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Abstract of

Management of childhood gastroenteritis in the community

Perceptions of general practitioners

Jennifer E Porteous, Richard L Henry, Edward V O'Loughlin, Malcolm Ireland, J Lynn Francis and Robyn G Hankin

Electronically published Thursday 12 June 1997. Please submit comments by Thursday 10 July 1997.

 

Abstract

Objective: To examine the stated practices of general practitioners (GPs) in managing childhood gastroenteritis and their perceptions about barriers to its optimal management.
Design: Cross sectional postal survey.
Setting: General practice in 1994.
Participants: All 422 urban and rural GPs practising in the Hunter Region were invited to participate. 289 (68%) responded.
Results: 97% of GPs recommended clear fluids in the management of childhood gastroenteritis, with 195 recommending oral electrolyte solution (OES). 170 GPs (59%) were assessed by an expert as managing gastroenteritis well, while an additional 33 (11%) managed gastroenteritis acceptably. 38 GPs (13%) suggested management that an expert considered inadvisable and/or potentially dangerous; and 48 (17%) provided answers that were too vague to classify. Multiple logistic regression analysis indicated that better management strategies were associated with being younger and practising in rural areas. The main barriers to effective care in gastroenteritis, as perceived by the GPs, were inadequate parenting skills ( n= 131, 45%), lack of parental understanding about gastroenteritis ( n= 118, 41%), other social problems ( n= 67, 23%), parental anxiety ( n= 57, 20%) and conflicting advice given by others ( n= 42, 15%). Only 33 (11%) identified the taste of OES as a major barrier and 16 (6%) its cost.
Conclusions: Most GPs made appropriate use of dilute clear fluids and avoided prescription medication when treating childhood gastroenteritis in the community. Perceived barriers to the effective management of gastroenteritis tended to reflect parental factors.
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