Why did the children stop coming? Reasons for paediatric emergency department attendance decrease during the first wave of the COVID-19 pandemic in the United Kingdom: A qualitative study
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Abstract
UK ‘Lockdown’ measures introduced in March 2020 aimed to mitigate the spread of Covid-19. Although seeking healthcare was still permitted within restrictions, paediatric emergency department attendances reduced dramatically and led to concern over risks caused by delayed presentation. Our aim was to gain insight into healthcare decisions faced by parents during the first wave of the Covid-19 pandemic and to understand if use of urgent healthcare, self-care, and information needs differed during lockdown as well as how parents perceived risks of Covid-19.
We undertook qualitative telephone interviews with a purposive sample of parents living in the North East of England recruited through online advertising. We used a semi-structured topic guide to explore past and current healthcare use, perceptions of risk and the impact of the pandemic on healthcare decisions. Interviews were transcribed and analysed using Thematic Analysis.
Three major themes were identified which concerned (i) how parents made sense of risks posed to, and by their children, (ii) understanding information regarding health services and (iii) attempting to make the right decision. These themes contribute to the understanding of the initial impact of Covid-19 and associated restrictions on parental decisions about urgent healthcare for children. These findings are important to consider when planning for potential future public health emergencies but also in the wider context of encouraging appropriate use of urgent healthcare.
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SciScore for 10.1101/2021.03.30.21254661: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: Ethical approval was granted by Newcastle University’s Faculty of Medical Sciences Research Ethics Committee (Ref: 1919/2812).
Consent: On clicking this link, participants were asked to complete a consent form and a short questionnaire including demographics, previous use of children’s emergency services and willingness to use these during the pandemic, willingness to participate in an interview, and contact details.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Digitally recorded telephone interviews were conducted by male and female researchers; a postdoctoral qualitative researcher (MB) and RW … SciScore for 10.1101/2021.03.30.21254661: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: Ethical approval was granted by Newcastle University’s Faculty of Medical Sciences Research Ethics Committee (Ref: 1919/2812).
Consent: On clicking this link, participants were asked to complete a consent form and a short questionnaire including demographics, previous use of children’s emergency services and willingness to use these during the pandemic, willingness to participate in an interview, and contact details.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Digitally recorded telephone interviews were conducted by male and female researchers; a postdoctoral qualitative researcher (MB) and RW (FiY1) and ST (Intercalating Medical Student) who received training and supervision throughout. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:One potential limitation is that we did not interview children, who are often active partners in making some of these decisions. The study population was relatively small, and represents those with motivation to participate, rather than the whole population. The sample was also skewed to a less deprived demographic than the general population. Member checking may have been helpful in ensuring that our interpretation of data were correct from a participant perspective. There are several implications for providers of paediatric emergency healthcare services, both during the current pandemic and in the future. First, providers should recognise the complex decision-making processes that parents perform in determining whether and when to seek help. As discussed, this process was likely to have been strongly influenced by national Covid-19 messaging, Local providers are well placed to understand specific needs of their communities, and provide crucial local context to broad national messaging; these providers could consider developing media-messaging, for example via social-media platforms, targeted locally to reassure parents. We have discussed the internal ‘threshold’ that parents described having to reach in order to seek care during the pandemic. This metaphor might also be useful for organisations attempting to reduce emergency attendances in other contexts, for example by redirecting to other elements of the healthcare system. Future work should attempt to identify specific g...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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