{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:25:47Z","timestamp":1787304347569,"version":"build-2736575974"},"reference-count":132,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Context: Previous studies and reviews in adult patients have shown that hope is an important coping mechanism in patients with serious health problems. Although there are individual studies in pediatric patients, there is a lack of a systematic review of how hope manifests and how it can be supported in children with life-threatening illnesses and their families. Objectives: This systematic review aims to identify the key factors that are associated with the experience of hope in pediatric palliative care. It examines how hope is fostered or diminished in children with life-limiting illnesses, their parents, and other family members. Methods: A systematic search was conducted across major medical databases for studies published between 1990 and 2024. Thematic analysis was used to identify factors associated with hope. The quality of the included studies was critically appraised. Results: Out of 1373 identified records, 105 studies met the inclusion criteria. Most studies were qualitative in design and met a high proportion of the applicable criteria in their respective design-specific appraisal tools. Factors associated with increased hope included open and empathetic communication, trusting relationships with healthcare providers, strong social and family support, spiritual and religious faith, effective symptom management, involvement in care decisions, and access to practical resources. Conversely, reduced hope was associated with poor communication, social isolation, uncontrolled symptoms, uncertainty, caregiver distress, financial strain, and negative healthcare experiences. These factors were consistent across cultural and diagnostic contexts, with some variation in emphasis. Conclusions: Hope in pediatric palliative care is associated with relational, psychological, spiritual, and systemic factors. Many of these are modifiable. A family-centered and multidisciplinary approach is essential to sustaining hope in pediatric palliative contexts.<\/jats:p>","DOI":"10.3390\/children13081117","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:14:01Z","timestamp":1787300041000},"page":"1117","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hope in Pediatric Palliative Care: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6262-1796","authenticated-orcid":false,"given":"Hana","family":"Bene\u0161ov\u00e1","sequence":"first","affiliation":[{"name":"Department of Psychiatry, First Faculty of Medicine, Charles University\u00a0and General University Hospital, 128 08 Prague, Czech Republic"},{"name":"Paediatric Supportive Care Team, Motol and Homolka University Hospital, 150 06 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0582-4581","authenticated-orcid":false,"given":"Miroslava","family":"Janou\u0161kov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, 116 36 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lou\u010dka","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Ethics, Faculty of Medicine, Masaryk University, 601 77 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Aldridge, J., and Sourkes, B.M. (2012). The Psychological Impact of Life-Limiting Conditions on the Child. Oxford Textbook of Palliative Care for Children, Oxford University Press.","DOI":"10.1093\/med\/9780199595105.003.0008"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1093\/pch\/20.3.139","article-title":"Charting the Territory: Children and Families Living with Progressive Life-Threatening Conditions","volume":"20","author":"Siden","year":"2015","journal-title":"Paediatr. Child Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101513","DOI":"10.1016\/j.copsyc.2022.101513","article-title":"Hope in the Context of Life-Threatening Illness and the End of Life","volume":"49","author":"Hill","year":"2023","journal-title":"Curr. Opin. Psychol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Silveira, A.O., Wernet, M., Franco, L.F., Dias, P.L.M., and Charepe, Z. (2023). Parents\u2019 Hope in Perinatal and Neonatal Palliative Care: A Scoping Review. BMC Palliat. Care, 22.","DOI":"10.1186\/s12904-023-01324-z"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1017\/S1478951509990307","article-title":"Hope in Palliative Care: An Integrative Review","volume":"7","author":"Duggleby","year":"2009","journal-title":"Palliat. Support. Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1001\/archpediatrics.2009.87","article-title":"Until the Last Breath","volume":"163","author":"Reder","year":"2009","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1111\/apa.13496","article-title":"Children with Cancer Share Their Views: Tell the Truth but Leave Room for Hope","volume":"105","author":"Jalmsell","year":"2016","journal-title":"Acta Paediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e529","DOI":"10.1016\/j.jpainsymman.2021.12.031","article-title":"International Standards for Pediatric Palliative Care: From IMPaCCT to GO-PPaCS","volume":"63","author":"Benini","year":"2022","journal-title":"J. Pain Symptom Manag."