Emotional and spiritual support vital for children in palliative care

A systematic review conducted by researchers at the University of Eastern Finland brings together studies from mainland China and Taiwan. The review highlights the importance of emotional security, family relationships and culturally sensitive support for children receiving end-of-life care.

The needs of children approaching the end of life extend beyond pain relief and the management of physical symptoms. Children may worry about losing loved ones, wish to stay in touch with friends and seek reassurance that they will be remembered.

The systematic review, published in Palliative Medicine, analyzed 16 studies conducted in mainland China and Taiwan and published between 2000 and 2025. The researchers examined the psychosocial and spiritual needs of children and their families, as well as how these needs were identified and addressed.

The findings highlight children's need for emotional security, meaningful relationships, connection with others and opportunities to express their feelings and thoughts. Children's spiritual concerns do not necessarily take a religious form. They may emerge through stories and imagination, or through questions about the meaning of life.

Family relationships play an important role in how children's needs are addressed. Parents sometimes try to protect their child by avoiding conversations about death. Although well-intentioned, this may also limit children's opportunities to express their fears, wishes and preferences.

The review also identified gaps in the support provided by professionals. Psychosocial and spiritual support was sometimes fragmented, while culturally informed guidance on communication and support for coping with grief were not consistently available.

A child approaching the end of life needs more than physical care. Children should have opportunities to express their feelings, maintain their relationships and have their voices heard. Addressing these needs requires close collaboration between healthcare professionals, children and their families."

Xiao Liu, Doctoral Researcher, University of Eastern Finland

The researchers emphasize that the findings do not necessarily suggest that children's needs in mainland China and Taiwan differ from those elsewhere. Rather, cultural expectations, family relationships and healthcare structures shape how needs are expressed and addressed.

The findings support integrating psychosocial support into paediatric end-of-life care. As members of multidisciplinary teams, social workers can support communication between children and their families, help identify psychosocial needs and connect families with appropriate services. Coordination between health and social care professionals and providers of psychosocial support should also be strengthened.

Relatively few of the studies included in the review explored children's experiences directly through their own accounts. Children's and families' needs were more often described from the perspectives of parents and professionals.