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Table 3 Themes identified

From: Parents’ experiences caring for children with acute otitis media: a qualitative analysis

Theme Sub Theme Text
Identifying AOM Most parents looked for ear tugging to identify AOM “when I noticed she was pulling her ears, I was going to take her to the emergency room, but I knew she had a doctor's appointment today.” (21)
In absence of otalgia, parents attributed other symptoms to diseases other than AOM “I didn't know if it was teething, just the fever. I didn't know. Because he didn't grab his ears or anything” (11)
Verbalized otalgia made parents more confident in their assumption of AOM “he's telling me it hurts, so now I can, ‘Oh, okay, we need to go to the doctor's. You've got another ear infection.’” (32)
Experience caring for a child with AOM Parents of children with history of AOM suspected AOM often “he started not sleeping, so then I was like, ‘Ah I bet it's his ears.’” (15)
Parents of children with no history of AOM generally did not suspect AOM if ear tugging was absent “I actually didn't think that it was an ear trouble. She hasn't been suffering [inaudible] or anything, it's just that she wasn't sleeping.” (24)
Symptoms that bothered child vs. bothered parent Symptoms that most troubled parents were often reported as the same symptom that most bothered their child “Which [symptoms] were most bothersome to you?” (interviewer) “I think the fever too, just because it was hard to manage.” (11)
Behaviors that led to parental distress Parents reported feelings of helplessness and sadness when children were difficult to console “Awful. Completely awful. I feel helpless.” (22)
Parents’ efforts to console their child Parents devoted more attention to their children “I pick her up. I cradle her, rock her back and forth in my arms. I try to rub her back, give her kisses.” (26)
Parents administered analgesics, antipyretics, and home remedies to their ill children “I was using a warm compress… to kind of calm or kind of keep him a little bit happier” (43)
Factors associated with the decision to seek medical evaluation Parents sought medical care when they believed they could not manage their child’s symptoms without assistance “the fact that I can't really calm him down and comfort him showed that I needed to get more help than just me” (22)
Fever and disturbed sleep were symptoms that caused parents concern and instilled a sense of urgency to take their child to a physician “I can take care of that, like a cough, sore throat, stuff like that. But the fever is what would really scare me” (18)
“[He] just was still not sleeping and just being fussy during the day and it just– I wasn't sleeping, and so that's when I was like, ‘I guess I'm just going to have him go checked out’” (15)
How parents determine when AOM has resolved Parents stated that their child being back to their ‘normal self’ signified AOM resolution “Just back to his normal routine. That usually tells me that he's better.” (11)