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e2022057011","DOI":"10.1542\/peds.2022-057011","article-title":"Guidance for Pediatric End-of-Life Care","volume":"149","author":"Linebarger","year":"2022","journal-title":"Pediatrics"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5265","DOI":"10.1200\/JCO.2006.06.5326","article-title":"Communication About Prognosis Between Parents and Physicians of Children with Cancer: Parent Preferences and the Impact of Prognostic Information","volume":"24","author":"Mack","year":"2006","journal-title":"J. Clin. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1136\/archdischild-2019-318398","article-title":"Breaking Bad News: What Parents Would like You to Know","volume":"106","author":"Brouwer","year":"2021","journal-title":"Arch. Dis. Child."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.1002\/pon.3305","article-title":"Trajectory of Parental Hope When a Child Has Difficult-to-treat Cancer: A Prospective Qualitative Study","volume":"22","author":"Granek","year":"2013","journal-title":"Psychooncology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1111\/apa.13510","article-title":"What Else Are You Hoping for? Fostering Hope in Paediatric Serious Illness","volume":"105","author":"Rosenberg","year":"2016","journal-title":"Acta Paediatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e54","DOI":"10.1093\/oncolo\/oyac227","article-title":"Perceptions of Death Among Patients with Advanced Cancer Receiving Early Palliative Care and Their Caregivers: Results from a Mixed-Method Analysis","volume":"28","author":"Bigi","year":"2023","journal-title":"Oncologist"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"114471","DOI":"10.1016\/j.socscimed.2021.114471","article-title":"Hopeful Dying? The Meanings and Practice of Hope in Palliative Care Family Meetings","volume":"291","author":"Kirby","year":"2021","journal-title":"Soc. Sci. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e26981","DOI":"10.1002\/pbc.26981","article-title":"Sources of Parental Hope in Pediatric Oncology","volume":"65","author":"Sisk","year":"2018","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Almack, K., Cox, K., Moghaddam, N., Pollock, K., and Seymour, J. (2012). After You: Conversations between Patients and Healthcare Professionals in Planning for End of Life Care. BMC Palliat. Care, 11.","DOI":"10.1186\/1472-684X-11-15"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1038\/d41586-023-01853-w","article-title":"ChatGPT: Standard Reporting Guidelines for Responsible Use","volume":"618","author":"Cacciamani","year":"2023","journal-title":"Nature"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Galli, C., Gavrilova, A.V., and Calciolari, E. (2025). Large Language Models in Systematic Review Screening: Opportunities, Challenges, and Methodological Considerations. Information, 16.","DOI":"10.3390\/info16050378"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"547","DOI":"10.23736\/S2724-5683.24.06568-2","article-title":"Using ChatGPT to Perform a Systematic Review: A Tutorial","volume":"72","author":"Teperikidis","year":"2024","journal-title":"Minerva Cardiol. Angiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using Thematic Analysis in Psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1177\/1367493518762584","article-title":"The Adaptation Process of Mothers Raising a Child with Complex Congenital Heart Disease","volume":"22","author":"Ahn","year":"2018","journal-title":"J. Child Health Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e34021","DOI":"10.1590\/s0103-7331202434021pt","article-title":"Expectativas de Fam\u00edlias de Crian\u00e7as Eleg\u00edveis Para Cuidados Paliativos","volume":"34","author":"Albuquerque","year":"2024","journal-title":"Physis Rev. Sa\u00fade Coletiva"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1016\/j.pedn.2018.12.004","article-title":"The Practice of Mutual Protection in the Care of Children with Palliative Care Needs: A Multiple Qualitative Case Study Approach from Jordan","volume":"45","author":"Atout","year":"2019","journal-title":"J. Pediatr. Nurs."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/NCC.0b013e3182a453aa","article-title":"Keeping Hope Possible: A Grounded Theory Study of the Hope Experience of Parental Caregivers Who Have Children in Treatment for Cancer","volume":"37","author":"Bally","year":"2014","journal-title":"Cancer Nurs."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Bally, J.M.G., Burles, M., Spurr, S., Holtslander, L., Hodgson-Viden, H., Sinha, R., and Zimmer, M. (2021). Keeping Hope Possible Toolkit: The Development and Evaluation of a Psychosocial Intervention for Parents of Infants, Children and Adolescents with Life Limiting and Life Threatening Illnesses. Children, 8.","DOI":"10.3390\/children8030218"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1017\/S1478951505050315","article-title":"Health-Related Quality of Life and Enrollment in Phase 1 Trials in Children with Incurable Cancer","volume":"3","author":"Barrera","year":"2005","journal-title":"Palliat. Support. Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/NCC.0b013e318291ba7d","article-title":"The Tenacity and Tenuousness of Hope: Parental Experiences of Hope When Their Child Has a Poor Cancer Prognosis","volume":"36","author":"Barrera","year":"2013","journal-title":"Cancer Nurs."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1111\/cge.13528","article-title":"Uncertainty, Hope, and Coping Efficacy among Mothers of Children with Duchenne\/Becker Muscular Dystrophy","volume":"95","author":"Bell","year":"2019","journal-title":"Clin. Genet."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e2726","DOI":"10.1136\/spcare-2023-004348","article-title":"Parent Experience of Advance Care Planning: Reconstructing Meaning\u2014Grounded Theory","volume":"14","author":"Bennett","year":"2024","journal-title":"BMJ Support. Palliat. Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s13030-024-00314-8","article-title":"A Qualitative Study on the Experiences of Family Caregivers of Children with End Stage Kidney Disease (ESKD)","volume":"18","author":"Boateng","year":"2024","journal-title":"Biopsychosoc. Med."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Boursange, S., Araneda, M., Stalens, C., Desguerre, I., Barnerias, C., Nougues, M.-C., Isapof, A., Quijano-Roy, S., Blu Genestine, N., and Ouillade, L. (2022). Parents\u2019 Dilemma: A Therapeutic Decision for Children with Spinal Muscular Atrophy (SMA) Type 1. Front. Pediatr., 10.","DOI":"10.3389\/fped.2022.1062390"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Bronsema, A., Thei\u00dfen, T., Oechsle, K., Wikert, J., Escherich, G., Rutkowski, S., Bokemeyer, C., and Ullrich, A. (2022). Looking Back: Identifying Supportive Care and Unmet Needs of Parents of Children Receiving Specialist Paediatric Palliative Care from the Bereavement Perspective. BMC Palliat. Care, 21.","DOI":"10.1186\/s12904-022-00971-y"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1177\/1043454207305296","article-title":"Achieving Balance: A Case Study Examination of an Adolescent Coping with Life-Limiting Cancer","volume":"24","author":"Callaghan","year":"2007","journal-title":"J. Pediatr. Oncol. Nurs."},{"key":"ref_35","first-page":"238","article-title":"The Story of Margaret and Her Family: Forced Choices, Obligations, and Hope","volume":"30","author":"Carnevale","year":"2004","journal-title":"Pediatr. Nurs."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1007\/s00431-021-04314-6","article-title":"Parents\u2019 Experiences of Initiation of Paediatric Advance Care Planning Discussions: A Qualitative Study","volume":"181","author":"Carr","year":"2022","journal-title":"Eur. J. Pediatr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/21507716.2011.638019","article-title":"Influences on Decision Making Identified by Parents of Children Receiving Pediatric Palliative Care","volume":"3","author":"Carroll","year":"2012","journal-title":"AJOB Prim. Res."},{"key":"ref_38","first-page":"508","article-title":"Virtual Support for Bereaved Parents: Acceptability, Feasibility, and Preliminary Efficacy of HOPE Group","volume":"28","author":"Drouin","year":"2024","journal-title":"J. Palliat. Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Dutta, O., Tan-Ho, G., Low, X.C., Tan, T.H.B., Ganapathy, S., Car, J., Ho, R.M.-H., Miao, C.Y., and Ho, A.H.Y. (2022). Acceptability and Feasibility of a Pilot Randomized Controlled Trial of Narrative E-Writing Intervention (NeW-I) for Parent-Caregivers of Children with Chronic Life-Threatening Illnesses in Singapore. BMC Palliat. Care, 21.","DOI":"10.1186\/s12904-022-00945-0"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Effendy, C., Uligraff, D.K., Sari, S.H., Angraini, F., and Chandra, L. (2022). Experiences of Family Caregivers of Children with Cancer While Receiving Home-Based Pediatric Palliative Care in Indonesia: A Qualitative Study. BMC Palliat. Care, 21.","DOI":"10.1186\/s12904-022-00986-5"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/j.1548-1387.2009.01036.x","article-title":"Emotional Experts: Parents\u2019 Views on End-of-Life Decisions for Preterm Infants in Iceland","volume":"23","year":"2009","journal-title":"Med. Anthropol. Q."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.spen.2006.06.009","article-title":"\u201cMy Son Is Still Walking\u201d: Stages of Receptivity to Discussions of Advance Care Planning Among Parents of Sons with Duchenne Muscular Dystrophy","volume":"13","author":"Erby","year":"2006","journal-title":"Semin. Pediatr. Neurol."},{"key":"ref_43","first-page":"117","article-title":"The Fragile Spirituality of Parents Whose Children Died in the Pediatric Intensive Care Unit","volume":"26","author":"Falkenburg","year":"2020","journal-title":"J. Health Care Chaplain."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1001\/archpediatrics.2010.146","article-title":"Parental Hopeful Patterns of Thinking, Emotions, and Pediatric Palliative Care Decision Making","volume":"164","author":"Feudtner","year":"2010","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e12325","DOI":"10.1111\/jspn.12325","article-title":"Therapeutic Letters: A Qualitative Study Exploring Their Influence on the Hope of Parents of Children Receiving Pediatric Palliative Care in Portugal","volume":"26","author":"Fonseca","year":"2021","journal-title":"J. Spec. Pediatr. Nurs."