Nurses' Experiences with Spiritual Care in Paediatric Palliative Care: A Systematic Review

Background/Objectives: Spiritual care is a core component of holistic paediatric palliative care, yet nurses often feel insufficiently prepared to address the spiritual and existential needs of seriously ill children and their families. This systematic review aimed to explore nurses' experiences of providing spiritual care to seriously ill and dying children in paediatric palliative care settings and to identify the factors that facilitate or hinder its provision. Methods: A systematic review was conducted in accordance with PRISMA 2020. CINAHL, PubMed, Web of Science and SAGE were searched for English-language qualitative, quantitative and mixed-methods studies published up to November 2025. Study quality was assessed using JBI critical appraisal checklists, and the findings were synthesised thematically following Thomas and Harden. Results: A total of 228 records were identified, of which ten studies met the predefined inclusion criteria. The thematic synthesis identified one overarching theme-nurses' engagement with spirituality while caring for seriously ill and dying children-supported by two sub-themes: managing emotional responses and maintaining professional, family-centred support. Conclusions: Nurses recognise spiritual care as essential in paediatric palliative care but often lack the competence and institutional support to provide it consistently. Education should prioritise spiritual assessment, developmentally appropriate communication, ethical boundaries, reflective practice and structured debriefing.