LAUSR

BACKGROUND Legacy building is a developmentally grounded, trauma-informed, and family-centered psychosocial intervention designed to bolster patient and family resilience through collaborative activities and meaning making. However, little is known about the effects of these interventions, partially because of a lack of clarity regarding how children of different developmental levels understand the concept of legacy. Therefore, this study explored the ways in which hospitalized children defined the concept of legacy. METHODS Semi-structured interviews were conducted with 45 hospitalized children (ages 6 to 18 years) on the acute and critical care units of an academic children's medical center. Interviews were audio-recorded and transcribed verbatim; transcripts were independently coded by at least two members of the research team using an inductive, line-by-line approach; and codes were categorized and assembled into four overarching themes resulting in a developmental typology of the concept of legacy. RESULTS Participants described legacy as: 1) concepts, actions, or feelings motivated by the future; 2) represented through both tangible and intangible means; 3) informed by personal, educational, experiential, and ideological sources; and 4) experienced as good, bad, or neutral. CONCLUSIONS The findings of this study demonstrate that hospitalized children are aware of and can articulate an emerging concept of legacy - one that mirrors the progression of cognitive complexity shaped by their unique personal life and healthcare experiences. The developmental typology presented in this study can be a useful starting point for clinicians as they present and facilitate legacy building interventions throughout a child's hospital stay.