Abstract
INTRODUCTION: Fever in children is typically not an indication of severe illness; however, parental anxiety remains high. Recently, factors such as declining birth rates and the COVID-19 pandemic have influenced parental health awareness and behavior. This study aimed to evaluate the concerns and knowledge about fever among parents whose children visited the emergency department in 2017 and 2024, and to evaluate the changes over the 7 years and the association with the download of the smartphone app "Oshiete! Doctor," which provides child healthcare information. METHODS: These repeated cross-sectional surveys were conducted at the Holiday Pediatric Medical Center in Saku in 2017 and 2024. A questionnaire was administered to caregivers of children aged ≤8 years to assess their anxiety about fever (brain damage, seizures, and dehydration) and knowledge (need for antibiotics for fever, body temperature as a criterion for consultation, and the criteria for attending daycare). The awareness and utilization of the application were also investigated. Data from 2017 and 2024 were compared using the chi-square and t-tests. RESULTS: A comparison between the 2017 survey (n = 224) and the 2024 survey (n = 261) revealed a significant increase in concerns about brain damage and seizures in response to fever (+14.4% and +14.9%, respectively). In contrast, substantial improvements were observed in the recognition of the necessity of antibiotics for fever, the recognition of body temperature as a criterion for consultation, and the criteria for attending daycare. When participants were stratified according to the application download status, anxiety levels increased in both groups; however, the magnitude of increase was slightly smaller in the download group. Nevertheless, statistical significance was not confirmed in the multivariable analysis. DISCUSSION: Over the past 7 years, an increase in parents' knowledge of fever and an escalation in their anxiety were observed. However, the dissemination of the application alone did not demonstrate an effect strong enough to offset the overall increase in societal anxiety. Future studies may be able to more clearly verify a suppressive effect on this increase by using more refined exposure measurements based on behavioral indicators, such as actual frequency of use, including by expanding the sample size.