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A systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (FAST)

BACKGROUND: Although body temperature is one of four key vital signs routinely monitored and treated in clinical practice, relatively little is known about the symptoms associated with febrile states. The purpose of this study was to assess the validity, reliability and feasibility of the Fever Asse...

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Autores principales: Ames, Nancy J., Powers, John H., Ranucci, Alexandra, Gartrell, Kyungsook, Yang, Li, VanRaden, Mark, Leidy, Nancy Kline, Wallen, Gwenyth R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408372/
https://www.ncbi.nlm.nih.gov/pubmed/28449675
http://dx.doi.org/10.1186/s12955-017-0644-6
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author Ames, Nancy J.
Powers, John H.
Ranucci, Alexandra
Gartrell, Kyungsook
Yang, Li
VanRaden, Mark
Leidy, Nancy Kline
Wallen, Gwenyth R.
author_facet Ames, Nancy J.
Powers, John H.
Ranucci, Alexandra
Gartrell, Kyungsook
Yang, Li
VanRaden, Mark
Leidy, Nancy Kline
Wallen, Gwenyth R.
author_sort Ames, Nancy J.
collection PubMed
description BACKGROUND: Although body temperature is one of four key vital signs routinely monitored and treated in clinical practice, relatively little is known about the symptoms associated with febrile states. The purpose of this study was to assess the validity, reliability and feasibility of the Fever Assessment Tool (FAST) in an acute care research setting. METHODS: Qualitative: To assess content validity and finalize the FAST instrument, 12 adults from an inpatient medical-surgical unit at the National Institutes of Health (NIH) Clinical Center participated in cognitive interviews within approximately 12 h of a febrile state (tympanic temperature ≥ 38° Celsius). Quantitative: To test reliability, validity and feasibility, 56 new adult inpatients completed the 21-item FAST. RESULTS: The cognitive interviews clarified and validated the content of the final 21-item FAST. Fifty-six patients completed the FAST from two to 133 times during routine vital sign assessment, yielding 1,699 temperature time points. Thirty-four percent of the patients (N = 19) experienced fever at one or more time points, with a total of 125 febrile time points. Kuder-Richardson 20 (KR-20) reliability of the FAST was 0.70. Four nonspecific symptom categories, Tired or Run-Down (12), Sleepy (13), Weak or Lacking Energy (11), and Thirsty (9) were among the most frequently reported symptoms in all participants. Using Generalized Estimating Equations (GEE), the odds of reporting eight symptoms, Warm (4), Sweating (5), Thirsty (9), General Body Aches (10), Weak or Lacking Energy (11), Tired or Run Down (12) and Difficulty Breathing (17), were increased when patients had a fever (Fever Now), compared to the two other subgroups—patients who had a fever, but not at that particular time point, (Fever Not Now) and patients who never had a fever (Fever Never). Many, but not all, of the comparisons were significant in both groups. CONCLUSION: Results suggest the FAST is reliable, valid and easy to administer. In addition to symptoms usually associated with fever (e.g. feeling warm), symptoms such as Difficulty Breathing (17) were identified with fever. Further study in a larger, more diverse patient population is warranted. TRIAL REGISTRATION: Clinical Trials Number: NCT01287143 (January 2011)
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spelling pubmed-54083722017-05-02 A systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (FAST) Ames, Nancy J. Powers, John H. Ranucci, Alexandra Gartrell, Kyungsook Yang, Li VanRaden, Mark Leidy, Nancy Kline Wallen, Gwenyth R. Health Qual Life Outcomes Research BACKGROUND: Although body temperature is one of four key vital signs routinely monitored and treated in clinical practice, relatively little is known about the symptoms associated with febrile states. The purpose of this study was to assess the validity, reliability and feasibility of the Fever Assessment Tool (FAST) in an acute care research setting. METHODS: Qualitative: To assess content validity and finalize the FAST instrument, 12 adults from an inpatient medical-surgical unit at the National Institutes of Health (NIH) Clinical Center participated in cognitive interviews within approximately 12 h of a febrile state (tympanic temperature ≥ 38° Celsius). Quantitative: To test reliability, validity and feasibility, 56 new adult inpatients completed the 21-item FAST. RESULTS: The cognitive interviews clarified and validated the content of the final 21-item FAST. Fifty-six patients completed the FAST from two to 133 times during routine vital sign assessment, yielding 1,699 temperature time points. Thirty-four percent of the patients (N = 19) experienced fever at one or more time points, with a total of 125 febrile time points. Kuder-Richardson 20 (KR-20) reliability of the FAST was 0.70. Four nonspecific symptom categories, Tired or Run-Down (12), Sleepy (13), Weak or Lacking Energy (11), and Thirsty (9) were among the most frequently reported symptoms in all participants. Using Generalized Estimating Equations (GEE), the odds of reporting eight symptoms, Warm (4), Sweating (5), Thirsty (9), General Body Aches (10), Weak or Lacking Energy (11), Tired or Run Down (12) and Difficulty Breathing (17), were increased when patients had a fever (Fever Now), compared to the two other subgroups—patients who had a fever, but not at that particular time point, (Fever Not Now) and patients who never had a fever (Fever Never). Many, but not all, of the comparisons were significant in both groups. CONCLUSION: Results suggest the FAST is reliable, valid and easy to administer. In addition to symptoms usually associated with fever (e.g. feeling warm), symptoms such as Difficulty Breathing (17) were identified with fever. Further study in a larger, more diverse patient population is warranted. TRIAL REGISTRATION: Clinical Trials Number: NCT01287143 (January 2011) BioMed Central 2017-04-27 /pmc/articles/PMC5408372/ /pubmed/28449675 http://dx.doi.org/10.1186/s12955-017-0644-6 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Ames, Nancy J.
Powers, John H.
Ranucci, Alexandra
Gartrell, Kyungsook
Yang, Li
VanRaden, Mark
Leidy, Nancy Kline
Wallen, Gwenyth R.
A systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (FAST)
title A systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (FAST)
title_full A systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (FAST)
title_fullStr A systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (FAST)
title_full_unstemmed A systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (FAST)
title_short A systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (FAST)
title_sort systematic approach for studying the signs and symptoms of fever in adult patients: the fever assessment tool (fast)
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408372/
https://www.ncbi.nlm.nih.gov/pubmed/28449675
http://dx.doi.org/10.1186/s12955-017-0644-6
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