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1002\/symb.195","article-title":"\u201cHe\u2019s Doing Fine\u201d: Hope Work and Emotional Threat Management Among Families of Seriously Ill Children","volume":"38","author":"Gengler","year":"2015","journal-title":"Symb. Interact."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1080\/09699260.2022.2152169","article-title":"Parents\u2019 Experiences with Prognosis Communication in Advanced Pediatric Cancers","volume":"31","author":"Ghoshal","year":"2023","journal-title":"Prog. Palliat. Care"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e004653","DOI":"10.1136\/bmjgh-2020-004653","article-title":"The Evolution of Parents\u2019 Beliefs about Childhood Cancer during Diagnostic Communication: A Qualitative Study in Guatemala","volume":"6","author":"Graetz","year":"2021","journal-title":"BMJ Glob. Health"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1002\/ajmg.a.36298","article-title":"Our Children Are Not a Diagnosis: The Experience of Parents Who Continue Their Pregnancy after a Prenatal Diagnosis of Trisomy 13 or 18","volume":"164","author":"Guon","year":"2014","journal-title":"Am. J. Med. Genet. A"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1097\/NCC.0000000000000450","article-title":"The Resilience in Illness Model Part 2: Confirmatory Evaluation in Adolescents and Young Adults with Cancer","volume":"40","author":"Haase","year":"2017","journal-title":"Cancer Nurs."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1017\/S1047951122002505","article-title":"Mapping Parents\u2019 Journey Following Prenatal Diagnosis of CHD: A Qualitative Study","volume":"33","author":"Harris","year":"2023","journal-title":"Cardiol. Young"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1177\/1043454216676836","article-title":"Pilot Evaluation of a Palliative and End-of-Life Communication Intervention for Parents of Children with a Brain Tumor","volume":"34","author":"Pradhan","year":"2017","journal-title":"J. Pediatr. Oncol. Nurs."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e20173549","DOI":"10.1542\/peds.2017-3549","article-title":"Changes in Parental Hopes for Seriously Ill Children","volume":"141","author":"Hill","year":"2018","journal-title":"Pediatrics"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.jpainsymman.2016.11.007","article-title":"Parental Concordance Regarding Problems and Hopes for Seriously Ill Children: A Two-Year Cohort Study","volume":"53","author":"Hill","year":"2017","journal-title":"J. Pain Symptom Manag."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1111\/hex.12078","article-title":"Problems and Hopes Perceived by Mothers, Fathers and Physicians of Children Receiving Palliative Care","volume":"18","author":"Hill","year":"2015","journal-title":"Health Expect."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1177\/1742395316664959","article-title":"Living with Uncertainty and Hope: A Qualitative Study Exploring Parents\u2019 Experiences of Living with Childhood Multiple Sclerosis","volume":"13","author":"Hinton","year":"2017","journal-title":"Chronic Illn."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1904722","DOI":"10.1080\/17482631.2021.1904722","article-title":"\u201cSuddenly We Have Hope That There Is a Future\u201d: Two Families\u2019 Narratives When a Child with Spinal Muscular Atrophy Receives a New Drug","volume":"16","author":"Hjorth","year":"2021","journal-title":"Int. J. Qual. Stud. Health Well-Being"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1080\/07347332.2014.955241","article-title":"Posttraumatic Growth and Hope in Parents of Children with Cancer","volume":"32","author":"Hullmann","year":"2014","journal-title":"J. Psychosoc. Oncol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1177\/02692163211027700","article-title":"A Good Death in the Child with Life Shortening Illness: A Qualitative Multiple-Case Study","volume":"35","author":"Chong","year":"2021","journal-title":"Palliat. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1177\/10105395231190830","article-title":"Spiritual Coping Among Families of Children with Cancer: A Qualitative Study","volume":"35","author":"Chong","year":"2023","journal-title":"Asia Pac. J. Public Health"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1177\/0269216319860662","article-title":"Building Trust and Improving Communication with Parents of Children with Trisomy 13 and 18: A Mixed-Methods Study","volume":"34","author":"Janvier","year":"2020","journal-title":"Palliat. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1002\/ajmg.c.31526","article-title":"Parental Hopes, Interventions, and Survival of Neonates with Trisomy 13 and Trisomy 18","volume":"172","author":"Janvier","year":"2016","journal-title":"Am. J. Med. Genet. C Semin. Med. Genet."