title: Management of respiratory tract infections in young children-A qualitative study of primary care providers' perspectives.
abstract: Respiratory tract infections in young children are the most common cause of general practice visits in Australia. Despite the availability of clinical practice guidelines, the treatment and management of respiratory tract infections in young children is inconsistent. The aim of the study was to explore the management of respiratory tract infections in young children from a multi-disciplinary perspective using across-sectional qualitative research design based on the theoretical domains framework and the Capability, Opportunity and Motivation-B model. In-depth interviews were conducted with 30 primary care providers to explore their knowledge, views and management of respiratory tract infections in young children. Interviews focused on symptomatic management, over-the-counter medications and antibiotic use, and data were thematically analysed. Our findings showed that factors such as primary care providers' time constraints, parental anxiety, general practitioners' perception of what parents want, perceived parental pressure, and fear of losing patients were some of the reasons why primary care providers did not always adhere to guideline recommendations. Primary care providers also provided conflicting advice to parents concerning over-the-counter medications and when children should resume normal activities. Overall, this study showed that complex interactions involving emotional and psychological factors influenced the decision making process of primary care providers' management of respiratory tract infections in young children. A team care approach with consistent advice, and improved communication between primary care providers and parents is vital to overcome some of these barriers and improve guideline adherence. The findings of this research will inform the development of interventions to better manage respiratory tract infections in young children.
  
  
  
  CLINICIANS SWAYED BY PARENTAL ANXIETY AND PRESSURE: The emotions and psychology of both parents and clinicians influence how respiratory tract infections (RTIs) are managed in young children. Researchers in Australia, led by Ruby Biezen from Monash University, interviewed 30 primary care clinicians about their views on how to care for children with RTIs, such as the common cold. The interviews focused on symptomatic management, over-the-counter medications and antibiotic use. Despite the availability of best-practice guidelines, clinicians did not always follow the recommendations owing to factors such as time constraints, parental anxiety, perceived parental pressure, and fear of losing patients. These are some of the reasons why clinicians sometimes advise or prescribe unnecessary medications. The authors suggest that a team approach involving multiple healthcare professionals who deliver consistent advice could improve guideline adherence.
authors.affiliation: Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia. ruby.biezen@monash.edu.
authors.forename: Ruby
authors.initials: R
authors.lastname: Biezen
authors.affiliation: Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia.|School of Occupational Therapy and Social Work, Curtin University, Building 401, Kent Street, Bentley, WA, 6152, Australia.
authors.forename: Bianca
authors.initials: B
authors.lastname: Brijnath
authors.affiliation: School of Applied Sciences, RMIT University, Building 223, Level 1, Bundoora Campus, Plenty Road, Bundoora, VIC , 3083, Australia.
authors.forename: Danilla
authors.initials: D
authors.lastname: Grando
authors.affiliation: Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia.
authors.forename: Danielle
authors.initials: D
authors.lastname: Mazza
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000996:Antitussive Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001315:Australia; D002675:Child, Preschool; D019468:Disease Management; D005440:Fluid Therapy; D058005:General Practitioners; D006801:Humans; D007223:Infant; D016389:Maternal-Child Nursing; D014663:Nasal Decongestants / Q000627:therapeutic use; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D009726:Nurses; D000070659:Patient Comfort; D010353:Patient Education as Topic; D010372:Pediatrics; D010595:Pharmacists; D010936:Plant Extracts / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D036301:Qualitative Research; D012141:Respiratory Tract Infections / Q000628:therapy*; D012146:Rest
chemical_list: D000900:Anti-Bacterial Agents; D000996:Antitussive Agents; D014663:Nasal Decongestants; D004366:Nonprescription Drugs; D010936:Plant Extracts; C012510:prospan