Pain experiences of Tibetan children with hematologic malignancies in China: A descriptive phenomenological study

BACKGROUND: Pain is common in children with hematologic malignancies. It can be highly distressing and can shape how children feel and function during hospitalization. Children's pain experiences are influenced not only by disease and treatment but also by developmental level, family context, language, and culture. However, little is known about how Tibetan children with hematologic malignancies experience and communicate pain in clinical settings. AIM: We aimed to explore the pain experiences of Tibetan children with hematologic malignancies and to inform culturally responsive pain assessment and nursing care. METHODS: We used a descriptive phenomenological design. From February to March 2026, we purposively recruited 15 Tibetan children with hematologic malignancies from a pediatric hematology-oncology ward in Sichuan, China. Data were collected through play-based, semi-structured face-to-face interviews with children and analyzed using an adapted version of Colaizzi's phenomenological method. RESULTS: Four themes were identified: (1) cultural and spiritual interpretations of pain, including silent endurance and religious or traditional coping; (2) linguistic and communicative constraints in pain expression, including limited Mandarin vocabulary and indirect expression of discomfort; (3) family-centered dimensions of pain experience, including emotional security through family presence, relational continuity through family accompaniment, and familiar family-based comfort practices; and (4) hospitalization-related disruptions to everyday social life, including disrupted schooling and peer contact and concerns about illness disclosure and social isolation. CONCLUSIONS: The findings suggest that culturally responsive pain assessment may benefit from child-centered communication, attention to indirect and nonverbal expressions of pain, and recognition of the supportive role of family relationships and familiar comfort practices.