目的 了解腰椎融合术后慢性疼痛患者选择非药物干预措施方式康复决策时的体验，为制订决策支持策略提供依据。方法 2024年12月至2025年3月，采用目的抽样法选取上海某三级甲等医院15例腰椎融合术后3个月仍有慢性疼痛的患者为研究对象，对其进行半结构式访谈。根据Colaizzi 7步分析法对资料进行整理。结果 共提炼出4个主题：手术疗效预期崩塌与应对失措；决策中的知、信、行三重困境；赋能体验与信心重塑使非药物干预措施迎来曙光；非药物干预措施面临的现实困境。结论 腰椎融合术后慢性疼痛非药物干预措施决策过程较曲折，应推进医疗共享决策及疾病自我管理模式，系统整合家庭支持维度，并建立多学科联合团队。

Objective To explore the decision-making experience of patients with chronic pain after lumbar fusion surgery when choosing rehabilitation methods involving non-pharmacological interventions,and to provide a basis for formulating decision support strategies.Methods From December 2024 to March 2025,15 patients who still experienced chronic pain 3 months after lumbar fusion surgery were selected using purposive sampling method and interviewed with a semi-structured format.Data were analyzed using Colaizzi’s 7-step analysis method.Results Four themes were extracted as follows: collapse of surgical efficacy expectations and loss of coping strategies;the triple dilemma of knowledge,belief,and practice in decision-making;empowerment experience and confidence reshaping bringing light to non-pharmacological interventions;realistic dilemmas faced by non-pharmacological interventions. Conclusions The decision-making process regarding non-pharmacological interventions for chronic pain after lumbar fusion surgery is tortuous.It is recommended to promote medical shared decision-making and disease self-management models,systematically integrate the dimension of family support,and establish a multidisciplinary collaborative team.

R473.6

国家自然科学基金项目（72304210）；上海申康医院发展中心第二轮《促进市级医院临床技能与临床创新三年行动计划》研究型医师创新转化能力培训项目（SHDC2023CRS024）