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Parental and physician disagreement on help-seeking in paediatric case scenarios
  1. Sarah Visscher1,
  2. Karlijn van Stralen1,
  3. Jaan Toelen2,3,4,
  4. Peter de Winter1,2,3
  1. 1 Department of Pediatrics, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
  2. 2 Department of Development and Regeneration, KU Leuven, Leuven, Belgium
  3. 3 Leuven Child and Youth Institute, KU Leuven, Leuven, Belgium
  4. 4 Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
  1. Correspondence to Peter de Winter, Department of Pediatrics, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands; pdewinter{at}


Objective Whenever a child falls ill, parents need to decide whether there is a need to contact medical professionals. Parental and physician perspectives on the severity of a child’s illness differ. We aimed to determine triggers for help-seeking among parents.

Design and setting We conducted a survey study among 200 parents. In four hypothetical case scenarios, an acutely ill child was described with a baseline symptom (abdominal pain, rhinitis, headache, limping), with deterioration over time. Parents had to answer when they would contact the general practitioner. Fifty-four physicians received the same case scenarios.

Main outcome measures Parents and physicians did not differ significantly in help-seeking in the abdominal pain case. In the non-urgent rhinitis case, parents sought help earlier than physicians wished them to, while in the urgent illness cases of headache and limping parents tend to seek help later than physicians wished. Rising body temperature was more alarming to parents than physicians, while loss of appetite did not concern either group. Parents did not recognise several red flags, for example, drowsiness and refusal to stand. Low educated parents and parents with a history of more frequent healthcare use were inclined to seek help earlier.

Implication of results In urgent cases, parents do not seem to recognise red flags, while some non-urgent symptoms trigger them to seek help. This reveals a need for mutual education. Physician awareness of a perception gap could help them adjust their communication and empower parents.

  • paediatrics
  • child health services
  • emergency care

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  • Contributors SV performed the study and made significant contribution to the manuscript. KvS codeveloped the study, performed all statistics and made significant contribution to the manuscript. JT developed the study design and made significant contribution to the manuscript. PdW is the principal investigator, developed the study and wrote the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.