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Although children\u2019s assent is ethically required, it is not always meaningfully implemented in practice. Understanding how children, siblings and parents experience the child\u2019s involvement in the assent process, including their attitudes towards research, is crucial for promoting ethically sound research and supporting genuine child participation. The aim of this study was to describe how children with cancer, siblings and parents experience the child\u2019s assent process during research recruitment in paediatric oncology, with particular attention to its motivational and relational dimensions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A descriptive qualitative study design. Interviews were undertaken with children with cancer (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911), siblings (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917) and parents (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099) regarding their experiences of recruitment to various types of research in Sweden. Data was analysed using reflexive thematic analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two main themes were identified:\n                      <jats:italic>a moral and emotional commitment to research<\/jats:italic>\n                      , and\n                      <jats:italic>relational assent\u2014trust, loyalty and parental mediation.<\/jats:italic>\n                      Children, siblings and parents described research participation as meaningful and morally significant in a vulnerable situation. Children\u2019s involvement in assent ranged from active participation to limited influence, with some decisions made primarily by parents. Decisions about research participation were shaped by relational dynamics, in which trust, loyalty, and emotional vulnerability and parental mediation played central roles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Families are strongly motivated to contribute to research in paediatric oncology. However, sustaining trust and safeguarding research integrity require consistent and meaningful implementation of children\u2019s assent. Child-centred, flexible, and context-sensitive assent processes are key, alongside ethical awareness of how relational dynamics shape children\u2019s autonomy. Recognising parents as key partners is essential for upholding both ethical standards and children\u2019s rights in paediatric research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13063-026-10011-2","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:33:55Z","timestamp":1789979635000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Children\u2019s participation in assent to paediatric oncology research: experiences of children, siblings and parents"],"prefix":"10.1186","volume":"27","author":[{"given":"Kajsa Norberg","family":"Wieslander","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Frygner-Holm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"L\u00f6vgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"H\u00f6glund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tove","family":"Godskesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"1","key":"10011_CR1","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1002\/ijc.33774","volume":"150","author":"L Smith","year":"2022","unstructured":"Smith L, Stiller CA, Aitken JF, Hjalgrim LL, Johannesen T, Lahteenmaki P, et al. 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Children provided assent in verbal and\/or written form, and parents gave informed consent for themselves and their child, as required by Swedish law [\n                      \n                      ]. Age-adapted information was given to children in written form and verbally, with questions and dialogue encouraged. In FTI, the children had the possibility to meet the interventionist at an information meeting face-to-face. They received information about the study and the intervention and were able to ask questions before they were asked about assent. If the interventionists did not meet the child at the information meeting, they informed the child about the study and the intervention before they met during the intervention meeting with the child. In the extended sample, a brief child-friendly video explaining the study was sent to the child beforehand. It was emphasized that participation was voluntary and confidential.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Consent for publication obtained for all participants.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"579"}}