People with physical disabilities face persistent inequities in healthcare, and a new systematic review suggests those inequities extend into end-of-life care, where emotional, social and spiritual needs are often overshadowed by a focus on physical symptoms. The review, published in BMC Palliative Care, synthesised evidence on the psychosocial-spiritual needs of people with physical disabilities, their caregivers and healthcare professionals at the end of life.

The researchers searched seven databases covering publications from 1 January 2000 to 1 December 2025. Of 2,496 studies screened for eligibility, 31 studies were included in the final synthesis. The team used a convergent integrated approach, transforming quantitative findings and integrating them with qualitative findings through thematic synthesis. Methodological quality was assessed with the Mixed Methods Appraisal Tool, and confidence in the qualitative findings was evaluated using GRADE-CERQual.

The included evidence was concentrated in neurological disease populations, a limitation that shapes how broadly the findings can be generalised across the wider population of people with physical disabilities. Even so, the review captured perspectives from all three stakeholder groups: disabled people themselves, their caregivers, and the healthcare professionals involved in their care.

Three overarching themes emerged from the synthesis: psychological needs, spiritual needs and social needs, broken down into ten subthemes. Across all three groups, the analysis identified psychological distress, gaps in care delivery, communication challenges, and uncertainties and misalignment in decision-making as common and interconnected needs.

Some experiences were shared between people with physical disabilities and their caregivers. Both groups reported existential questioning and a tendency to avoid conversations about end-of-life matters.

Other needs were specific to particular groups. For people with physical disabilities, the review highlighted loss of autonomy, worries about burdening others, and social isolation and stigma as distinct concerns.

The authors argue that end-of-life care for people with physical disabilities should move beyond symptom management to prioritise early, inclusive and dignity-conserving conversations about end-of-life preferences and care decisions.

Because this was a systematic review of existing studies, its conclusions reflect the scope and quality of the underlying literature rather than new clinical data. The concentration of evidence in neurological disease populations means needs in other disability groups remain less well documented. The authors conclude that addressing psychosocial-spiritual needs requires a whole-system approach that acknowledges the interconnected roles of people with physical disabilities, caregivers and healthcare professionals.

Subject of Research: Psychosocial and spiritual end-of-life needs of people with physical disabilities, their caregivers and healthcare professionals

Article Title: Psychosocial-spiritual needs of persons with physical disabilities, their caregivers and healthcare professionals at the end of life: a mixed methods systematic review

Article References: Chan, J., Chow, A. Y. M., Cong, Q., Yu, W. C., Chen, Q., Ha, C. S. W., Cheung, M. K. Y., Chun, G. K. M., & Chung, P. H. (2026). Psychosocial-spiritual needs of persons with physical disabilities, their caregivers and healthcare professionals at the end of life: a mixed methods systematic review. BMC Palliative Care. https://doi.org/10.1186/s12904-026-02401-9

Image Credits: AI Generated

DOI: 10.1186/s12904-026-02401-9

Keywords: palliative care, end-of-life care, physical disabilities, systematic review, psychosocial needs, spiritual care, caregiver burden, healthcare inequities, communication, decision-making, mixed methods, neurological disease