Sustaining Compassionate Care in Pediatric and Neonatal Palliative Care: A Qualitative Meta‐Synthesis of Nurses’ Experiences Amid Uncertainty and Loss
- 1Department of Neonatology Nursing West China Second University Hospital Sichuan University Chengdu 610041 China scu.edu.cn
- 2Key Laboratory of Birth Defects and Related Diseases of Women and Children Ministry of Education Sichuan University Chengdu 610041 China scu.edu.cn
- 3Department of Pediatrics West China Second University Hospital Sichuan University Chengdu 610041 China scu.edu.cn
Abstract
Background: Nurses provide pediatric and neonatal palliative care amid substantial emotional and relational demands. Qualitative evidence remains fragmented on how nurses sustain compassionate care and how relational and organizational conditions shape these efforts. This systematic review and meta‐synthesis examined these experiences across palliative and end‐of‐life settings.
Methods: PubMed, CINAHL, Embase, PsycINFO, Web of Science, and Scopus were searched from inception to September 2026. Qualitative studies and separately extractable qualitative components of mixed‐methods studies addressing nurses’ experiences of pediatric or neonatal palliative care were eligible. Two reviewers independently screened records, extracted data, and applied the Joanna Briggs Institute qualitative appraisal checklist. Findings were synthesized using Thomas and Harden’s three‐stage thematic synthesis, with confidence assessed using GRADE‐CERQual.
Results: Thirty‐seven studies from 21 countries reported a total of 599 nursing participants. Four analytical themes and 18 descriptive subthemes were generated: (1) finding meaning through care for children and families; (2) managing relational closeness and professional boundaries; (3) responding to grief and loss through coping and meaning‐making; and (4) seeking and using interpersonal and organizational support. Confidence was moderate for Themes 1–3 and high for Theme 4. Valued care, relational involvement, coping, and support coexisted with persistent grief, emotional depletion, and unmet needs.
Conclusions: Nurses’ efforts to sustain compassionate care involve interacting personal, relational, and organizational processes. Meaningful care can coexist with persistent grief and emotional strain, with variation in emotional availability and recovery. These findings highlight the importance of organizational support alongside individual coping.
Implications for Nursing Management: Managers should protect time and resources for relational care and strengthen nursing participation in interdisciplinary decisions. Emotional and clinical support should be accessible and responsive to nurses’ preferences, including opportunities for reflection, supervision, and peer support.
Related
- Nurses’ experiences of delivering palliative care in Asia: a qualitative systematic review
- Physiotherapists’ knowledge and experiences of palliative care in neonatal intensive care units: a qualitative study Conhecimentos e vivência de fisioterapeutas sobre cuidados paliativos em unidade de terapia intensiva neonatal: um estudo qualitativo
- Physiotherapists’ knowledge and experiences of palliative care in neonatal intensive care units: a qualitative study
- Nurses’ experiences of expanded responsibilities, independent decision-making and action in specialized outpatient palliative care: a qualitative interview study
- From Compassionate Intuition to Clinical Competence: Spiritual Care Among Palliative Care Professionals in Ecuador.
BibTeX
@article{li2026sustaining,
title = {{Sustaining Compassionate Care in Pediatric and Neonatal Palliative Care: A Qualitative Meta‐Synthesis of Nurses’ Experiences Amid Uncertainty and Loss}},
author = {Yuan Li and Shiqi Luo and Xia Li and Hanmei Peng and Yanling Hu and Qiong Chen},
journal = {Journal of Nursing Management},
year = {2026},
month = nov,
doi = {10.1155/jonm/5143378},
url = {https://doi.org/10.1155/jonm/5143378},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Sustaining Compassionate Care in Pediatric and Neonatal Palliative Care: A Qualitative Meta‐Synthesis of Nurses’ Experiences Amid Uncertainty and Loss
AU - Yuan Li
AU - Shiqi Luo
AU - Xia Li
AU - Hanmei Peng
AU - Yanling Hu
AU - Qiong Chen
PY - 2026
DA - 2026/11/01
JO - Journal of Nursing Management
DO - 10.1155/jonm/5143378
UR - https://doi.org/10.1155/jonm/5143378
AB - Background: Nurses provide pediatric and neonatal palliative care amid substantial emotional and relational demands. Qualitative evidence remains fragmented on how nurses sustain compassionate care and how relational and organizational conditions shape these efforts. This systematic review and meta‐synthesis examined these experiences across palliative and end‐of‐life settings. Methods: PubMed, CINAHL, Embase, PsycINFO, Web of Science, and Scopus were searched from inception to September 2026. Qualitative studies and separately extractable qualitative components of mixed‐methods studies addressing nurses’ experiences of pediatric or neonatal palliative care were eligible. Two reviewers independently screened records, extracted data, and applied the Joanna Briggs Institute qualitative appraisal checklist. Findings were synthesized using Thomas and Harden’s three‐stage thematic synthesis, with confidence assessed using GRADE‐CERQual. Results: Thirty‐seven studies from 21 countries reported a total of 599 nursing participants. Four analytical themes and 18 descriptive subthemes were generated: (1) finding meaning through care for children and families; (2) managing relational closeness and professional boundaries; (3) responding to grief and loss through coping and meaning‐making; and (4) seeking and using interpersonal and organizational support. Confidence was moderate for Themes 1–3 and high for Theme 4. Valued care, relational involvement, coping, and support coexisted with persistent grief, emotional depletion, and unmet needs. Conclusions: Nurses’ efforts to sustain compassionate care involve interacting personal, relational, and organizational processes. Meaningful care can coexist with persistent grief and emotional strain, with variation in emotional availability and recovery. These findings highlight the importance of organizational support alongside individual coping. Implications for Nursing Management: Managers should protect time and resources for relational care and strengthen nursing participation in interdisciplinary decisions. Emotional and clinical support should be accessible and responsive to nurses’ preferences, including opportunities for reflection, supervision, and peer support.
SN - 0966-0429
SN - 1365-2834
ER -