The Impacts of Legacy-Making Interventions in the Pediatric Palliative Care Setting

Introduction: Worldwide, millions of children experience life-limiting or life-threatening illnesses. Providing quality palliative care requires interventions that target the psychological, psychosocial, emotional, and spiritual needs of these children and their families. Among these are legacy-making interventions (LMIs), which encompass the creation of tangible memories, intangible experiences, and Living Legacy Projects. Despite their increasing implementation, the effects of LMIs within pediatrics remain largely underexplored, with their real impact on children and families being unknown. Objectives: To evaluate the impact of LMIs on pediatric patients, their families, and health care providers in the context of pediatric palliative care (PPC). Materials and Methods: We conducted a narrative review of the literature. Database records were extracted from PubMed, Web of Science, and EMBASE using search terms related to the topic. Of the 224 articles, 61 were selected after excluding duplicates and unrelated articles. These were read in full to verify adherence to the inclusion criteria: studies that evaluated the psychosocial, emotional, and psychological impact of LMIs on children, family members, and health care providers, with 26 articles being selected for thematic analysis. Results: The existence of positive impacts was verified in the three groups considered. In pediatric patients, studies reported enhanced emotional expression, a strengthened sense of remembrance, and improved coping in stressful situations. For family members, studies highlighted a reinforced parent-child connection, greater empowerment to honor their children's lives, and enhanced coping abilities to deal with grief and loss. Among health care providers, studies described improvements in the processing and reflection of difficult emotions. Conclusions: Different types of LMIs have beneficial effects on pediatric patients with palliative needs, their family members, and health care providers. The evidence gathered in this review supports the integration of LMIs into PPC. Future studies should continue to explore the effects of these interventions, particularly focusing on children's experiences.