Background
Methods
Participants
Data collection and analysis
Topics in the interview guide | |
---|---|
What do you think causes the illness? | |
What treatments are available? | |
Which treatment do you think is best? | |
How do you know this? | |
How does your GP know? | |
Do you think ‘no antibiotic treatment’ is an option? | |
In what ways can you decide which treatment is the best? |
Results
Participant | Age (years) | Number of children | Tertiary education | Health professional qualification | REALM Score |
---|---|---|---|---|---|
1 | 40 | 2 | No | No | 63 |
2 | 41 | 2 | Yes | No | 66 |
3 | 49 | 6 | No | No | 65 |
4 | 39 | 2 | Yes | No | 66 |
5 | 39 | 2 | Yes | No | 66 |
6 | 37 | 3 | Yes | No | 65 |
7 | 31 | 1 | Yes | No | 66 |
8 | 41 | 4 | Yes | No | 65 |
9 | 33 | 1 | Yes | No | 66 |
10 | 35 | 3 | Yes | Yes | 66 |
11 | 32 | 1 | Yes | Yes | 66 |
12 | 35 | 1 | Yes | Yes | 66 |
13 | 36 | 2 | No | No | 66 |
14 | 29 | 2 | Yes | No | 65 |
15 | 35 | 2 | Yes | Yes | 66 |
Participant (parent ID) | Antibiotic treatmenta |
---|---|
1 | + |
2 | + |
3 | + |
4 | + |
5 | + |
6 | + |
7 | Delayed prescriptionb |
8 | + |
9 | + |
10 | + |
11 | No |
12 | No |
13 | + |
14 | + |
15 | + |
Causes of acute otitis media
“Absolutely no idea, I don’t even know what an ear infection is really, it’s just something that I’m told that my children have” (Participant 1)
“I thought it was like an extended version of a cold. A cold gone wrong basically, or gone worse” (Participant 6)“I’d say he probably had a cold beforehand which then turned into something more than that” (Participant 9)
“Teething maybe, build up of ear wax I think” (Participant 1)“I think in our children they have been water related. They’ve been swimming, something hasn’t drained, a little germ has festered in the ear and it’s got out of all control” (Participant 4)“I think it’s because the Eustachian tubes are straight at that age, so anything like mucus and saliva and things that they have a cold can quite easily make their way to their ears” (Participant 12)
Reasons for consulting a GP
“…you don’t like little ones to be in pain, so it is quite traumatising when they carry on. You know when you’re not really treating anything and just letting go. So it is quite emotional as well. I want it to be fixed right then and there” (Participant 11)“Well it could go further down and they could get like a… I have heard of people getting, well even septicaemia from going into the blood systems” (Participant 15)“Possibly end up in hospital on a rehydration drip, which she has done previously, when she was very little” (Participant 4)
“I don’t really want his eardrum to burst” (Participant 5)“I think most mothers worry about their child’s hearing…” (Participant 14)“I would probably say that it might have a long-term impact on hearing. Irreversible” (Participant 13)
Beliefs about treatments
“…each time the antibiotics have worked like magic.” (Participant 4)“I kind of thought it was quite simple really, just had an ear infection and that I needed antibiotics” (Participant 15)“I think first of all you need to find out whether it’s viral or bacterial and then follow the according treatment” (Participant 11)
“The only option we were given was antibiotics. Apart from that, I wouldn’t imagine that there’s much else” (Participant 7)“Well the only thing I’ve ever been offered is antibiotics, so I don’t know of anything else” (Participant 1)“No, it was just, ‘Here’s the antibiotics and off you go’” (Participant 14)
“Yes, I think in certain circumstances, but it would have to be monitored, so… that the infection is resolving and that they’re not going to have any hearing issues as a result” (Participant 10)“I would try it [no antibiotic treatment], as long as my option would be then to go back in a few days to make sure that it hasn’t got worse…” (Participant 3)
“… I am thinking well if they don’t treat him, what if he goes deaf?” (Participant 1)“Preferably not, not when it comes to ears. I don’t want to take that chance with my child’s hearing” (Participant 2)“…he was in full-time day care and from my point of view I had to get it fixed. So we went and got it filled that morning” (Participant 9)“We are on holidays, we are in a different environment, if antibiotic is a suggested option, I will certainly go down that track…” (Participant 5)
“But if I knew straight away that it was an ear infection, then I wouldn’t bother with just Panadol or something like that, I would go straight to the antibiotics to help their body knock it” (Participant 4)
Sources of knowledge
“Well I actually hope he knows what’s best, because he’s done more studies that what I’ve done… yeah, I mean we put a lot of faith in our GP’s” (Participant 3)“Well, one hopes that they’re [GP’s] trained better than us to have a lot more information than we do, and I suppose we have to trust that they have done the research and that they do know” (Participant 13)…some GPs have children themselves and understand that children need to be seen straight away… (Participant 6)
“I probably get the most information from the GP and trust that that source of information is relevant to my child, because I think every child is different” (Participant 5)“I probably go to ‘Google’ or ‘Doctor Google’, one of those” (Participant 14)“…mum usually diagnoses anything for everyone before they even suspect there’s something wrong themselves” (Participant 4)“…if I couldn’t get into a doctor or something, which happens quite regularly, I would maybe go to the pharmacist…” (Participant 1)
“…there [are] options presented as hypotheticals, but they [GP’s] will always come to a decision and say, look I think we need to do the medication”… (Participant 5)“Well I know they [GPs] used to give antibiotics, but I’ve been explained by the GP that that’s not what they do anymore. That they [antibiotics] don’t seem to alter the course of the illness, they tend to just give them pain relief and wait and see what happens…” (Participant 12)
“…because it is an emergency appointment it feels quite rushed, it’s in and out the door…” (Participant 2)