An Integrative Review of Korean Nursing Studies on Pediatric Tonsillectomy

PURPOSE: Tonsillectomy is a very common surgical procedure, particularly in children. The purpose of this study was to identify current evidence in nursing research on pediatric tonsillectomy by analyzing and evaluating Korean nursing studies related to pediatric tonsillectomy. METHODS: An integrative literature review of Korean pediatric tonsillectomy research was conducted. Databases were searched to identify research that related to nursing care for pediatric tonsillectomy children. RESULTS: Of the 115 studies identified, 13 studies met the inclusion criteria for this review. All studies were experimental studies and most of those studies had a quasi experimental design. No correlational studies or qualitative studies were found. Providing nursing information and education for children and their mothers at pre, during, and post tonsillectomy by pediatric nurses were found to be effective in reducing children's pain and anxiety and their mother's anxiety and uncertainty, and increasing children's appropriate sick role behaviors and their mother's satisfaction with nursing services provided and knowledge related to tonsillectomy. CONCLUSION: Although most studies reported positive effects in terms of post tonsillectomy outcomes, lack of methodological rigor limits the current evidences for pediatric tonsillectomy nursing interventions. Greater attention to improve methodological rigor for Korean research on pediatric tonsillectomy is needed.

Childhood Fever Management: Current Practice vs Evidence

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.

Fever Phobia: A Survey of Children's Parents in a Pediatric Outpatient Clinic

PURPOSE: Purposes of this study were to identify the level of parental fever phobia and to investigate the relationship between level of parental concern about fever and related variables. METHODS: Participants were 151 parents of children who visited a pediatric outpatient clinic. A self-reported structured questionnaire was used for data collection and data were analyzed using descriptive statistics and chi2-test. RESULTS: Almost half of participants defined a minimum temperature for fever as 37.8degrees C and a minimum temperature for high fever as 38.9degrees C. About 75% of participants identified harmful effects of fever as seizure and brain damage, were 'very worried' about fever, measured their child's temperature every hour or less, provided tepid massage and woke children to give antipyretics during febrile illness. There were significant relationships between level of parental concerns about fever and prior experience of febrile seizures, and/or being parents of a single child. CONCLUSION: Results indicate that fever phobia is prevalent among parents. Further studies are needed to develop and evaluate childhood fever management educational programs for parents. Considering health care providers as a primary information resource about fever management, health care providers should play a vital role to reduce parental unrealistic concerns about fever.