Not Too Young to Understand: Meaning Making From the Perspectives of School-Aged Children With Cancer-A Scoping Review.

BACKGROUND

Meaning making is increasingly recognized as an important determinant of psychosocial adjustment in adult oncology. However, how school-aged children make meaning of cancer and how developmental, relational, and sociocultural influences shape this process remain insufficiently characterized, particularly because frameworks are largely derived from adult research and centered on intrapersonal processes.

AIMS: To synthesize evidence on meaning making among school-aged children with cancer and examine these findings through Park's meaning-making model while identifying dimensions not fully captured by the model.

METHODS

A scoping review was conducted according to PRISMA-ScR guidelines. Four databases and reference lists were searched for peer-reviewed studies examining meaning making through direct reports from children aged 6-12 years with cancer. Park's meaning-making model informed study selection, data extraction, and deductive coding, while inductive coding identified dimensions not represented in the model.

RESULTS

Thirty-nine studies were included. Children's meaning making encompassed global beliefs and developmental and healthcare-related goals; appraisals of threats to the self, normalcy, relationships, and future; and cognitive, emotional, socially informed, spiritual, experiential, and avoidance-related processes. Meaning making emerged as a dynamic, developmentally grounded, and relational process shaped by caregivers, healthcare professionals, and sociocultural contexts across the cancer trajectory. Evidence regarding children's sense of meaning or purpose and meanings made was limited.

CONCLUSIONS

School-aged children actively construct meaning throughout the cancer trajectory. Integrating interdisciplinary support for meaning making that is child-centered and developmentally and culturally responsive into psychosocial care, serious illness communication, and pediatric palliative care may strengthen children's participation, coping, and psychosocial-spiritual well-being.