Management of childhood gastroenteritis in the community.
OBJECTIVE
To examine general practitioners' (GPs') management of childhood gastroenteritis and their perceptions about barriers to optimal management in the community.


METHODS
Cross-sectional postal survey in which GPs' self-reported practices were assessed by a paediatric gastroenterologist for compliance with published guidelines.


METHODS
Hunter region of NSW, mid 1994.


METHODS
All 422 urban and rural GPs practising in the Hunter region were sent questionnaires; 289 (243 urban and 46 rural) GPs responded.


RESULTS
Nearly all GPs (97%) recommended clear fluids in the management of childhood gastroenteritis, with 195 (67%) recommending oral electrolyte solution. Management practices were assessed as: optimal, 170 GPs (59%); acceptable, 33 GPs (11%); inappropriate or potentially dangerous, 38 GPs (13%); and too vague to classify, 48 GPs (17%). Multiple logistic regression analysis showed that better management strategies were associated with being younger and practising in rural areas. GPs perceived the main barriers to effective management of gastroenteritis were: inadequate parenting skills, 131 GPs (45%); lack of parental understanding about the illness, 118 GPs (41%); other social problems, 67 GPs (23%); parental anxiety, 57 GPs (20%); and conflicting advice given by others, 42 GPs (15%). Only 33 GPs (11%) identified the taste and 16 (6%) the cost of oral electrolyte solution as major barriers.


CONCLUSIONS
Most GPs reported management of gastroenteritis was acceptable, although not necessarily optimal. GPs need to ensure that parents fully understand the nature of their child's illness and their recommendations for management at home.
Porteous
J E
JE
Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, NSW. jennyp@cceb.newcastle.edu.au
Henry
R L
RL
O'Loughlin
E V
EV
Ireland
M
M
Francis
J L
JL
Hankin
R G
RG
D002648:Child; D003430:Cross-Sectional Studies; D005194:Family Practice; D005440:Fluid Therapy / Q000191:economics; D005759:Gastroenteritis / Q000628:therapy*; D006801:Humans; D016487:Parenting; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011368:Professional-Family Relations