A Cross-sectional Study on the Development and Current Status of Child Life Services in 36 Medical Institutions Across 14 Provinces in China

Abstract

Background: Child Life Services (CLS) provide developmentally appropriate psychosocial support to reduce children’s fear, pain, and distress during medical care and to enhance family-centered pediatric care. Although CLS have been gradually introduced in China, their implementation remains uneven, and multi-institutional evidence on service models, staffing, organizational support, and barriers to development is limited. Objectives: This study aimed to describe the development and current status of CLS among participating medical institutions in China and to provide evidence to inform service management and policy planning. Methods: In December 2025, a cross-sectional survey was conducted using convenience sampling at 36 medical institutions participating in the CLS Collaborative Innovation Network, which is coordinated by the National Clinical Research Center for Children and Adolescents' Health and Diseases. Data were collected using a purpose-designed questionnaire covering organizational support, service content and formats, staffing patterns, perceived effects, barriers, and future development plans. Results: Among all participating institutions (n = 36), 19.4% had established systematic CLS programs, 63.9% had implemented non-systematic CLS, and 16.7% had not implemented CLS. Among institutions that had implemented any CLS (n = 30), services were mainly affiliated with nursing or pediatric departments; 83.3% employed fewer than 2 full-time staff members, and only 36.7% had a regular training system. Emotional support, disease education, and psychological preparation were the most commonly reported service components. More than 90% of respondents from institutions with CLS reported improvements in children’s pain, emotional status, and parental satisfaction. Conclusions: This study provides a multi-institutional overview of CLS development among participating institutions in China. CLS implementation remains variable across these institutions. Strengthening policy support, workforce development, and sustainable funding mechanisms is essential to facilitate the integration of CLS into routine pediatric care.