Discussion

The overarching theme ‘The Ongoing Process of Recovery: Body, Mind, and Self’ captures children’s recovery as a holistic and deeply lived process. Corrective surgery and rehabilitation were not experienced as isolated clinical events but as a prolonged, multidimensional process that gradually reshaped children’s sense of self. Recovery extended far beyond physical healing, encompassing body image, psychological wellbeing, and social experience. This interpretation aligns with nursing science literature, which describes identity change in chronic illness as a process of becoming whole again through meaning-making and social relationships (Hajdarevic et al., 2024), and with qualitative research on polio survivors, which demonstrates that early experiences of immobilization, painful treatment, and separation from home necessitated the development of psychological coping strategies that could become maladaptive in later life at the onset of post-polio syndrome (Sjödahl Hammarlund et al., 2021).

The central finding is that surgical treatments carried dual significance: while they were necessary and function-restoring, they were also highly distressing and potentially traumatizing. Pain, physical distress, procedural fear, and anxiety shaped how children remember surgery and how it became embedded in their broader experience of recovery. This is consistent with international research, according to which invasive treatment events may trigger posttraumatic stress-like symptoms in children and families (Kazak et al., 2015), perioperative anxiety is associated with the intensity of postoperative pain (Chieng et al., 2014), and surgical procedures may leave significant psychological sequelae for both children and parents (Stanzel & Sierau, 2021; Turgoose et al., 2021). These experiences must be understood in their historical contexts. The Finnish children’s experiences of repeated surgery, inadequate pain relief, and bodily subordination reflect the structural conditions of an era in which children’s subjective experience remained peripheral to treatment decision-making.

The findings indicate that children suffered both emotional and physical harm during treatment—harm that was at times intentional and at times inadvertent. In this study, participants’ experiences of intentional harm were tied to their identities as children living with disabilities, resulting in harsh discipline and force-feeding. Their experiences of inadvertent harm included the pain and fear caused by treatments they perceived as experimental. Research has shown that the treatment of polio patients was callous in the 1940s and 1950s, with no emotional support provided and ties to home left unnurtured (Schanke et al., 1999). The children adapted to appear unrelentingly upbeat, learning to please others and to ensure that nursing staff and families could celebrate their rehabilitation, a performance that concealed profound suffering (Schanke et al., 1999). This illusion of cheerfulness was reinforced by the prevailing view that polio survivors were expected to walk again, even when this was not always realistic, arising from a disability culture in which disability was seen as a source of shame and people living with disabilities were expected to be made fit for society as quickly as possible (Wilson, 2005).

In the present research, children’s narratives in which the experience of being a ‘guinea pig,’ force-feeding, and bitterness at unfair treatment appeared as accounts in which medical practices silenced their lived experiences and subjugated their bodies to external authority. These experiences can be understood through the Foucauldian framework of bodily objectification outlined by Yoshida and Shanouda (2015), in which the disabled body is subjected to medical and rehabilitative discourses that silence children’s lived experiences. In the present research, this silencing operated on multiple levels: the treatment procedures were not explained, children’s emotional expressions were evaluated through the lens of discipline rather than care, and children’s own accounts of pain and fear were systematically dismissed. Children’s resistance, such as throwing food out of windows, demanding discharge, and retrieving confiscated toys, can be read not merely as behavioral non-compliance but as embodied assertions of selfhood against a system that treated the body as an object of intervention rather than as a subject of experience.

In this study, rehabilitation was found to be a prolonged process, with some children spending up to three years in rehabilitation facilities. During extended hospital stays, free time, play, and imagination played a significant role in building a sense of security. This finding is supported by international literature demonstrating that play and activity-based interventions reduce children’s stress and support recovery during hospitalization (Gjærde et al., 2021) and that in-hospital education supports developmental continuity and facilitates reintegration into mainstream schooling (Burns et al., 2021). The significance of hospital schooling identified in this study connects to a broader historical pattern documented in research on polio and education. Polio profoundly disrupted children’s access to schooling, with many children excluded from mainstream education during and after treatment (Altenbaugh, 2006). In the present study, hospital school represented a counterforce to this disruption: It provided educational continuity, a sense of normality, and a structured daily rhythm within an institution otherwise organized entirely around medical procedures. That participants recalled the hospital school in predominantly positive terms—and in some cases described the children’s hospital as a paradise—suggests that educational provision functioned not merely as academic instruction but as a form of psychosocial protection within a depriving environment.