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e20201865","DOI":"10.1542\/peds.2020-1865","article-title":"Uncertainty at the Limits of Viability: A Qualitative Study of Antenatal Consultations","volume":"147","author":"Kaemingk","year":"2021","journal-title":"Pediatrics"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1542\/peds.2014-2855","article-title":"Parental Hope for Children with Advanced Cancer","volume":"135","author":"Kamihara","year":"2015","journal-title":"Pediatrics"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1002\/pbc.22532","article-title":"Factors Influencing Parental Readiness to Let Their Child with Cancer Die","volume":"54","author":"Kars","year":"2010","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1186\/s13023-020-01477-7","article-title":"Experiences of Caregivers of Children with Spinal Muscular Atrophy Participating in the Expanded Access Program for Nusinersen: A Longitudinal Qualitative Study","volume":"15","author":"Kiefer","year":"2020","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1111\/jan.13888","article-title":"Impact of Resilience on the Health-related Quality of Life of Adolescents with a Chronic Health Problem: A Structural Equation Approach","volume":"75","author":"Kim","year":"2019","journal-title":"J. Adv. Nurs."},{"key":"ref_68","first-page":"1","article-title":"The Most Important Aspects for a Good Death: Perspectives from Parents of Children with Cancer","volume":"58","author":"Kim","year":"2021","journal-title":"Inq. J. Health Care Organ. Provis. Financ."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1177\/13674935211059041","article-title":"Crossroads of Parental Decision Making: Intersections of Hope, Communication, Relationships, and Emotions","volume":"27","author":"Koch","year":"2023","journal-title":"J. Child Health Care"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1089\/jpm.2022.0154","article-title":"\u201cBetween Wings of Hope and Fear\u201d: Muslim Parents\u2019 Experiences with the American Health Care System","volume":"26","author":"Kolmar","year":"2023","journal-title":"J. Palliat. Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/S0277-9536(98)00113-0","article-title":"Reframing the Meaning of Disability to Families: The Embrace of Paradox","volume":"47","author":"Larson","year":"1998","journal-title":"Soc. Sci. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1002\/pon.5098","article-title":"Exploratory Analysis of Treatment Response Trajectories in the PRISM Trial: Models of Psychosocial Care","volume":"28","author":"Lau","year":"2019","journal-title":"Psycho-Oncology"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Layshock, M.N., Porter, A.S., Bogetz, J.F., McLachlan, L., Weill, S., Rosenberg, A., Winger, J.G., Houtrow, A., Noll, R.B., and Schenker, Y. (2024). Experiences in Coping with Stress\u2014A Qualitative Study of Family Caregivers of Children with Medical Complexity. Children, 11.","DOI":"10.3390\/children11091151"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Lee, S., and Ahn, J.-A. (2020). Experiences of Mothers Facing the Prognosis of Their Children with Complex Congenital Heart Disease. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17197134"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e3504","DOI":"10.1590\/1518-8345.5515.3504","article-title":"Waves of Family Hope: Narratives of Families in the Context of Pediatric Chronic Illness","volume":"29","author":"Leite","year":"2021","journal-title":"Rev. Lat.-Am. Enferm."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e730","DOI":"10.1200\/OP.20.00762","article-title":"Hope-Colored Glasses: Perceptions of Prognosis Among Pediatric Oncology Patients and Their Parents","volume":"17","author":"Levine","year":"2021","journal-title":"JCO Oncol. Pract."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1038\/s41409-020-0794-8","article-title":"Thoughts from the Threshold: Patient and Family Hopes, Fears, Values, and Goals at the Onset of Pediatric Hematopoietic Cell Transplantation","volume":"55","author":"Levine","year":"2020","journal-title":"Bone Marrow Transplant."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1756686","DOI":"10.1080\/17482631.2020.1756686","article-title":"Consulting with a Folk Deity before Making Decisions: Spiritual Practices in Parents Facing End-of-Life Decisions for Their Child on Life Support with Brain Stem Dysfunction","volume":"15","author":"Lin","year":"2020","journal-title":"Int. J. Qual. Stud. Health Well-Being"},{"key":"ref_79","first-page":"29","article-title":"Taiwanese Parents\u2019 Experience of Making a \u201cDo Not Resuscitate\u201d Decision for Their Child in Pediatric Intensive Care Unit","volume":"8","author":"Liu","year":"2014","journal-title":"Asian Nurs. Res. (Korean Soc. Nurs. Sci.)"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1177\/0269216316679913","article-title":"\u201cHope for the Best, Prepare for the Worst\u201d: A Qualitative Interview Study on Parents\u2019 Needs and Fears in Pediatric Advance Care Planning","volume":"31","author":"Lotz","year":"2017","journal-title":"Palliat. