Holding children and young people for clinical procedures: moving towards an evidence-based practice

Page, Andrea Christina (2015) Holding children and young people for clinical procedures: moving towards an evidence-based practice. Doctoral thesis, Birmingham City University.

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Abstract

Holding practices are employed to help a child or young person stay still during the administration of treatments, prevent treatment interference or to undertake an examination which can sometimes be invasive. The aim of this thesis was to explore holding practices from the perspective of nurses and healthcare professionals. This included identifying and examining holding techniques currently in use to help a child or young person stay still. An exploratory sequential mixed methods design was followed. Studies 1, 2 and 3 examined assumptions and practices of holding to develop theories about ‘what is happening on the ground’ following Grounded Theory methodology for practicing nurses and other allied health professionals (1), undergraduate nursing students, university lecturers and clinical mentors (2) and university lecturers from other institutions (3). A core category of ‘indifference’ emerged. Studies 4 and 5 explored technique preference to establish theories about what is known about the techniques in use. Descriptive statistics was used to analyse the data.

The practice of therapeutic holding is often covert and not considered to be part of the treatment per se, which has led to concealment and a reticence to discuss practices openly. Studies 1, 2 and 3 identified that there is variance in the experiences and practices of the participants. The prominent themes that emerged were a lack of clarity, lack of policy, lack of training, and that parents are often expected to hold their child. There appears to be a strong element of denial that there is a problem and little evidence that nationally this is seen as an issue. Studies 4 and 5 showed that healthcare staff ‘prefer’ techniques they are familiar with, in particular ‘cuddling’ and ‘wrapping’ of young children and found it more difficult to judge techniques for young people. It appears that therapeutic holding practices have moved from being viewed as ‘uncontested’ to ‘indifferent’. These findings have serious implications for current practice and the future training of healthcare professionals.

Item Type:	Thesis (Doctoral)
Dates:	Date Event June 2015 Completed
Subjects:	CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-01 - nursing (non-specific)
Divisions:	Faculty of Health, Education and Life Sciences > College of Nursing and Midwifery Doctoral Research College > Doctoral Theses Collection
Depositing User:	Richard Birley
Date Deposited:	17 Jul 2017 09:58
Last Modified:	12 Jan 2022 11:26
URI:	https://www.open-access.bcu.ac.uk/id/eprint/4850