Acute gastroenteritis: a qualitative study of parental motivations, expectations, and experiences during out-of-hours primary care

Anouk Weghorst, Marian Van Den Brink, Irma Bonvanie, Jolanda Tuinstra, Gea Holtman, Elleke Landeweer, Marjolein Berger

Keywords: acute gastroenteritis, motivation, expectation, primary care, general practitioner

Background:

Acute gastroenteritis is a common infectious disease in children under 6 years old. Although it is a self-limiting disease, it nevertheless has a high consultation rate in primary care, especially during out-of-hours primary care (OOH-PC). Reasons for this high consultation rate are still unclear.

Research questions:

What are the parental motivations, expectations, and experiences of OOH-PC contacts for children with acute gastroenteritis?

Method:

A qualitative study with a purposive sample of parents who contacted OOH-PC for children aged 6 months to 6 years with acute gastroenteritis was performed. Fourteen semi-structured interviews with parents who contacted the OOH-PC were conducted. Interviews were video recorded, transcribed and analysed by constant comparison.

Results:

Unusual behaviour of the sick child, absent micturition, and on-going vomiting and/or diarrhoea, with either reduced or no fluid intake, motivated parents to contact the OOH-PC. Parents instigated contact to prevent symptom deterioration and to be reassured by a general practitioner (GP), expecting them to perform a thorough physical examination, provide information, and make follow-up agreements. Parents reported dissatisfaction if they felt unheard, misunderstood, or not taken seriously, and this increased their likelihood of seeking another consultation. Unfortunately, GPs did not always meet parental expectations.

Conclusions:

Multiple factors affect the decision for parents to contact the OOH-PC for their child with gastroenteritis. There is a mismatch between the parental expectations and actions of the GP. Awareness about the feelings and understanding expectations of parents can guide GPs in the interaction with parents which could improve satisfaction with primary healthcare.

Points for discussion:

General practitioners communication skills

Education of parents for home management

Fulfilling expectations of parents by general practitioners

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