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1097\/NCC.0000000000000178","article-title":"A Retrospective Study of Mothers\u2019 Perspectives of the Lived Experience of Anticipatory Loss of a Child from a Terminal Brain Tumor","volume":"38","author":"Lou","year":"2015","journal-title":"Cancer Nurs."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1177\/1043454215616605","article-title":"Bereaved Siblings\u2019 Advice to Health Care Professionals Working with Children with Cancer and Their Families","volume":"33","author":"Jalmsell","year":"2016","journal-title":"J. Pediatr. Oncol. Nurs."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"e12527","DOI":"10.1111\/nin.12527","article-title":"New Medicine for Neuromuscular Diseases: An Evolving Paradox for Patient and Family Hopes and Expectations","volume":"30","author":"Mahoney","year":"2023","journal-title":"Nurs. Inq."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1093\/jpepsy\/jsl046","article-title":"The Relationship of Hope and Illness-Related Uncertainty to Emotional Adjustment and Adherence Among Pediatric Renal and Liver Transplant Recipients","volume":"32","author":"Maikranz","year":"2006","journal-title":"J. Pediatr. Psychol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"23743735221106589","DOI":"10.1177\/23743735221106589","article-title":"Listening to Parents of Children with Cancer\u2014Between Life and Its End","volume":"9","year":"2022","journal-title":"J. Patient Exp."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1002\/cncr.31194","article-title":"Intended and Unintended Consequences: Ethics, Communication, and Prognostic Disclosure in Pediatric Oncology","volume":"124","author":"Marron","year":"2018","journal-title":"Cancer"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"4315","DOI":"10.1002\/cncr.35518","article-title":"Bereaved Parent Preferences on Quality End-of-life Care for Children with Cancer in the South","volume":"130","author":"Martinez","year":"2024","journal-title":"Cancer"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1590\/0104-1169.0468.2588","article-title":"The Family\u2019s Experience of the Child and\/or Teenager in Palliative Care: Fluctuating between Hope and Hopelessness in a World Changed by Losses","volume":"23","author":"Misko","year":"2015","journal-title":"Rev. Lat.-Am. Enferm."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.jpainsymman.2020.03.033","article-title":"A Pilot Study of the Effects of COMPLETE: A Communication Plan Early Through End of Life, on End-of-Life Outcomes in Children with Cancer","volume":"60","author":"Moody","year":"2020","journal-title":"J. Pain Symptom Manag."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"127","DOI":"10.4103\/IJPC.IJPC_195_17","article-title":"Still Hoping for a Miracle: Parents\u2019 Experiences in Caring for Their Child with Cancer under Palliative Care","volume":"24","author":"Nafratilova","year":"2018","journal-title":"Indian J. Palliat. Care"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1046\/j.1440-172X.2003.00411.x","article-title":"The Impact of Regular Hospitalization of Children Living with Thalassaemia on Their Parents in Sri Lanka: A Phenomenological Study","volume":"9","author":"Nahalla","year":"2003","journal-title":"Int. J. Nurs. Pract."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1080\/07347332.2017.1292573","article-title":"Parental Spirituality in Life-Threatening Pediatric Cancer","volume":"35","author":"Nicholas","year":"2017","journal-title":"J. Psychosoc. Oncol."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Barros Polita, N., de Montigny, F., Verdon, C., and Nascimento, L.C. (2023). Les Exp\u00e9riences des P\u00e8res d\u2019enfants Atteints de R\u00e9cidive de Cancer. Enfances Fam. G\u00e9n\u00e9r., 42.","DOI":"10.7202\/1108407ar"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1177\/1043454214563404","article-title":"Parents\u2019 Experience with Their Child\u2019s Cancer Diagnosis: Do Hopefulness, Family Functioning, and Perceptions of Care Matter?","volume":"32","author":"Popp","year":"2015","journal-title":"J. Pediatr. Oncol. Nurs."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"253","DOI":"10.4103\/ijnmr.IJNMR_156_17","article-title":"\u201cImmersion in an Ocean of Psychological Tension\u201d: The Voices of Mothers with Children Undergoing Hemodialysis","volume":"23","author":"Pourghaznein","year":"2018","journal-title":"Iran. J. Nurs. Midwifery Res."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"e2022061050","DOI":"10.1542\/peds.2022-061050","article-title":"Diversity of Parent Emotions and Physician Responses During End-of-Life Conversations","volume":"152","author":"Prins","year":"2023","journal-title":"Pediatrics"},{"key":"ref_97","unstructured":"Rafferty, K.A. (2015). \u201cEverything Remains Uncertain\u201d: Theorizing Parents\u2019 Communication About Uncertainty, Hope, and Hopelessness While Managing Complex Pediatric Chronic Conditions. [Ph.D. Thesis, The University of Wisconsin-Milwaukee]."