242 Parents' views of using children's emergency services during the covid-19 pandemic. (17th August 2022)

• Record Type: Journal Article
• Authors: Walsh, Rebecca; Breckons, Matthew; Thorne, Sophie; Bhopal, Sunil; Owens, Stephen; Rankin, Judith
• Is Part Of: Archives of disease in childhood. Volume 107(2022)Supplement 2
• Page Start: A4
• Page End: A4
• Publication Date: 2022-08-17
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2022-rcpch.6
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: In March 2020 the World Health Organisation declared COVID-19 as a global pandemic. At this time the UK's healthcare services were becoming overwhelmed. To relieve the pressures the government initiated the first ever 'lockdown', the key message being 'Stay home, Protect the NHS, Save Lives'. Although seeking healthcare was still permitted, there was an alarming reduction in the number of attendances to paediatric accident and emergency units. The Royal College of Paediatrics and Child Health expressed concern in relation to delayed presentation, identifying nine deaths across the UK where delay was a potential factor. We aimed to describe parents' decision-making regarding use of children's urgent healthcare services during the first wave of COVID-19 and the experience of those who had accessed services. Methods: The study was in two phases: 1) Parents were invited, via online platforms, to complete an online survey which collected demographic data and responses about use of, and attitudes towards, accessing urgent paediatric healthcare during the pandemic. 2) A purposive sample of survey respondents were invited to take part in a telephone interview, where a semi-structured topic guide was used to further explore experiences and views. Interviews were recorded, transcribed, and analysed according to principles of Thematic Analysis. Results: In total 121 parents responded to the online survey, in order to obtain maximum variation we purposely sampled, 21 were then interviewed. The largest represented age group was 35-39 years, with most families having 2 children. When asked if COVID-19 impacted their decision around the use of emergency departments, 8 (38.1%) replied yes, 11 (52.5%) replied no and 2 (9.5%) responses were missing. The interviews identified three main themes: i) Making sense of risks: Parents differentiated between the risk to the child of contracting COVID-19 in the emergency department (ED) and the potential risk of viral transmission from the child to the wider community; it was the latter that commonly took precedence. Most regarded the risk to their child from COVID-19 as small. (ii) Understanding information regarding health service availability: Many parents understood that emergency services were accessible throughout, however some inferred 'protect the NHS' meant they should not be used. Parents cited that the overwhelming amount of information and resources available often lead to dissemination of misinformation and made identifying correct guidance difficult. (iii) Attempting to make the right decision: Parents stated it was a perpetual struggle between managing risks and acting within the 'rules'. They were acutely aware of not applying unnecessary pressure on an already stretched NHS but most stated that ultimately their primary concern would be their childrens' health. Conclusion: The data provides a real time snapshot of parental views on seeking emergency healthcare for children during the early stages of the pandemic. Our insights into parental decision-making help to explain part of the reduction in ED attendance. This work could be used to formulate future messages and improve communication from governmental and local bodies to the public during public health emergencies. Post-pandemic this may contribute to initiatives encouraging the appropriate use of urgent healthcare.