Parents' and Caregivers' Experiences of Procedural Holding and Restraint: 'We Want to Be Their Safe Place and Not Associated With Medical Trauma': A Qualitative Descriptive Study

Abstract

AIM: To explore parent/caregivers' perceptions of procedures in which their child was held still and the reported impact of these experiences on both the child and parent. DESIGN: Qualitative descriptive study using an online survey. METHODS: Three research teams (United Kingdom (UK), New Zealand (NZ), and Australia) administered a qualitative survey to parents/caregivers of a child who had been held for a procedure in the last 2 years. Data were analysed using inductive thematic analysis. RESULTS: One hundred and twenty parents and three caregivers described 215 clinical procedures during which their child had been held. Four themes, conceptualised as procedural journeys, captured how parents described experiences unfolding over time: (1) Unravelling restraint, (2) Inevitable restraint led by professionals, (3) Inevitable restraint led by parents/caregivers, and (4) Child-centred holding. Parent/caregivers'accounts highlighted how procedures characterised by limited planning, rapid escalation, reduced responsiveness to child distress and restraint were experienced as particularly challenging and linked to feelings of guilt, regret and trauma. Procedures involving preparation, communication, flexibility and supportive comfort holds were described more positively and as less traumatic. CONCLUSION: The use of restraint was described as distressing for both the child and the parent/caregiver, particularly when procedures unfolded without adequate planning. Approaches that prioritised preparation and collaboration were perceived to support more positive experiences. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: There is a need to move away from default or reactive restraint practices towards more deliberate, rights-based, trauma-informed procedural care. REPORTING METHOD: The Consolidated Criteria for Reporting Qualitative Research (COREQ) were utilised when reporting findings. PATIENT OR PUBLIC CONTRIBUTION: To ensure that study materials and survey questions were clear and relevant, consultation occurred with two parents in the UK and three parents in NZ. The study design and questions were also presented to the New Zealand Mātauranga Māori Committee for feedback to ensure cultural appropriateness.