Legacy-Oriented Interventions for Supporting Family Bereavement and Psychosocial Adaptation in Pediatric Palliative Care: A Systematic Review.

All nine included studies were conducted in the United States, so the findings may not transfer to other cultural or healthcare settings. The review included only qualitative studies, so it reports participants’ descriptions rather than measured bereavement outcomes. The search may have missed studies because of language restrictions and because unpublished or grey literature was not included. Heterogeneity of interventions, outcomes and study designs prevented meta-analysis or structured comparison. No quality threshold was applied to exclude lower-quality studies. All studies were unclear on whether researchers made their own beliefs explicit, and most were unclear on researcher influence. One study lacked an explicit ethics statement. Most participants were bereaved parents, with fewer perspectives from children and other family members.

The authors reported no financial support and no potential conflicts of interest.

Do not conclude that legacy activities improve bereavement or reduce anxiety. The review included only qualitative studies of families’ and children’s descriptions, and clinical outcomes such as symptom control were reported in one study without a controlled comparison.