http://repub.eur.nl/res/aut/39833/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/28043/ 2010-05-01T00:00:00Z Objective: The objective was to study parental fever management and attitude toward fever from the perspective of the child's ethnicity and age. Patients and setting:: Children with fever presenting at the pediatric emergency department (PED) of the Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands, in the period from February 2002 to March 2004. DESIGN:: Prospective observational. MAIN OUTCOME MEASURES:: Parental fever attitude and management assessed by a questionnaire. Results: Two hundred eleven children with fever (median age, 1.2 years; interquartile range, 0.7-2.0 years) were included, of whom 108 (55%) were boys. One hundred fourteen children (54%) were self-referrals at the PED. Accompanying symptoms were reported in 95% (50% had ≥3); median temperature measured at PED was 39.5°C (interquartile range, 38.9°C-40.8°C). One hundred fifty-five parents (74%) had used antipyretics to reduce fever, and 155 parents (74%) were worried about fever and its possible complications. Differences between Dutch and non-Dutch ethnicities were seen in temperature-reducing techniques, self-referral, and parental anxiety of fever and its complications. Age did not influence parental fever attitude and management. Conclusions: For most children in our population, the use of antipyretics was justified, as the majority of our children visiting the PED for an acute febrile episode are young infants, in particular with a high degree of fever and accompanying symptoms. We confirm and extend previous findings of ethnicity influencing parental fever management. http://repub.eur.nl/res/pub/31982/ 2002-10-09T00:00:00Z The general paediatric outpatient care in the university hospitals in the Netherlands provides secondary and tertiary care to children aged from 0 to 16 years. Since several years, the patient population and the use of healthcare appears to be changing and these developments require further analyses. Outpatient departments as well as emergency departments are visited by children with different ethnic and socio-economic backgrounds with a diversity of health problems. The first aim of this thesis was to obtain insights into patient characteristics, especially ethnicity and socio-economic status, and medical problems presented to the emergency department and the outpatient department of a university paediatric hospital. Clinicians suggest changes in healthcare use by parents and patients. They perceive an increase of non-urgent visits to emergency departments and an increase of second opinion visits at outpatient departments. Therefore, the second aim was to evaluate non-urgent visits and second opinion visits in paediatric outpatient care. The third aim was to obtain and delineate possible explanations for differences in health and helpseeking behaviour between ethnic minorities Insight into these aspects of paediatric outpatient care (healthproblems, healthcare use and patient characteristics), can be helpful in the development of strategies that might optimise and fine tune the care for groups of children with different backgrounds and health problems