The findings also reflect the rehabilitation philosophy operating in Finnish pediatric care during the 1950´s-1960´s. While the Kenny method based on active patient participation had begun to transform rehabilitation practice internationally in the early 1940s (Neumann, 2004; Rogers, 2021), it was not adopted in Finland; the nursing textbooks of the 1950s and 1960s did not recommend it, and treatment remained nurse-centered and symptom-based (Veltheim et al., 2024). This absence of a patient-active rehabilitation philosophy may partly account for the variation in rehabilitation experiences described by the participants, ranging from prolonged enforced bedrest to intensive physiotherapy, and for the limited agency children had over their own recovery. In this research, the meaning of assistive devices proved to be contextual. Previous research has shown that orthoses could be experienced primarily as symbols of disability and sources of social stigma (Sjödahl Hammarlund et al., 2021), whereas in the present study, corsets and metal splints could also be experienced as providing a sense of security for a weakened body.

The findings also showed that children’s agency was expressed not only through cooperation with treatment but also through adaptation, resistance, emotional regulation, and coping mediated by peers and connections to home. Power structures, ward routines, restricted visiting hours, and limited family contact profoundly shaped children’s sense of safety and control. Viewed through family-centered care frameworks—in which dignity and respect, information sharing, participation, and collaboration are core principles—the situations described in this study—where children’s participation was restricted and information withheld—constitute significant risk factors for psychological safety. Previous research confirms that family-centered care models are associated with reduced parental anxiety and improved communication, although no model has yet provided continuity across all phases of care (Curtis et al., 2016).

The experiences of the polio survivors strongly reflected children’s insignificance in the eyes of adults. The questions concerning children’s needs and hopes were not systematic. The Finnish hospital system was being modernized in the 1950s and 1960s, and children’s medical care was only beginning to develop after the Second World War. Children were initially treated alongside adults and did not have any special status in hospital care, which was vividly reflected in the narratives of the research participants. There was also a shortage of nursing skills in Finland at the time (Muiluvuori, 2010), and the nursing culture globally had only just begun to develop competence in family-centered care (Jolley & Shields, 2009). The research findings support previous research that has indicated that children living with disabilities have very little control over their bodies and treatment (Yoshida & Shanouda, 2015).

Strengths and Limitations

This study has several limitations that should be considered when evaluating its findings. Although interviews provide valuable research material, people tend to recount what they consider worthy of sharing. The purpose of the study was not to produce a generalized oral history but to highlight children’s experiences of illness and treatment, which can complement the broader history of nursing and medicine.

The sample is homogeneous in terms of its historical context: All the participants were Finnish polio survivors who contracted the disease during the epidemic years of the 1940s and 1950s. This is a contextual feature of the study that simultaneously limits the transferability of its findings to other national or cultural settings. Sex-differentiated analysis was not among the study objectives; nor was the sample large enough to support a systematic comparison between sexes. Women were considerably more represented than men in the sample (28 women, 13 men)—which may reflect self-selection or sex differences in the willingness to participate in oral history research—and this should be taken into account when interpreting the findings.

From the perspective of oral history research, the method has both strengths and limitations. As a strength, oral history captures experiences that are not recorded in official documents: Children’s subjective experience of hospital care is precisely the kind of tacit knowledge that remains in the shadow of the official history of medicine and nursing. The dialogical interview method, with its use of memorabilia, activates sensory memory and produces richer data than interviewing alone, and the material complements the official history of medicine and nursing from the patient’s perspective. As a limitation, it must be noted that oral testimony is constructive in nature: Memories are shaped by later experiences, accounts heard from others, and collective social memory, and the boundary between individual memories and collective memory cannot always be clearly drawn. Furthermore, self-selection may influence the data: Those who wish to share their experiences may differ from those who do not, particularly with regard to traumatic experiences. The interview situation itself also shapes what is recounted and how.

The participants narrated events from decades ago, making accurate recollection uncertain. It cannot always be determined whether the narratives were based on the participants' own memories or on accounts learned from others over time. Their memories may also have been affected by the psychological suppression of painful or traumatic childhood events, and translations may not fully capture the linguistic richness of the original Finnish expressions. The participants were invited to bring memorabilia to the interviews, such as photographs, toys, and treatment records, which played an important role in activating memories.

The trustworthiness of the analysis conducted by the researcher was strengthened by returning regularly to the original data throughout the entire analytical process, ensuring that the interpretations remained grounded in the data. A research diary and analytical memos were maintained throughout the research process, supporting reflexivity and the documentation of analytical decisions (Braun et al., 2022 ). The research generated information about the historical treatment experiences of significant social relevance in Finland. This research report was produced in compliance with responsible scientific practice and is not intended as a critique of past events (Boschma et al., 2008). Instead, it aims to examine those experiences in the context of the prevailing culture of care at the time.