Holding children for procedures: An international survey of health professionals

J Child Health Care. 2018 Jun;22(2):205-215. doi: 10.1177/1367493517752499. Epub 2018 Jan 21.


Children undergoing clinical procedures can experience pain and/or anxiety. This may result in them being unwilling to cooperate and being held still by parents or health professionals. This study aimed to capture an international perspective of health professionals' reported practices of holding children still for clinical procedures. An online questionnaire was distributed through network sampling to health professionals working with children aged under 16 years of age. A total of 872 responses were obtained from Australia ( n = 477), New Zealand ( n = 237) and the United Kingdom ( n = 158). Responses were from nurses ( n = 651), doctors ( n = 159) and other professionals ( n = 53). Health professionals reported children as held still for clinical procedures quite often (48%) or very often (33%). Levels of holding varied significantly according to country of practice, profession, student status, length of time working within a clinical setting, training received and the availability of resources in the workplace. Health professionals who gained permissions (assent from children and/or consent from parents) before procedures were less likely to hold children still for a clinical procedure than those who did not. Holding children still for procedures is an international practice, which is influenced by training, access to guidance, country of practice and profession. Children's permission and parental consent is often not sought before a child is held for a procedure to be completed.

Keywords: Assent; children; clinical holding; clinical procedures; consent.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / prevention & control*
  • Australia
  • Child
  • Child, Preschool
  • Female
  • Health Personnel / psychology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • New Zealand
  • Parents / psychology*
  • Physical Examination / methods*
  • Restraint, Physical / psychology*
  • Surveys and Questionnaires
  • United Kingdom