Peer-reviewed article
"It Could Become a Standard"-A Qualitative Study of the CARD<sup>TM</sup> System for Needle-Related Procedures in a Children's Hospital.
Casaulta F, Marfurt-Russenberger K, Zeller A, Taddio A, Vetsch J ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how the CARD™ system, which helps children choose evidence-based coping strategies, works for needle procedures like blood draws in hospitals. Nine children aged 10–15 and seven nurses were interviewed about their experiences using CARD™ during these procedures. The system helped children understand their options, prepare themselves, and feel more in control, while nurses found it straightforward to use. The findings suggest CARD™ could become a standard way to reduce fear and pain during hospital needle procedures.
Key points
- CARD™ helped children identify available options and select strategies to manage pain and fear during needle procedures
- The system promoted participation and self-efficacy in children undergoing venipuncture and related procedures
- CARD™ strengthened the relationship between nurses and children by providing a concrete framework for action
- Nurses perceived CARD™ to be easy to implement in hospital practice
- The adapted system was found to be acceptable for use in hospital needle-related procedures
Limitations
The study is qualitative with a small sample of nine children and seven nurses from a single children's hospital, so it cannot determine the magnitude of benefit or generalizability to other settings. No comparison group was used, so we cannot know how CARD™ compares to standard care or other interventions.
Abstract
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.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- CARD™ system adapted for hospital needle procedures, allowing children to choose from evidence-based coping strategies across four categories: Comfort, Ask, Relax, and Distract
- Population
- Children aged 10–15 years undergoing needle-related procedures in a children's hospital, and nurses performing these procedures
Key finding
CARD™ helped children identify available options, prepare themselves, and recognize their own needs
F et al. · Europe PMC · 20 Jul 2026