Spirituality in children with life-limiting, life-threatening and/or complex chronic conditions: A scoping review

To map available knowledge about spirituality in children with life-limiting, life-threatening and/or complex chronic conditions.

This review followed the Joanna Briggs Institute methodology for scoping reviews. Registration was done with the Open Science Framework. The searches were conducted in PubMed, CINAHL Complete, Psychology & Behavioral Sciences Collection, via EBSCOhost, and in the Portuguese Open Access Scientific Repository, in September 2024. The sample was composed of 48 studies.

The concept of spirituality is represented by the relationship established with oneself, with the world, and the notion of transcendence. Spiritual needs relate to developmental stage, relationships, sense of normalcy, meaning, and purpose. The relationship established between spirituality and illness is bidirectional, represented by beliefs, practices, and mechanisms of spiritual adaptation. Spiritual care is about supporting children with insights about beliefs, values and behaviours, addressing needs inherent in the developmental process, setting achievable goals that can support a meaningful life and legacy, fostering connections, mediating communication, improving spiritual coping, alleviating spiritual suffering, managing losses, and redefining hope.

This review underlines the complexity, variability, and importance of spirituality while living within a complex, life-threatening or life-limiting paediatric context. However, there is still an urgent need to develop studies on the concept in specific subgroups of this paediatric population.

Spirituality has an undeniable and aggregating role throughout the course of a life-limiting, life-threatening and/or complex chronic condition. Spiritual care and nurturing should be prioritised in care plans within these complex paediatric contexts.