【摘要】 目的 通过患儿主要照顾者、护士双视角下的视域融合深入了解耳鼻咽喉科患儿术后疼痛管理困境的相关因素，为制定科学、有效的患儿术后疼痛管理方案提供依据。方法 选取2024年1-4月杭州市某三级甲等医院耳鼻咽喉科收治的11名8岁以下患儿主要照顾者、10名耳鼻咽喉科护士作为调查对象，进行半结构式访谈，借助Nvivo11软件进行访谈资料整理，采用Colaizzi 7步分析法归纳并提炼主题。结果 共提炼出3个核心主题，7个副主题。①疼痛管理感受包括照顾者参与患儿术后疼痛管理深刻体验、患儿术后疼痛感知差异性；②疼痛认知包括疼痛相关知识缺乏、对止痛药物副作用的担忧；③疼痛应对包括照顾者参与疼痛管理应对态度不一、参与疼痛管理应对能力欠缺、渴望医护人员更多的专业支持。结论 通过弥合感知差异重建照顾者疼痛认知，鼓励并关注照顾者参与患儿疼痛管理积极性；提供针对性支持完善应对策略，提高照顾者应对能力及对患儿用药认知水平；多学科交叉提供精准、个体化医疗协助完善患儿疼痛服务体系，有效促进患儿术后康复。

    【关键词】 术后疼痛；主要照顾者；质性研究；疼痛管理；儿科护理学

    中图分类号 R762 文献标识码 A 文章编号 1671-0223(2024)23--05

    Qualitative investigation of postoperative pain management dilemma of children in otorhinolaryngology department Sun Chunrong， Liu Ling， Sang Ming， Wei Jianhua. The First Affiliated Hospital，Zhejiang University School of Medicine，Hangzhou 310003，China

    【Abstract】 Objective To gain an in-depth understanding of the factors related to postoperative pain management dilemma of children in otorhinolaryngology department through the fusion of fields of view under the dual perspectives of children's primary caregivers and nurses， so as to provide a basis for the development of a scientific and effective postoperative pain management program for children. Methods A total of 11 primary caregivers of children under 8 years of age admitted to the otolaryngology department of a tertiary-level hospital in Hangzhou City and 10 otolaryngology nurses were selected as research subjects through purposive sampling from January-April 2024 to conduct semi-structured interviews ......