"It Could Become a Standard"-A Qualitative Study of the CARDTM System for Needle-Related Procedures in a Children's Hospital.

Background/

Objectives

Needle-related procedures such as venipuncture are common in pediatric hospitals and are a major cause of pain, fear and distress for those affected. Despite the availability of a wide range of evidence-based support options, it is often the professionals who decide which interventions are offered. In this study, we adapted the CARDTM (Comfort, Ask, Relax, Distract) system for needle-related procedures in hospitals. CARDTM was originally developed to encourage children to actively participate in their vaccination process at school. It allows them to choose from numerous evidence-based interventions in the four different letter categories (C-A-R-D) to reduce pain, fear and related vaccination symptoms. Our aim was to examine perceptions of CARDTM for needle-related procedures in a children's hospital, including aspects of acceptability, feasibility, self-efficacy in managing fear and pain, and overall experiences.

Methods

A qualitative descriptive design was used. The sample included nine children aged 10 to 15 undergoing needle-related procedures and seven nurses who performed these procedures. We conducted individual interviews and asked them about their experiences with CARDTM. Data were evaluated using qualitative content analysis.

Results

Four themes were identified: awareness of options and needs; relationship building; empowerment; and acceptability. CARDTM helped children identify available options, prepare themselves, recognize their own needs and select strategies. CARDTM offered a concrete framework for action that promoted participation and self-efficacy and strengthened the relationship between nurses and children. In practice, CARDTM was perceived to be easy to implement and acceptable.

Conclusions

The present findings suggest the applicability of CARDTM for hospital needle-related procedures.