Abstract
OBJECTIVE: To identify existing legacy-making interventions for children in the context of palliative care, to evaluate the reported outcomes of these interventions, and to explore the perceptions and experiences of children, family members, and healthcare professionals regarding these interventions. METHODS: A mixed-methods systematic review was conducted. Six English databases, including PubMed, the Cochrane Library, Embase, CINAHL via EBSCO, ProQuest Nursing & Allied Health Database, and PsycINFO via EBSCO, and three Chinese databases, including CNKI, Wanfang, and Weipu, were systematically searched from inception to July 21, 2024. Articles reporting the results of qualitative, quantitative, or mixed-methods studies related to legacy-making interventions for children receiving palliative care were selected. A meta-synthesis and a quantitative narrative synthesis were conducted, and the findings were integrated using a convergent segregated approach. RESULTS: Twenty-one articles were included. Existing legacy-making interventions were categorized into tangible legacy items and living legacy projects. These interventions were found to have numerous benefits, such as improving children's quality of life, preserving dignity, fostering adaptive coping mechanisms for illness-specific stressors for both children and their parents, enhancing parent-child communication, and promoting psychosocial well-being. They also contributed to reducing compassion fatigue and burnout among healthcare professionals. The majority of children's and parents' experiences with legacy-making interventions were positive, with high acceptability of these interventions. Suggestions from family members and healthcare professionals for enhancing these interventions were also reported. CONCLUSIONS: Legacy-making interventions could benefit children, their families, and healthcare professionals. More rigorous clinical trials should be conducted to confirm the effects of these interventions in the future. SYSTEMATIC REVIEW REGISTRATION: This systematic review has been registered on PROSPERO (Registration No. CRD42024490925).