学龄期扁桃体切除术后患儿疼痛管理棋盘游戏的设计及应用研究

doi:10.3761/j.issn.0254-1769.2026.10.012

摘要/Abstract

摘要：

目的设计并开发适用于学龄期扁桃体切除术后患儿疼痛管理棋盘游戏，探索其在改善术后疼痛、减轻医疗恐惧、减少行为问题及提升家庭出院准备度方面的效果，为探索儿童术后疼痛管理新路径提供依据。方法以活动理论为指导，通过文献分析及专家函询构建疼痛管理棋盘游戏内容并根据学龄期儿童认知特征设计游戏。采用便利抽样法，选取2024年1月—2025年1月就诊于福建省某三级甲等综合性医院耳鼻咽喉科行扁桃体切除手术的80例6~12岁学龄期患儿作为研究对象，依据随机数字表法分为试验组和对照组，每组各40例。试验组在常规术后疼痛健康教育的基础上接受疼痛管理棋盘游戏干预，对照组接受常规术后疼痛健康教育。比较两组术后疼痛情况、医疗恐惧、术后行为改变发生率及父母出院准备度情况。结果纳入的80例患儿均完成研究。干预后，试验组术后24 h和48 h疼痛评分低于对照组（F_时间=565.842、F_组间=38.820、F_交互=18.179，P<0.001）；术后1 d儿童医疗恐惧量表得分低于对照组（t=-5.815，P<0.001）；术后第2天试验组的行为改变发生率低于对照组（χ²=5.000，P=0.025）；父母出院准备度得分高于对照组（t=3.376，P<0.001）。结论疼痛管理棋盘游戏能改善学龄期扁桃体切除术后患儿的疼痛体验与行为结局，并提升家庭照护能力，为构建以家庭参与为核心的非药物疼痛管理新模式提供了实践路径，对改善儿科术后康复质量具有积极的临床意义。

关键词: 扁桃体切除手术, 学龄期儿童, 疼痛管理, 棋盘游戏, 儿科护理学

Abstract:

Objective To design and develop a board game for pain management in school-aged children after tonsillectomy，and to explore its effects on improving postoperative pain，reducing medical fear，decreasing behavioral issues，and enhancing family readiness for hospital discharge，thereby providing a basis for exploring new models of postoperative pain management in children.Methods Guided by activity theory，the content of the board game was developed through literature analysis and expert consultation，and the game was designed according to the cognitive characteristics of school-aged children. Using convenience sampling，80 children aged 6 to 12 years who underwent tonsillectomy in the otorhinolaryngology department of a tertiary A general hospital in Fujian Province from January 2024 to January 2025 were selected as participants. They were randomly divided into an experimental group and a control group using a random number table，with 40 children in each group. The experimental group received the board game intervention in addition to routine pain education，while the control group received only routine pain education. Postoperative pain，medical fear，incidence of behavioral changes，and parental readiness for hospital discharge were compared between the 2 groups.Results All 80 children completed the study. After the intervention，the experimental group had lower pain scores at 24 h and 48 h postoperatively compared to the control group（F_time=565.842，F_group=38.820，F_interaction=18.179，P<0.001）. The medical fear score at 1 d postoperatively was lower in the experimental group than it in the control group（t=0.851，P<0.001）. The incidence of behavioral changes on the second postoperative day was lower in the experimental group than it in the control group（χ²=5.000，P=0.025）. The parental readiness for hospital discharge score was higher in the experimental group than it in the control group（t=3.376，P<0.001）.Conclusion The pain management board game significantly improved pain experience and behavioral outcomes in children after tonsillectomy and enhanced family care capacity. This approach provides a practical pathway for establishing a new non-pharmacological pain management model centered on family involvement，demonstrating positive clinical significance for improving the quality of postoperative recovery in pediatric care.

Key words: Tonsillectomy, School-Aged Children, Pain Management, Board Game, Pediatric Nursing

张爱花, 庄嘉元, 王艳, 陈晓华. 学龄期扁桃体切除术后患儿疼痛管理棋盘游戏的设计及应用研究[J]. 中华护理杂志, 2026, 61(10): 1386-1394.

ZHANG Aihua, ZHUANG Jiayuan, WANG Yan, CHEN Xiaohua. Design and application of a board game for pain management in school-aged children after tonsillectomy[J]. Chinese Journal of Nursing, 2026, 61(10): 1386-1394.

图/表 5

表1 学龄期扁桃体切除术后患儿疼痛管理棋盘游戏的指标内容

Table 1 Shows the index contents of the board game for pain management in school-age children after tonsillectomy

表2 学龄期儿童扁桃体切除术后疼痛管理棋盘游戏内容

Table 2 The content of a board game for post-tonsillectomy pain management in school-age children

表3 两组一般资料的比较[例（百分比，%）]

Table 3 Comparison of general data between the 2 groups[case（percentage，%）]

表4 两组术后不同时间点疼痛评分的比较（分，$\bar{x} \pm s$）

Table 4 Comparison of postoperative VAS pain scores between the 2 groups at different time points（scores，$\bar{x} \pm s$）

表5 两组医疗恐惧评分的比较（分，$\bar{x} \pm s$）

Table 5 Comparison of medical fear scores between the 2 groups（scores，$\bar{x} \pm s$）

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