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.pedhc.2020.06.003","article-title":"When Facing Hopeful and Hopeless Experiences: Using Snyder\u2019s Hope Theory to Understand Parents\u2019 Caregiving Experiences for Their Medically Complex Child","volume":"34","author":"Rafferty","year":"2020","journal-title":"J. Pediatr. Health Care"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1089\/jpm.2020.0618","article-title":"\u201cIt Can Be Hard but It\u2019s Not Bad\u201d: Three Questions to Solicit Caregiver Perceptions of Benefits and Burdens to Participating in Pediatric Palliative Care Research","volume":"24","author":"Reggio","year":"2021","journal-title":"J. Palliat. Med."},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Robert, R., Razvi, S., Triche, L.L., Bruera, E., and Moody, K.M. (2022). Bereaved Parent Perspectives on End-of-Life Conversations in Pediatric Oncology. Children, 9.","DOI":"10.3390\/children9020274"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1080\/07347332.2017.1382646","article-title":"Hope, Distress, and Later Quality of Life among Adolescent and Young Adults with Cancer","volume":"36","author":"Rosenberg","year":"2018","journal-title":"J. Psychosoc. Oncol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1089\/jpm.2022.0482","article-title":"\u201cIt Becomes a Family I\u2019m a Part of\u2026We Get to Carry Each Other\u201d: Themes from Qualitative Interview of Patients Enrolled in an Inpatient Palliative Care Support Program for Adolescents and Young Adults","volume":"26","author":"Rujimora","year":"2023","journal-title":"J. Palliat. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"428","DOI":"10.25259\/IJPC_24_2022","article-title":"Experiences of Adolescents with Cancer Attending a Tertiary Care Cancer Centre: A Thematic Analysis","volume":"28","author":"Salins","year":"2022","journal-title":"Indian J. Palliat. Care"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1017\/S1047951123004390","article-title":"The Experience of Fathers of Children Hospitalised with Advanced Heart Disease","volume":"34","author":"Samsel","year":"2024","journal-title":"Cardiol. Young"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1177\/1742395309104343","article-title":"The Lived Experience of Hope among Parents of a Child with Duchenne Muscular Dystrophy: Perceiving the Human Being beyond the Illness","volume":"5","author":"Samson","year":"2009","journal-title":"Chronic Illn."},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Shi, L., Tang, W., Zhang, H., Zhang, Y., Yang, H., Wu, D., Li, X., Liu, L., Liu, L., and Chen, X. (2024). The Relationship between Socioeconomic Status, Medical Accessibility, Hope and Psychological Resilience of Caregivers of Children with Chronic Kidney Disease in China: Structural Equation Model. BMC Psychol., 12.","DOI":"10.1186\/s40359-024-01901-8"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.pedn.2023.12.025","article-title":"Gaps in Pediatric Oncologic End of Life Care as Recounted by the Bereaved Parents in Isarel","volume":"75","author":"Ash","year":"2024","journal-title":"J. Pediatr. Nurs."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"e20201193","DOI":"10.1542\/peds.2020-1193","article-title":"Communication in Pediatric Oncology: A Qualitative Study","volume":"146","author":"Sisk","year":"2020","journal-title":"Pediatrics"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"e29588","DOI":"10.1002\/pbc.29588","article-title":"Interdependent Functions of Communication with Adolescents and Young Adults in Oncology","volume":"69","author":"Sisk","year":"2022","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"e12226","DOI":"10.1111\/jspn.12226","article-title":"Supporting Parental Caregivers of Children Living with Life-threatening or Life-limiting Illnesses: A Delphi Study","volume":"23","author":"Smith","year":"2018","journal-title":"J. Spec. Pediatr. Nurs."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"109790","DOI":"10.1016\/j.yebeh.2024.109790","article-title":"Caregiver Perceptions of the Impact of Dravet Syndrome on the Family, Current Supports and Hopes and Fears for the Future: A Qualitative Study","volume":"156","author":"Bjurulf","year":"2024","journal-title":"Epilepsy Behav."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1016\/j.pedn.2022.07.002","article-title":"A Investigation into Hope, Self-Efficacy, Distress and Uncertainty in Parents Who Have a Child with a Life-Threatening or Life-Limiting Illness","volume":"66","author":"Spurr","year":"2022","journal-title":"J. Pediatr. Nurs."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"e12341","DOI":"10.1111\/nin.12341","article-title":"Parental Experience of Hope in Pediatric Palliative Care: Critical Reflections on an Exemplar of Parents of a Child with Trisomy 18","volume":"27","author":"Szabat","year":"2020","journal-title":"Nurs. Inq."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1177\/02692163231171182","article-title":"Understanding the Experiences of Mothers Receiving Perinatal Palliative Care: A Qualitative Study","volume":"37","author":"Tewani","year":"2023","journal-title":"Palliat. Med."