• Qi Liu, Ling Jiang, Ka Yan Ho, Katherine K W Lam, Winsome Lam, Funa Yang, Ting Mao, Mei Sun, Biyu Shen, Jacqueline Mc Ho, P K Liu, S Y Chiu, and Frances-Kam-Yuet Wong.
• School of Nursing (Q.L., L.J., K.Y.H., K.K.W.L., W.L., F.Y., T.M., J.M.C.H., F.K.Y.W.), Hong Kong Polytechnic University, Hung Hom, Kowloon, HKSAR.
• J Pain Symptom Manage. 2024 Jul 1; 68 (1): e8e20e8-e20.

ContextAlthough spiritual intervention is crucial in the care of childhood cancer patients (CCPs), its effectiveness has not yet been systematically evaluated.ObjectivesTo determine the effectiveness of existing spiritual interventions on psychological, spiritual outcomes, and quality of life (QoL) in CCPs.MethodsWe searched eight databases to identify relevant randomized controlled trials and quasi-experimental studies. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials. Results were either synthesized in a systematic narrative synthesis or a meta-analysis using a random effects model, where appropriate. The pooled treatment effect was estimated using the standardized mean difference (SMD) and 95% confidence interval (CI).ResultsTwelve studies with 576 CCPs were included. Eight studies showed a high risk of bias. The overall effect of existing spiritual interventions on QoL (Z = 1.05, SMD = 0.64, 95%CI = -0.15 to 1.83, P = 0.29), anxiety (Z = 1.11, SMD = -0.83, 95%CI = -2.30 to 0.64, P = 0.28) and depressive symptoms (Z = 1.06, SMD = -0.49, 95%CI = -1.40 to 0.42, P = 0.12) were statistically nonsignificant. The nonsignificant findings could be attributed to the high heterogeneity among the included studies (QoL: I2 = 85%; anxiety: I2 = 90%; depressive symptoms: I2 = 58%).ConclusionEvidence to support the positive effects of existing spiritual interventions on psychological and spiritual outcomes and QoL in CCPs is insufficient. Future studies should adopt a more rigorous design and unify the outcome measures to reduce the risk of bias and heterogeneity, respectively.Copyright © 2024 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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