Background <p>Spiritual distress represents a significant yet under-addressed dimension of suffering among children with cancer. Despite its influence on emotional resilience, treatment adherence, and psychological well-being, spiritual care in pediatric oncology remains inconsistently implemented due to developmental misalignment, cultural variability, and limited professional training.</p> Aim <p>This study aimed to synthesize the literature and propose a a preliminary, developmentally responsive, and culturally adaptable nursing-centered conceptual framework for spiritual care in pediatric oncology, designed to guide nursing practice while supporting interdisciplinary collaboration in pediatric oncology, termed the Developmental-Spiritual Oncology Care Model (DSOCM).</p> Methods <p>An integrative literature review was conducted across six databases, yielding 227 sources, including empirical studies, theoretical works, clinical guidelines, and foundational texts. A manual inductive thematic analysis was performed to identify recurring concepts, relational patterns, and care processes relevant to pediatric spiritual care. Selected theoretical foundations—including Fowler’s Faith Development Theory, Watson’s Caring Theory, Travelbee’s Human-to-Human Relationship Model, Benner’s Competency Framework, and Mercer’s spiritual constructs— were critically evaluated and used to inform the development of the conceptual framework.</p> Results <p>DSOCM proposes core assumptions, paradigmatic and meta-paradigmatic concepts, guiding objectives, and a holistic nursing care approach. The framework highlights inclusivity, interdisciplinary collaboration, and competency-based training.</p> Conclusion <p>As a preliminary literature-derived conceptual framework, DSOCM offers a structured guide for spiritual nursing care in pediatric oncology and requires further empirical testing, cross-cultural adaptation, and contextual refinement.</p>