"Becoming desensitised and sensitized Despite the physical and emotional challenges that encapsulated participants’ experiences of administering manual restraint for CNF of young persons with AN, and unlike the “Importance of coping” theme which described participants’ conscious attempts to cope with the procedure, five of the eight nursing assistants reported becoming emotionally desensitised to the practice over time. This was an adaptation predominately reported by male nursing assistants through descriptions such as “getting used to it”, becoming “desensitised” and becoming “immune”: We’re kind of immune to the screams, the noises, the fighting, the everything so it’s much easier nowadays, if it’s done properly and you’re not being hurt, it’s easy to go through a restraint without feeling very guilty that you’re doing anything wrong. (Participant 2) For some nursing assistants, this familiarity to the practice of applying manual restraint for CNF appeared to be facilitated by a change in their attitudes towards the practice over time. This attitude change appeared to involve the acceptance of CNF under restraint as something that was necessary, either as part of their job role or for the young person’s own safety: Now it’s just what needs to be done, it’s what needs to be done because the patient is not taking the responsibility of feeding themselves so we have to take on that responsibility. (Participant 4) In contrast to becoming desensitised, two nursing assistants reported that they had become emotionally sensitised to the manual restraint procedure. Participating in the restraint had become more emotionally challenging for these participants over time due to the therapeutic relationship they had built with the young person over time: The first restraints were a lot easier because I didn’t have a connection with the patients, whereas the later on it’s got, the more connection I have with the patients, the more worried I am, and the more emotionally demanding it is. (Participant 5)"