Abstract
BACKGROUND: Little is known regarding parents' experiences caring for children with acute otitis media (AOM). This study aimed to explore parents' experiences caring for their child with AOM, identifying symptoms they observed, their thoughts and feelings about those symptoms, how they managed the episode, and what factors caused them to seek medical evaluation. METHODS: From October 2019 to February 2020, we conducted 24 semi-structured cross-sectional interviews with parents of children 3 to 36 months of age with AOM diagnosed at primary care offices associated with the Children's Hospital of Pittsburgh regarding (1) symptoms and behaviors that led parents to believe their child might have AOM; (2) symptoms that were most bothersome to parent and child; (3) what parents did in response to these symptoms; (4) motivations for seeking clinical care; and (5) parents' expectations regarding AOM resolution. Data were analyzed using template analysis, resulting in a hybrid inductive/deductive analytic process. RESULTS: We interviewed 24 parents within 72 h of diagnosis of AOM. Parents frequently believed ear tugging was the symptom most indicative of AOM, despite its presence in only half of the children in this sample. Parents consistently sought medical care when their child had an elevated temperature or lack of sleep, or when symptoms worsened or were unresponsive to home remedies. Parents of children with history of recurrent AOM had less difficulty identifying symptoms of AOM than parents of children with their first ear infection. CONCLUSIONS: Our findings provide insight into symptoms of AOM that cause parents concern and motivate the use of healthcare services. Parents differed in their abilities to observe and report symptoms of AOM. Thus, when interviewing parents who are concerned their preverbal child has AOM, rather than focusing on ear tugging and fever alone, providers should ascertain all unusual behaviors observed by the parent.