Mapping the palliative care needs of children with cancer: a scoping review through the bio-psycho-socio-spiritual lens.
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BACKGROUND: Paediatric palliative care (PPC) is essential in alleviating the multidimensional burden of cancer for children and their families, yet their needs remain insufficiently understood across diverse settings. This scoping review mapped the palliative care needs of children with cancer through the bio-psycho-socio-spiritual lens, examining how these needs relate to quality of life and highlighting gaps in current practice. METHODS: A systematic search was conducted across six databases for studies published in English between January 2014 and December 2024, guided by PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and Arksey and O'Malley's framework. RESULTS: Forty-six studies from 22 countries were included, with most originating from high-income settings and limited representation from low- and middle-income countries. Marked disparities were observed between high-income and low- and middle-income settings, particularly in the representation of social and spiritual domains and the availability of structured paediatric palliative care services. Physical symptoms such as pain and fatigue were consistently reported, while emotional distress, social isolation, and caregiver burden were common but often lacked structured interventions. Spiritual needs were the least explored, reflecting a significant gap in holistic care. The majority of studies focused on hospital-based settings, with minimal attention to home and community care. CONCLUSION: Findings underscore substantial unmet PPC needs across all domains, particularly in resource-limited contexts. There is an urgent need for culturally sensitive, family-centred, and standardised approaches that integrate child- and caregiver perspectives. This review provides evidence to guide clinical practice, inform policy, and shape future research agendas in paediatric palliative oncology. IMPACT: This scoping review synthesises evidence on the multidimensional palliative care needs of children with cancer across bio-psycho-socio-spiritual framework. It integrates fragmented evidence into a single, holistic map of paediatric palliative care needs across physical, psychological, social, and spiritual domains. It informs clinical practice, outcome measurement, and policy by highlighting unmet and underrepresented palliative care needs in paediatric oncology. This work informs clinical practice, outcome selection, and policy development for integrated paediatric palliative oncology services.