目的 深入探究7~12岁白血病患儿自我健康管理的体验，挖掘其促进与障碍因素，以期为构建自我管理干预方案提供实证依据。方法 2025年8-10月，目的抽样法选取郑州市某三级甲等医院小儿血液肿瘤病区16例患儿及其父母为研究对象，采用半结构式深度访谈，以内容分析法归纳主题。结果 共提炼出3个主题及7个亚主题，包括主体性建构与发展（自我效能的激发与强化、知识的主动建构、策略的创造与应用），自我健康管理过程中面临的困境与制约（化疗相关躯体症状的困扰、疾病健康知识的匮乏），支持系统的困境与失衡（保护性养育的越界与缺位、健康宣教的认知错位与脱节）。结论 7~12岁白血病患儿具备参与自我健康管理的内在潜能与认知基础，能够发展出主体性的管理行为；但其自我管理实践深受躯体症状困扰、疾病知识匮乏以及外部支持系统失衡的多重制约。因此，临床护理应致力于优化症状管理、创新童趣化健康教育方式，并引导家长实现从过度保护向适度赋能的角色转变，从而有效激发患儿的学习动机，提升其自我管理效能。

Objective To deeply explore the self-health management experience of children aged 7-12 with leukemia, identify its facilitating and hindering factors, and provide an empirical basis for constructing self-management intervention programs.Methods From August to October 2025, 16 children and their parents from the pediatric hematology/oncology ward of a tertiary A hospital in Zhengzhou were selected by purposive sampling. Semi-structured in-depth interviews were conducted, and themes were summarized using content analysis.Results A total of 3 themes and 7 sub-themes were extracted, including the construction and development of subjectivity (stimulation and reinforcement of self-efficacy, active construction of knowledge, creation and application of strategies), dilemmas and constraints faced in the process of self-health management (distress from chemotherapy-related physical symptoms, lack of disease and health knowledge), and dilemmas and imbalances in the support system (transgression and absence of protective parenting, cognitive mismatch and disconnect in health education).Conclusions Children aged 7-12 with leukemia possess the intrinsic potential and cognitive foundation to participate in self-health management and can develop subjective management behaviors. However, their self-management practice is significantly constrained by physical symptom distress, lack of disease knowledge, and an imbalanced external support system. Therefore, clinical nursing should focus on optimizing symptom management, innovating child-friendly health education methods, and guiding parents to shift from overprotection to appropriate empowerment, thereby effectively stimulating children’s learning motivation and enhancing their self-management efficacy.

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