Why Parents Seek Care for Acute Illness in the Clinic or the ED: The Role of Health Literacy. Acad Pediatr 2018 Apr;18(3):289-296
Date
06/20/2017Pubmed ID
28625711Pubmed Central ID
PMC5732897DOI
10.1016/j.acap.2017.06.010Scopus ID
2-s2.0-85028331804 (requires institutional sign-in at Scopus site) 43 CitationsAbstract
OBJECTIVE: To explore the decision to seek care and decision-making regarding location of care among parents with low and adequate health literacy.
METHODS: Parents of children 8 years old or younger who presented for 'sick child' visits at a clinic or a nonurgent emergency department (ED) visit (triage level 5) were interviewed. The Newest Vital Sign was used to categorize parental health literacy. Interviewers followed a semistructured interview guide to understand: 1) care-seeking for current illness, and 2) choice of clinic or ED. Themes emerged using a grounded theory process, facilitated by NVivo version 10.0 software (QSR International, Melbourne, Australia). Themes included the experiences of low and adequate health literacy in the clinic as well as in the ED.
RESULTS: Fifty semistructured interviews were completed with parents who brought their child to the ED for a nonurgent visit (n = 30) and clinic parents (n = 20) with 56% possessing low health literacy. Parents with low health literacy were more inclined to overestimate severity of illness and seek care sooner to gain answers about the illness and treatment options, and visit the clinic only when an appointment was available within hours. Parents with adequate health literacy sought reassurance for their ongoing illness management and valued close relationships with their physician, and were willing to wait longer for an appointment. Fever, vomiting, and young child age prompted some parents to seek expedient care regardless of health literacy.
CONCLUSIONS: Caregiving skills (eg, assessing and treating illness, understanding illness severity, and navigating the health care system) in addition to physician-parent relationships and perception of care seem to influence the behavior of parents managing their child's mild acute illness. These factors might be amenable to a future health literacy intervention.
Author List
May M, Brousseau DC, Nelson DA, Flynn KE, Wolf MS, Lepley B, Morrison AKAuthors
Kathryn Eve Flynn PhD Vice Chair, Professor in the Medicine department at Medical College of WisconsinDavid A. Nelson PhD Professor in the Family Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Acute DiseaseAdolescent
Adult
Ambulatory Care Facilities
Child
Child, Preschool
Decision Making
Emergency Service, Hospital
Female
Grounded Theory
Health Literacy
Humans
Infant
Infant, Newborn
Male
Middle Aged
Parents
Patient Acceptance of Health Care
Professional-Family Relations
Young Adult
