血液造血干细胞移植（HSCT）后住院的儿童在治疗过程中经历复杂且长时间的疼痛，其程度与治疗的强度有关。本研究旨在描述儿童HSCT治疗期间的疼痛管理情况，以及与临床环境相关的环境因素如何影响医疗提供者与父母的疼痛管理实践。本研究采用定性案例研究方法，包括对30天和90天移植后的（n=10）父母进行半结构化访谈，并对由健康医护人员（n=10）提供给儿童（n=29）的与疼痛相关的护理进行自然观察。另外，还对医疗提供者（n=14）进行了半结构化访谈。疼痛管理干预的效果受到儿童经历的疼痛的多种因素的阻碍，缺乏对疼痛提供心理社会干预的提供，以及缺乏针对长期使用阿片类药物和辅助药物的循证指南。医疗提供者有关根据疼痛严重程度逐步加强疼痛管理和区分阿片类药物耐受和成瘾之间的差异的误解得到证明。父母在儿童疼痛管理中发挥了积极作用，尤其提供非药物干预措施。与外部疼痛服务的合作以及在隔离环境中照顾儿童所带来的影响延缓了对疼痛的及时管理。迫切需要制定基于循证的支持性护理指南，以优化儿童的疼痛缓解。如果要让父母和儿童参与疼痛管理，就必须更加努力地提升他们做出明智决策的能力。 © 2023 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.

Children hospitalized following hematopoietic stem cell transplantation (HSCT) experience complex and prolonged pain in response to the intensity of this treatment.To describe how pain was managed for children during HSCT therapy and how contextual factors related to the clinical environment influenced healthcare providers' and parents' pain management practices.A qualitative case study was conducted and involved semi-structured interviews at two time points following transplantation (30 and 90 days) with parents (n = 10) and naturalistic observations of pain-related care provided to children (n = 29) during HSCT therapy by their healthcare providers (n = 10). Semi-structured interviews were also conducted with healthcare providers (n = 14).The effectiveness of pain management interventions was hindered by the multifactorial nature of pain children experienced, a gap in the provision of psychosocial interventions for pain and a lack of evidence-based guidelines for the sustained, and often long-term, administration of opioids and adjuvant medications. Misconceptions were demonstrated by healthcare providers about escalating pain management according to pain severity and differentiating between opioid tolerance and addiction. Parents were active in the management of pain for children, especially the provision of nonpharmacological interventions. Collaboration with external pain services and the impact of caring for children in protective isolation delayed timely management of pain.There is a pressing need to create evidence-based supportive care guidelines for managing pain post transplantation to optimize children's relief from pain. If parents and children are to be involved in managing pain, greater efforts must be directed toward building their capacity to make informed decisions.© 2023 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.