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Errors in body temperature assessment related to individual variation, measuring technique and equipment
Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, Primary Care . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics . Linköping University, The Institute of Technology.
Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
2005 (English)In: International journal of nursing practice, ISSN 1322-7114, Vol. 10, no 5, 216-223 p.Article in journal (Refereed) Published
Abstract [en]

Errors in body temperature measurement might seriously influence the evaluation of an individual's health condition. We studied individual variation, measurement technique and the equipment used when assessing body temperature. In the first part of the study, three volunteers performed repeated measurements for five mornings. In the second part, the morning rectal, oral, ear and axillary temperatures were measured once in 84 men and women (19–59 years). The repeated measurements showed a daily temperature difference of 0.1–0.4°C in rectal and oral temperatures, 0.2°C−1.7°C in the ear and 0.1–0.9°C in the axillary temperatures. In the sample of 84 subjects, men and postmenopausal women had a lower mean body temperature compared to premenopausal women. The mean deviation between rectal temperature, and oral, ear and axillary temperatures, respectively, was > 0.5°C, with a large individual variation. In conclusion, in order to improve the evaluation of body temperature, the assessment should be based on the individual variation, the same site of measurement and no adjustment of oral, ear or axillary temperatures to the rectal site.

Place, publisher, year, edition, pages
2005. Vol. 10, no 5, 216-223 p.
Keyword [en]
body temperature, gender, individual variation, repeated measurements, standardized
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-13664DOI: 10.1111/j.1440-172X.2004.00483.xOAI: oai:DiVA.org:liu-13664DiVA: diva2:21129
Available from: 2004-12-19 Created: 2004-12-19 Last updated: 2009-06-04
In thesis
1. Measurement and evaluation of body temperature: Implications for clinical practice
Open this publication in new window or tab >>Measurement and evaluation of body temperature: Implications for clinical practice
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim was to explore factors influencing the normal variation and measurement of body temperature. Additional aims were to study morbidity, mortality and the clinical presentation of pneumonia and predictors for survival in elderly nursing-home residents. Two hundred and thirty seven non-febrile nursing home residents (aged 66-99 years) and 87 healthy adults (aged 19-59 years) were included. In elderly individuals, the morning ear and rectal body temperature was measured at baseline and pneumonia and survival was observed at one- two and three-year. In healthy adults the rectal, ear, oral and axillary temperature were measured simultaneously on one morning and repeated measurements were performed in three subjects.

Overall, the range of normal body temperature was wider then traditionally stated. In elderly nursinghome residents, functional and cognitive impairment and BMI < 20 were related to a lower body temperature and medication with analgesics to a higher. Compared to adults < 60 years elderly persons had a higher average ear and a lower rectal temperature. Men and postmenopausal women < 60 years had lower body temperature than premenopausal women. The repeated measurements showed a wide individual variability irrespective of the site of measurement, and that replicated measurements do not improve accuracy. When comparing the rectal temperature with oral, ear and axillary readings the average difference was > 0.5°C with a wide individual variation.

The yearly incidence of nursing-home acquired pneumonia varied between 6.9% and 13.7%. Functional impairment, chronic obstructive pulmonary disease (COPD) and male sex were related to a higher risk of acquiring pneumonia and presenting non-specific symptoms were common. Age and functional impairment predicted mortality, irrespective of gender, while cerebral vascular insult, a lower body mass index and malnutrition in women and heart disease, COPD, medication with sedatives and mortality rate index in men were gender specific predictors. Surviving women had a higher baseline body temperature than non-surviving, while no such difference was found in men.

When assessing body temperature, it is important to consider the site of measurement, technical design, operator technique, age and gender and, in elderly nursing-home residents, physical and cognitive impairment, body constitution and medication with analgesics. The best approach is to use an unadjusted mode, without adjusting to another site. To prevent a delayed diagnosis of pneumonia, one should be aware of a low baseline body temperature and lack of specific clinical symptoms in elderly nursing-home residents. Preserving and/or improving functional, cognitive, nutritional status and preventing agitation and confusion would improve survival in nursing-home residents.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2004. 54 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 872
Keyword
Assessment, body temperature measurement, elderly, evaluation, infection, nursing home, pneumonia, survival
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-5200 (URN)91-7373-848-4 (ISBN)
Public defence
2004-12-02, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2004-12-19 Created: 2004-12-19 Last updated: 2012-01-25Bibliographically approved

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Sund-Levander, MärthaGrodzinsky, EwaLoyd, DanWahren, Lis Karin

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Sund-Levander, MärthaGrodzinsky, EwaLoyd, DanWahren, Lis Karin
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Clinical Physiology Faculty of Health SciencesPrimary Care Applied Thermodynamics and Fluid Mechanics The Institute of TechnologyDepartment of Social and Welfare Studies
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