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An Exploration and Reconsideration of Normal Body Temperature in Healthy Adults Rebecca Mayo University of New Mexico UNM Digital Repository Nursing ETDs Electronic Theses and Dissertations 8-17-2011 An Exploration and Reconsideration of Normal Body Temperature in Healthy Adults Rebecca Mayo Follow this and additional works at: https://digitalrepository.unm.edu/nurs_etds Recommended Citation Mayo, Rebecca. "An Exploration and Reconsideration of Normal Body Temperature in Healthy Adults." (2011). https://digitalrepository.unm.edu/nurs_etds/4 This Dissertation is brought to you for free and open access by the Electronic Theses and Dissertations at UNM Digital Repository. It has been accepted for inclusion in Nursing ETDs by an authorized administrator of UNM Digital Repository. For more information, please contact [email protected]. i ii AN EXPLORATION AND RECONSIDERATION OF NORMAL BODY TEMPERATURE IN HEALTHY ADULTS BY REBECCA MAYO B.A., Communications, University of Minnesota, 1966 M.A., Communications, University of Minnesota, 1973 M.S.N., Nursing, University of New Mexico, 2002 DISSERTATION Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Nursing The University of New Mexico Albuquerque, New Mexico iii © 2010, Rebecca Mayo iv DEDICATION This dissertation is dedicated to my parents, Bob and Harriet Jones, my sister, Betty Jones, my children, Jennifer Kelley and Molly Mayo, and my dear friend, Peg Wangensteen. Without you, none of this would have been possible. v ACKNOWLEDGMENTS It is my pleasure to thank and acknowledge the following family members, friends, advisors, and assistants. You have all helped me tremendously and I am deeply in your debt. I could never have accomplished this without you. Thank you. Thank you. First and foremost, my sister Betty Jones. My parents, Bob and Harriet Jones, and my children, Jennifer Kelley and Molly Mayo. Bruce Marron and Steve Kelley. My Committee, especially my Chair, Leah Albers, and Mark Parshall, Ann Caudell, and Dana Davis Peg and Doug Wangensteen, lifelong friends. Marythelma Brainard. Rich Rubin Larry Deckel Cristina Murray-Kazen Patricia Peralta and Sallie Kleyboecker Melissa Kirera Wendy Orley Jimmy Santiago Moreno Warren Laskey My PhD cohort vi AN EXPLORATION AND RECONSIDERATION OF NORMAL BODY TEMPERATURE IN HEALTHY ADULTS BY REBECCA MAYO ABSTRACT OF DISSERTATION Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Nursing The University of New Mexico Albuquerque, New Mexico December, 2010 vii AN EXPLORATION AND RECONSIDERATION OF NORMAL BODY TEMPERATURE IN HEALTHY ADULTS by REBECCA MAYO B.A., Communications, University of Minnesota, 1966 M.A., Communications, University of Minnesota, 1973 M.S.N., Nursing, University of New Mexico, 2002 Ph.D., Nursing, University of New Mexico, 2010 ABSTRACT The human body temperature generally considered normal by medical professionals and the lay public and believed to be an important referent in diagnosing illness and determining its severity is 98.60 Fahrenheit (F). The initial work establishing 98.60 F published over 140 years ago may be flawed; and, even if correct, may not reflect the present normal body temperature. To investigate mean body temperature in adults ages 21- 100 who regarded themselves as ―well,‖ an observational descriptive study was undertaken to measure body temperature using two commonly used measurement methods, oral and tympanic. 1000 adults comprised the non probability non randomized sample and were drawn from four metropolitan areas, 250 from each: Portland, OR, Minneapolis/St Paul, MN, Hartford, CT, and Albuquerque, NM. Temperatures were taken from 8 AM – 8 PM. Data on covariates as suggested from extant literature were collected. The mean oral viii temperature was 98.30F. The mean tympanic temperature was 97.90F. Both means were statistically different from 98.60F (p <.001). There was only moderate correlation between thermometer measurement methods (R2 .35). Multiple regression analysis identified age, gender, and time of day temperature was taken as statistically significant covariates (p <.001 for all), but together they accounted for less than 18% of the variance regardless of measurement method. Public health implications are discussed. The referent of 98.60F should be replaced with 98.20F for most adults in evaluating oral temperature. When tympanic measurements are taken, a lower ―normal‖ of 97.90F should be considered. ix TABLE OF CONTENTS LIST OF FIGURES...................................................................................................... xiv LIST OF TABLES........................................................................................................ xv CHAPTER 1: INTRODUCTION................................................................................ 1 Purpose...................................................................................................................... 1 History of Assessment and Understanding of Body Temperature............................. 1 Development of Temperature Measurement Devices................................................ 4 Early Use of Thermometers....................................................................................... 5 The Work of Wunderlich........................................................................................... 7 Development of Clinical Thermometers.................................................................... 11 Summary.................................................................................................................... 15 CHAPTER 2: HUMAN BODY TEMPERATURE: REGULATION AND IMPLICATIONS FOR RESEARCH.......................................................................... 17 Temperature Regulation............................................................................................ 17 Normal Temperature........................................................................................... 18 Failure of Regulatory Mechanisms..................................................................... 18 Change in Thermoregulatory Set Point.............................................................. 19 Fever................................................................................................................... 20 Low Body Temperature...................................................................................... 20 Implications for Research......................................................................................... 21 Ongoing Questions.................................................................................................... 24 x CHAPTER 3: DESIGN AND METHODOLOGY..................................................... 26 Research Question.................................................................................................... 26 Hypotheses................................................................................................................ 26 Design....................................................................................................................... 26 Institutional Approval............................................................................................... 26 Methods.................................................................................................................... 27 Setting................................................................................................................. 27 Sample Size......................................................................................................... 28 Study Population................................................................................................. 29 Inclusions........................................................................................................ 29 Exclusions....................................................................................................... 30 Study Variables................................................................................................... 30 Data Collection and Analysis.................................................................................... 31 Instruments.......................................................................................................... 31 Data Collection.................................................................................................... 32 Data Management................................................................................................ 34 Data Analysis....................................................................................................... 34 Screening......................................................................................................... 34 Descriptive Statistics....................................................................................... 34 Correlation...................................................................................................... 34 Analysis of Variance....................................................................................... 35 Multiple Regression......................................................................................... 35 Student‘s t Test................................................................................................ 35 xi CHAPTER 4: RESULTS.............................................................................................. 36 Data Preparation for Analysis.................................................................................... 36 Results of the Analysis..............................................................................................
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