• Nancy J Ames, Claudia Peng, John H Powers, Nancy Kline Leidy, Claiborne Miller-Davis, Alice Rosenberg, Mark VanRaden, and Gwenyth R Wallen.
• National Institutes of Health, Clinical Center, Bethesda, Maryland, USA. Electronic address: names@cc.nih.gov.
• J Pain Symptom Manage. 2013 Dec 1; 46 (6): 807816807-16.

ContextFever is an important sign of inflammation recognized by health care practitioners and family caregivers. However, few empirical data obtained directly from patients exist to support many of the long-standing assumptions about the symptoms of fever. Many of the literature-cited symptoms, including chills, diaphoresis, and malaise, have limited scientific bases, yet they often represent a major justification for antipyretic administration.ObjectivesTo describe the patient experience of fever symptoms for the preliminary development of a fever assessment questionnaire.MethodsQualitative interviews were conducted with 28 inpatients, the majority (86%) with cancer diagnoses, who had a recorded temperature of ≥38°C within approximately 12 hours before the interview. A semi-structured interview guide was used to elicit patient fever experiences. Thematic analyses were conducted by three independent research team members, and the data were verified through two rounds of consensus building.ResultsEleven themes emerged. The participants reported experiences of feeling cold, weakness, warmth, sweating, nonspecific bodily sensations, gastrointestinal symptoms, headaches, emotional changes, achiness, respiratory symptoms, and vivid dreams/hallucinations.ConclusionOur data not only confirm long-standing symptoms of fever but also suggest new symptoms and a level of variability and complexity not captured by the existing fever literature. Greater knowledge of patients' fever experiences will guide more accurate assessment of symptoms associated with fever and the impact of antipyretic treatments on patient symptoms in this common condition. Results from this study are contributing to the content validity of a future instrument that will evaluate patient outcomes related to fever interventions.Published by Elsevier Inc.

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