Managing discomfort and involving participation in non-emergency MRI: children’s coping strategies during a first procedure

Abstract

Purpose: Building on existing work, this paper aims to develop a detailed analysis of the practical coping strategies developed by children who had not previously experienced an MRI, regarding a non-emergency examination of the brain. Materials and Methods: Semi-structured interviews with N=22 children, aged between eight and sixteen years, were conducted immediately post-procedure. Emergent qualitative data were thematically analysed in line with the core precepts of Glaserian Grounded Theory. Results: The primary concern among interviewees related to how they had coped with the discomfort (prospective and extant) of an unfamiliar medical procedure; this was recurrently managed through a process herein termed Involving Participation. This comprised three phases. The first, participation preparation, describes the children’s reported attempts to ready themselves for the examination (with parents) ahead of arriving in hospital. The second, enabling participation, describes how the children (immediately before examination, with input from parents and radiographers) endeavored to understand what was to come, and select viable distraction techniques. Finally, sustaining participation describes the children’s reports of actualizing their preparations during the examination itself. Where the overall process of participation development was successful, the children reported a sense of mastery, growth and even joy. Conclusion: While much work in the domain portrays children as relatively ‘passive’ agents during an MRI procedure, the findings herein point to how they can (with varying degrees of success) actively and constructively work with others. This, it is contended, has direct import for the improvement of support, both prior to and within a procedure itself