Maternal perception of dehydration in children with diarrhoea: a study of agreement with medical diagnosis

Abstract

The mother's perception of signs and symptoms of dehydration in children under three years of age was studied and compared with the medical classification. The study was carried out in a children's hospital in the city of Rio de Janeiro, among children hospitalized with diarrhoea between January, 1987 and February, 1988. The number of excretions and of vomitings, thirst and condition of eyes constituted the signs and symptoms most frequently reported by mothers. However, they had difficulty in judging the amount of urine, humidity of mouth and tongue and turgidity of the skin. These signs were almost always regarded as normal or, at most, as indicating only slight alteration. Those mothers who tended to underestimate the severity of the dehydration indicated by the physician were of a lower educational level and had more severely undernourished children and greater difficulty of access to the hospital. On the other hand, those who tended to overestimate it belonged to a higher educational level, had better-nourished children, greater ease of access to the hospital and were attended to by a smaller number of health care services before reaching the hospital surveyed. Those who agreed with the medical diagnosis were in ,an intermediate situation, although they tended to be closer to those who underestimated the gravity of the dehydration. Those mothers whose children had already gone through a dehydration episode did not present a more intense agreement with the physician's diagnosis, thus evidencing that the information afforded at the health care service was either non-existent or inadequate.