title: Beyond intuition: patient fever symptom experience.
abstract: BACKGROUND
  Fever is an important sign of inflammation recognized by health care practitioners and family caregivers. However, few empirical data obtained directly from patients exist to support many of the long-standing assumptions about the symptoms of fever. Many of the literature-cited symptoms, including chills, diaphoresis, and malaise, have limited scientific bases, yet they often represent a major justification for antipyretic administration.
  
  
  OBJECTIVE
  To describe the patient experience of fever symptoms for the preliminary development of a fever assessment questionnaire.
  
  
  METHODS
  Qualitative interviews were conducted with 28 inpatients, the majority (86%) with cancer diagnoses, who had a recorded temperature of ≥38°C within approximately 12 hours before the interview. A semi-structured interview guide was used to elicit patient fever experiences. Thematic analyses were conducted by three independent research team members, and the data were verified through two rounds of consensus building.
  
  
  RESULTS
  Eleven themes emerged. The participants reported experiences of feeling cold, weakness, warmth, sweating, nonspecific bodily sensations, gastrointestinal symptoms, headaches, emotional changes, achiness, respiratory symptoms, and vivid dreams/hallucinations.
  
  
  CONCLUSIONS
  Our data not only confirm long-standing symptoms of fever but also suggest new symptoms and a level of variability and complexity not captured by the existing fever literature. Greater knowledge of patients' fever experiences will guide more accurate assessment of symptoms associated with fever and the impact of antipyretic treatments on patient symptoms in this common condition. Results from this study are contributing to the content validity of a future instrument that will evaluate patient outcomes related to fever interventions.
authors.affiliation: National Institutes of Health, Clinical Center, Bethesda, Maryland, USA. Electronic address: names@cc.nih.gov.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Ames
authors.forename: Claudia
authors.initials: C
authors.lastname: Peng
authors.forename: John H
authors.initials: JH
authors.lastname: Powers
authors.forename: Nancy Kline
authors.initials: NK
authors.lastname: Leidy
authors.forename: Claiborne
authors.initials: C
authors.lastname: Miller-Davis
authors.forename: Alice
authors.initials: A
authors.lastname: Rosenberg
authors.forename: Mark
authors.initials: M
authors.lastname: VanRaden
authors.forename: Gwenyth R
authors.initials: GR
authors.lastname: Wallen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005334:Fever / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D018908:Muscle Weakness / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D011594:Psychometrics / Q000379:methods; D015203:Reproducibility of Results; D012120:Respiration Disorders / Q000150:complications / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000379:methods*; D055815:Young Adult
keywords: Fever; content validity; qualitative research; symptoms