Curious, thoughtful and affirmative-Young children's meanings of participation in healthcare situations when using an interactive communication tool.

AIMS AND OBJECTIVES: To describe young children's demonstrated participation in healthcare situations while using an interactive communication tool.

BACKGROUND: Participation is a multidimensional concept influenced by situational and contextual issues. In child participation, verbal and nonverbal communicative expressions are of interest, as both demonstrate the child's perspective. Children have a right to participate in all situations that matter to them, for instance healthcare situations. Children, understood as social actors, express a wish and a need to participate in these situations to get information and to enable preparation.

DESIGN/METHOD: In a pilot study, video observations were used to capture the children's use of the interactive communication tool in healthcare situations. A hermeneutic analysis was conducted to achieve a deeper understanding of the children's demonstrated cues of participation.

RESULTS: The expressed cues of participation were understood as having either a curious, thoughtful or affirmative meaning of participation and there was a continuous movement between them. Curious cues were expressed when introducing or reintroducing the tool in the situation and demonstrated a wish to get knowledge of the things shown on the screen or to perform the virtual tasks. Thoughtful cues slowed down the progression of the situation when the children needed time to think or adapt to the virtual procedures. Affirmative cues were self-rewarding and demonstrated at successful task performance.

CONCLUSION: An interactive communication tool used in healthcare situations can promote young children's understanding and facilitate their situated participation, which potentially reduces feelings of distress or anxiety. This innovative use of interactive technology within paediatric health care provides new ways of revealing the child's perspective in the situation.

RELEVANCE TO CLINICAL PRACTICE: Interactive technology improves understanding and participation of children in healthcare situations, which impact them positively, both in the present and for the future. A communication tool enhances professionals' opportunities to adopt a child-centred approach by responding sensitively to the children's expressions.