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1177\/1043454211418666","article-title":"Concordance Between Couples Reporting Their Child\u2019s Quality of Life and Their Decision Making in Pediatric Oncology Palliative Care","volume":"28","author":"Tomlinson","year":"2011","journal-title":"J. Pediatr. Oncol. Nurs."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.pec.2011.08.015","article-title":"The Role of Hope in Adaptation to Uncertainty: The Experience of Caregivers of Children with Down Syndrome","volume":"87","author":"Truitt","year":"2012","journal-title":"Patient Educ. Couns."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1089\/jpm.2014.0287","article-title":"Parents\u2019 Faith and Hope during the Pediatric Palliative Phase and the Association with Long-Term Parental Adjustment","volume":"18","author":"Falkenburg","year":"2015","journal-title":"J. Palliat. Med."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.socscimed.2017.09.048","article-title":"What Is Not, but Might Be: The Disnarrated in Parents\u2019 Stories of Their Child\u2019s Cancer Treatment","volume":"193","author":"Brage","year":"2017","journal-title":"Soc. Sci. Med."},{"key":"ref_119","doi-asserted-by":"crossref","unstructured":"von Scheven, E., Nahal, B.K., Kelekian, R., Frenzel, C., Vanderpoel, V., and Franck, L.S. (2021). Getting to Hope: Perspectives from Patients and Caregivers Living with Chronic Childhood Illness. Children, 8.","DOI":"10.3390\/children8060525"},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"von Scheven, E., Braun, M., Nahal, B., Perito, E.R., Brakeman, P., Soulsby, W.D., Quill, L., Cuneo, A., and Franck, L.S. (2024). Voices of Hope: Leveraging Think-Aloud Cognitive Interviews to Develop a Hope Assessment Tool for Young People Living with Chronic Health Conditions. Children, 11.","DOI":"10.3390\/children11111396"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1038\/s41416-023-02429-1","article-title":"Hopes, Concerns, Satisfaction and Regret in a Precision Medicine Trial for Childhood Cancer: A Mixed-Methods Study of Parent and Patient Perspectives","volume":"129","author":"Wakefield","year":"2023","journal-title":"Br. J. Cancer"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1111\/j.1365-2214.2007.00804.x","article-title":"Parents of Children with Cystic Fibrosis: How They Hope, Cope and Despair","volume":"34","author":"Wong","year":"2008","journal-title":"Child Care Health Dev."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1001\/archpediatrics.2009.284","article-title":"Palliative Care of Children with Brain Tumors","volume":"164","author":"Zelcer","year":"2010","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1177\/1049909115627772","article-title":"Hope, Symptoms, and Palliative Care","volume":"34","author":"Davis","year":"2017","journal-title":"Am. J. Hosp. Palliat. Med."},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Cotter, V.T., and Foxwell, A.M. (2015). The Meaning of Hope in the Dying. Spiritual, Religious, and Cultural Aspects of Care, Oxford University Press.","DOI":"10.1093\/med\/9780190244231.003.0005"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/j.pedn.2022.12.004","article-title":"Experiences with the End-of-Life Decision-Making Process in Children with Cancer, Their Parents, and Healthcare Professionals: A Systematic Review and Meta-Ethnography","volume":"69","author":"Hirata","year":"2023","journal-title":"J. Pediatr. Nurs."},{"key":"ref_127","first-page":"35","article-title":"Hope in Families of Children with Developmental Disabilities","volume":"10","author":"Kaushar","year":"2003","journal-title":"J. Dev. Disabil."},{"key":"ref_128","doi-asserted-by":"crossref","unstructured":"Novak-Pavlic, M., Rosenbaum, P., and Di Rezze, B. (2023). Changing Directions and Expanding Horizons: Moving towards More Inclusive Healthcare for Parents of Children with Developmental Disabilities. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20216983"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"101509","DOI":"10.1016\/j.copsyc.2022.101509","article-title":"Hope Therapy","volume":"49","author":"Cheavens","year":"2023","journal-title":"Curr. Opin. Psychol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"104273","DOI":"10.1016\/j.ijnurstu.2022.104273","article-title":"The Effectiveness of Dignity Therapy on Hope, Quality of Life, Anxiety, and Depression in Cancer Patients: A Meta-Analysis of Randomized Controlled Trials","volume":"132","author":"Zhang","year":"2022","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/j.1545-5300.2010.01305.x","article-title":"Reasonable hope: Construct, clinical applications, and supports","volume":"49","author":"Weingarten","year":"2010","journal-title":"Fam. Process"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1117\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:41:03Z","timestamp":1787301663000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1117"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":132,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["children13081117"],"URL":"https:\/\/doi.org\/10.3390\/children13081117","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]}}}