Forms of involving children and young people during nursing procedures: A grounded theory study building on the concept of child centred care

Abstract
Purpose
Knowledge about how paediatric patients are involved in their healthcare is limited. The purpose of the study was to explore the involvement of children and adolescents in nurse-led procedures in hospital settings and how they perceive their involvement in these procedures.
Method
With a grounded theory design, data were collected through participant observation and in situ questioning of 13 children aged 5 to 16 years, across three inpatient and three outpatient paediatric units. Field notes were recorded. Consistent with constructivist grounded theory, data were analysed through three phases of coding.
Results
Three forms of involvement were identified: Exploratory involvement, Socio-emotional involvement, and Symbolic involvement. Four related subcategories, spanning across the forms of involvement, were identified: The nurse's assessment of the child's needs, The child's position in interaction with the nurse, Communication, and The sequence of actions. The three forms of involvement and subcategories constitute the theory: Forms of Child-Centred Involvement during Nurse-led Procedures.
Conclusion
This study contributes to a theoretical framework for understanding how the involvement of children can be tailored to meet the child's needs.
Implications to practice
The three different forms of involvement guide paediatric nursing practice and can serve to inform the further development of Child-Centred Care.