ArticleBMJ open2026
Understanding parents' decisions to seek care for children with serious bacterial infections: a qualitative study.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo explore which factor or combination of factors is perceived by parents as most distinctive in prompting them to seek medical care for children aged 0-5 years who were admitted to the hospital with fever due to a serious bacterial infection (SBI), in order to inform further development of an e-health tool.
designA qualitative study was conducted using semi-structured interviews with a purposive sampling strategy. Interviews were conducted by a medical intern and supervised by a clinician researcher. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis to identify key themes in parental decision-making.
settingPaediatric ward of the Juliana Children's Hospital in The Hague, an urban teaching hospital in the Netherlands, between April and June 2024.
participantsParents of children aged 0-5 years admitted with a suspected SBI were eligible. Of the 17 parents approached, 15 agreed to participate in 13 interviews (ie, in two interviews both parents participated).
results13 interviews with 15 parents revealed five themes. Parents sought medical attention when they perceived a shift in their child's illness state, based on three themes: perceived abnormal illness presentation through either single alarming symptoms (altered consciousness, breathing difficulties, skin changes) or symptom combination, symptom recognition based on previous experiences or prolonged fever and respiratory complaints. Many parents demonstrated awareness of symptoms aligning with professional red flag indicators. The fourth and fifth themes, work constraints and limited general practitioner access, highlighted external barriers that sometimes delayed help-seeking.
conclusionThis study highlights key factors influencing parents' decisions to seek medical care for febrile children with an SBI, emphasising the importance of both parental perceptions and clinical symptoms. The findings may inform parent-centred resources including an e-health tool, which support parents in assessing illness severity and deciding when to seek medical care.
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