TL;DR
A systematic review in Palliative Medicine examined 16 studies from mainland China and Taiwan on children’s psychosocial and spiritual needs near the end of life. It identifies emotional security, relationships and opportunities to speak as important alongside physical care, while noting that children’s own accounts were rarely included.
A systematic review of 16 studies has found that children approaching the end of life need support for emotional security, relationships and self-expression alongside treatment of physical symptoms. Published in Palliative Medicine, the review examined research from mainland China and Taiwan and also identified gaps in professional support and in research based directly on children’s accounts.
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The review examined studies published between 2000 and 2025 on the psychosocial and spiritual needs of children and their families, including how those needs were recognized and addressed. The report says children may fear losing loved ones, want to remain connected with friends, and seek reassurance that they will be remembered.
Spiritual concerns, the researchers note, do not necessarily involve religion. They may appear in stories, imagination or questions about life’s meaning. The review describes children’s need for opportunities to express feelings and thoughts, maintain meaningful relationships and have their voices heard.
Family communication can shape whether those needs are addressed. Parents may avoid discussing death in an effort to protect a child, the report says, but that can also leave fewer opportunities for children to share fears, wishes or preferences. The review found that psychosocial and spiritual support could be fragmented, with culturally informed communication guidance and grief support not consistently available.
Making Space for Children’s Voices
The findings matter because end-of-life care for children involves more than managing pain and other physical symptoms. Support for emotional safety, relationships and communication can affect whether a child has space to express concerns and preferences during care. The review points to a need for professionals to work with children and families rather than assuming that adults’ accounts fully describe what a child needs.
The authors say the findings support integrating psychosocial care into pediatric end-of-life services. Social workers may help identify needs, support communication between children and families, and connect families with services. The report also calls for stronger coordination among health care, social services and psychosocial support providers. These are implications drawn by the researchers; the review does not establish that one particular service model improves outcomes.
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What the Review Examined
The paper, by Xiao Liu and colleagues, is titled “Psychosocial and spiritual needs of children at the end of life and their families in Chinese societies: A systematic review.” It was published in Palliative Medicine in 2026. Its evidence base consists of 16 studies conducted in mainland China and Taiwan and published over a 25-year period.
The researchers caution against reading the regional focus as proof that children’s needs there differ from those elsewhere. Instead, the report says cultural expectations, family relationships and health care structures can shape how needs are expressed and addressed. The review focuses on psychosocial and spiritual support for children and families; it does not replace clinical guidance on physical care.
“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.”
— Xiao Liu, doctoral researcher at the University of Eastern Finland
Limits in the Available Evidence
The review’s findings are limited by its evidence base: only 16 studies were included, all from mainland China and Taiwan. The authors say the regional focus does not show that children’s needs differ from those in other places, and the available information does not establish how widely the findings apply across different health systems or communities.
A further gap is whose perspectives the studies captured. The review found that children’s experiences were relatively rarely reported in their own words; parents and professionals more often described needs. The source report does not provide detailed study-by-study results, estimates of how common each need was, or evidence comparing specific support approaches. Those points remain unclear from the information available.
Building Better-Connected Support
The researchers argue for incorporating psychosocial support into pediatric end-of-life care, with clearer coordination between clinical teams, social workers and other support providers. Their recommendations include helping families communicate with children and making services available for coping with grief. The review does not announce a new program or implementation timetable.
Further research that records children’s own accounts could help clarify how they describe their concerns and what kinds of support they find useful. For now, the report’s next step is a practice implication rather than a scheduled event: care teams and services can consider how to give children opportunities to speak, stay connected and take part in conversations about their needs.
Key Questions
What did the review find?
It identifies emotional security, relationships and opportunities for self-expression as important needs for children approaching the end of life, alongside physical care.
How many studies were included?
The review analyzed 16 studies conducted in mainland China and Taiwan and published between 2000 and 2025.
Does spiritual support mean religious care?
Not necessarily. The report says children’s spiritual concerns may emerge through stories, imagination or questions about the meaning of life, without taking a religious form.
What evidence gap did the researchers identify?
Children’s experiences were relatively rarely recorded directly. The review says needs were more often described by parents and professionals than in children’s own accounts.
What changes do the researchers support?
They support integrating psychosocial care into pediatric end-of-life services and improving coordination among health care, social services and psychosocial support providers. The report does not specify a timetable or a single required model.
Source: medicalxpress.com
