clinical Pharmacology 57, 611–615.
- Ecklund CR & Ross MC (2001) Over-the-counter medication use in preschool children. Journal of Pediatric Health Care 15, 168–172.
- Eiland LS, Salazar ML & English TM (2008) Caregivers’ perspectives when evaluating nonprescription medication utilization in children. Clinical Pediatrics 47, 578–587.
- Goldman RD & Macpherson A (2006) Internet health information use and e-mail access by parents attending a paediatric emergency department. Emergency medicine journal 23, 345–348.
- Gross GJ & Howard M (2001) Mothers’ decision-making processes regarding health care for their children. Public Health Nursing 18, 157–168.
- Haddow G & Watts R (2003) Caring for a febrile child: the quality of Internet information. Collegian 10, 7–12.
- Hammond T, Clatworthy J & Horne R (2004) Patients’ use of GPs and community pharmacists in minor illness: a cross-sectional questionnaire-based study. Family Practice 21, 146–149.
- Hay AD, Heron J & Ness A (2005) The prevalence of symptoms and consultations in pre-school children in the Avon Longitudinal Study of Parents and Children (ALSPAC): a prospective cohort study. Family Practice 22, 367–374.
- Hodgson C & Wong I (2004) What do mothers of young children think of community pharmacists? A descriptive survey. Journal of Family Health Care 14, 73–74.
- Hung CC, Chen YC, Mao HC & Chiang BL (2002) Effects of systematic nursing instruction of mothers on using medication and on health status of asthmatic children. Journal of Nursing Research 10, 22–32.
- Ikemba CM, Kozinetz CA, Feltes TF, Fraser CD Jr, McKenzie ED, Shah N & Mott AR (2002) Internet use in families with children requiring cardiac surgery for congenital heart disease. Pediatrics 109, 419–422.
- Janicke DM & Finney JW (2001) Children’s primary health care services: a social-cognitive model of sustained high use. Clinical Psychology-Science and Practice 8, 228–241.
- Janicke DM, Finney JW & Riley AW (2001) Children’s health care use: a prospective investigation of factors related to care-seeking. Medical Care 39, 990–1001.
- Janz NK & Becker MH (1984) The Health Belief Model: a decade later. Health Education Quarterly 11, 1–47.
- Kai J (1996a) Parents’ difficulties and information needs in coping with acute illness in preschool children: a qualitative study. British Medical Journal 313, 987–990.
- Kai J (1996b) What worries parents when their preschool children are acutely ill and why: a qualitative study. British Medical Journal 313, 983–986.
- Karwowska A, Nijssen-Jordan C, Johnson D & Davies HD (2002) Parental and health care provider understanding of childhood fever: a Canadian perspective. Canadian Journal of Emergency Medical Care 4, 394–400.
- Keatinge D (2006) Parents’ preferred child health information sources: implications for nursing practice. The Australian Journal of Advanced Nursing 23, 13–18.
- Kogan MD, Pappas G, Yu SM & Kotelchuck M (1994) Over-the-counter medication use among US preschool-age children. Journal of the American Medical Association 272, 1025–1030.
- Lagerlov P, Helseth S & Holager T (2003) Childhood illnesses and the use of paracetamol (acetaminophen): a qualitative study of parents’ management of common childhood illnesses. Family Practice 20, 717–723.
-
McIntyre J,
Conroy S,
Collier J,
Birchley N,
Rodgers S,
Neil K,
Choonara I &
Avery A (2003) Use of over-the-counter medicines in children.
International Journal of Pharmacy Practice
11, 209–215.
10.1211/0022357022629 Google Scholar
- Morris CJ, Cantrill JA & Weiss MC (2001) GPs’ attitudes to minor ailments. Family Practice 18, 581–585.
- Neill SJ (2000) Acute childhood illness at home: the parents’ perspective. Journal of Advanced Nursing 31, 821–832.
- Noll S, Spitz L & Pierro A (2001) Additional medical information: prevalence, source and benefit to parents. Journal of Pediatric Surgery 36, 791–794.
- Pandolfini C, Impicciatore P & Bonati M (2000) Parents on the web: risks for quality management of cough in children. Pediatrics 105, e1.
- Pridham KF (1998) Guided participation and development of care-giving competencies for families of low birth-weight infants. Journal of Advanced Nursing 28, 948–958.
- Purssell E (2007) Treatment of fever and over-the-counter medicines. Archives of Disease in Childhood 92, 900–901.
- Rosenstock IM (1974) The Health Belief Model and preventive health behavior. Health Education Monographs 2, 354–385.
- Semere W, Karamanoukian HL, Levitt M, Edwards T, Murero M, D’Ancona G, Donias HW & Glick PL (2003) A pediatric surgery study: parent usage of the Internet for medical information. Journal of Pediatric Surgery 38, 560–564.
- Sim NZ, Kitteringham L, Spitz L, Pierro A, Kiely E, Drake D & Curry J (2007) Information on the World Wide Web – how useful is it for parents? Journal of Pediatric Surgery 42, 305–312.
- Slack-Smith LM, Read AW & Stanley FJ (1998) The use of medication in children attending childcare in Western Australia. Journal of Paediatrics and Child Health 34, 183–187.
- Tomassoni AJ & Simone K (2001) Herbal medicines for children: an illusion of safety? Current Opinion in Pediatrics 13, 162–169.
- Trewin D (2003) Census of Population and Housing: Socio-economic Indexes for Areas (SEIFA), Australia 2001 (Information paper) Cat. no. 2039.0. Australian Bureau of Statistics, Canberra.
- Trewin D (2004) Census of Population and Housing: Socio-economic Indexes for Areas (SEIFA), Australia 2001 (Technical paper) Cat. no. 2039.0.55.001. Australian Bureau of Statistics, Canberra.
- Tuffrey C & Finlay F (2002) Use of the internet by parents of paediatric outpatients. Archives of Disease in Childhood 87, 534–536.
- Vuckovic N & Nichter M (1997) Changing patterns of pharmaceutical practice in the United States. Social Science & Medicine 44, 1285–1302.
- Wainstein BK, Sterling-Levis K, Baker SA, Taitz J & Brydon M (2006) Use of the Internet by parents of paediatric patients. Journal of Paediatrics and Child Health 42, 528–532.
- Walsh A, Edwards H & Fraser J (2007a) Influences on parents’ fever management: beliefs, experiences and information sources. Journal of Clinical Nursing 16, 2331–2340.
- Walsh A, Edwards H & Fraser J (2007b) Over-the-counter medication use for childhood fever: a cross-sectional study of Australian parents. Journal of Paediatrics and Child Health 43, 601–606.
- Wilson K, Dowson C & Mangin D (2007) Prevalence of complementary and alternative medicine use in Christchurch, New Zealand: children attending general practice versus paediatric outpatients. New Zealand Medical Journal 120, U2464.
- World Self-Medication Industry (2007) Legal classification status of selected ingredients worldwide: Non-prescription ingredients classification. Available at: http://www.wsmi.org/otc.htm (accessed 26 July 2007).