"Sharing the Horrible Moment"; the Experiences and Perceptions of Children of Being Held for Clinical Procedures: An Exploratory Qualitative Study.

Abstract

Children continue to be held still within pediatric practice for clinical tests, treatments and examinations. Existing literature has focussed on health professionals' and parent's views and experiences of the use of holding and restraint, and children's views and experiences remain largely absent. This study aimed to explore the experiences and perceptions of children with long-term conditions of being held for clinical procedures in hospital environments. A qualitative descriptive design used interviews and participatory arts-based approaches to hear the experiences of children aged 4-12 years. Recruitment occurred through a children's hospital. Data were analyzed using thematic and content analysis processes. Twenty-two children aged 4-12 years were interviewed. Children gave detailed accounts of how they had been held, with many describing experiences of distress and forceful holding. Children shared their understanding of why they had been held and talked of difficult communication during the "horrible moment" because adults were either "not saying anything" or "being angry." They talked of preferring to be held by their parents or given a choice over who holds them. Children discussed that being informed, listened to, and able to rehearse events helped them during a procedure and led to less forceful holding. This study adds important knowledge of children's perspectives of being held for clinical procedures, demonstrating that even young children have complex emotions and understandings of what happened when they were held. Adopting a trauma-informed approach and providing supportive debriefs is key to avoiding the accumulation of fear, distress and harm.