An integrative literature review to develop a conceptual framework for spiritual nursing care in pediatric oncology

Spiritual distress represents a significant yet under-addressed dimension of suffering among children with cancer. Despite its influence on emotional resilience, treatment adherence, and psychological well-being, spiritual care in pediatric oncology remains inconsistently implemented due to developmental misalignment, cultural variability, and limited professional training.

This study aimed to synthesize the literature and propose a a preliminary, developmentally responsive, and culturally adaptable nursing-centered conceptual framework for spiritual care in pediatric oncology, designed to guide nursing practice while supporting interdisciplinary collaboration in pediatric oncology, termed the Developmental-Spiritual Oncology Care Model (DSOCM).

An integrative literature review was conducted across six databases, yielding 227 sources, including empirical studies, theoretical works, clinical guidelines, and foundational texts. A manual inductive thematic analysis was performed to identify recurring concepts, relational patterns, and care processes relevant to pediatric spiritual care. Selected theoretical foundations-including Fowler's Faith Development Theory, Watson's Caring Theory, Travelbee's Human-to-Human Relationship Model, Benner's Competency Framework, and Mercer's spiritual constructs- were critically evaluated and used to inform the development of the conceptual framework.

DSOCM proposes core assumptions, paradigmatic and meta-paradigmatic concepts, guiding objectives, and a holistic nursing care approach. The framework highlights inclusivity, interdisciplinary collaboration, and competency-based training.

As a preliminary literature-derived conceptual framework, DSOCM offers a structured guide for spiritual nursing care in pediatric oncology and requires further empirical testing, cross-cultural adaptation, and contextual refinement.