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Wiener LS, Steffen-Smith E, Fry T, Wayne A. Hematopoietic stem cell donation in children: a review of the sibling donor experience. J Psychosoc Oncol 2007; 25:45-66. [PMID: 17360315 PMCID: PMC2367259 DOI: 10.1300/j077v25n01_03] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Hematopoietic Stem Cell Transplant (HSCT) represents the second most frequent major organ transplant in the United States. Compared with other family members, siblings are more likely to be immunologically matched with the recipient and therefore are often the most suitable donors. Due to a dearth of information on the positive and adverse effects of HSCT on pediatric sibling donors, we sought to examine available data. Eight published reports assessing the pediatric sibling donor experience were identified in the literature. Studies were predominately small (n < 44) and cross-sectional. Results suggest a range of psychological distress responses with higher distress in pediatric donor than non-donor siblings. Recommendations include future longitudinal research on sibling donor psychosocial adjustment, identification of sibling donors at high risk for maladaptive responses, and development of educational and psychosocial interventions for this overlooked pediatric population.
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Affiliation(s)
- Lori S. Wiener
- Lori Wiener, Ph.D., ACSW, is Coordinator Pediatric Psychosocial Support & Research Program Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute. . Emilie Steffen-Smith, B.A., is a clinical research fellow, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail: . Terry Fry, M.D., is a staff clinician, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail: . Alan S. Wayne, M.D., is Clinical Director and Head, Hematologic Diseases Section, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail:
| | - Emilie Steffen-Smith
- Lori Wiener, Ph.D., ACSW, is Coordinator Pediatric Psychosocial Support & Research Program Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute. . Emilie Steffen-Smith, B.A., is a clinical research fellow, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail: . Terry Fry, M.D., is a staff clinician, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail: . Alan S. Wayne, M.D., is Clinical Director and Head, Hematologic Diseases Section, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail:
| | - Terry Fry
- Lori Wiener, Ph.D., ACSW, is Coordinator Pediatric Psychosocial Support & Research Program Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute. . Emilie Steffen-Smith, B.A., is a clinical research fellow, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail: . Terry Fry, M.D., is a staff clinician, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail: . Alan S. Wayne, M.D., is Clinical Director and Head, Hematologic Diseases Section, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail:
| | - Alan Wayne
- Lori Wiener, Ph.D., ACSW, is Coordinator Pediatric Psychosocial Support & Research Program Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute. . Emilie Steffen-Smith, B.A., is a clinical research fellow, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail: . Terry Fry, M.D., is a staff clinician, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail: . Alan S. Wayne, M.D., is Clinical Director and Head, Hematologic Diseases Section, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, e-mail:
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Abstract
Transition has been described by many disciplines. However, the concept of transition has yet to be applied to the sibling experience of childhood cancer. Understanding the transitions that siblings encounter is important because it will offer nurses new possibilities for enhancing siblings' outcomes. Accordingly, the purpose of this article is to provide a conceptual framework that will assist nurses in their efforts to promote healthy transitions in siblings of children with cancer. The method of concept analysis developed by Walker and Avant [Walker, L., & Avant, K. (1995). Concept analysis. In Strategies for theory construction in nursing (3rd ed.) (pp. 37-54). Norwalk, CT: Appleton and Lane.] is employed. The result is a definition of transition that is relevant and useful for research and clinical practice in pediatric oncology.
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Affiliation(s)
- Krista Lynn Wilkins
- Helen Glass Center for Nursing, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.
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Batte S, Watson AR, Amess K. The effects of chronic renal failure on siblings. Pediatr Nephrol 2006; 21:246-50. [PMID: 16240159 DOI: 10.1007/s00467-005-2064-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Revised: 07/06/2005] [Accepted: 07/12/2005] [Indexed: 11/25/2022]
Abstract
It is well recognised that chronic illness in children can have a significant effect upon siblings, but their viewpoints need to be sought if we are to change our practice. We conducted semi-structured interviews at home with 15 siblings (8 males) aged 8-12 years whose brother/sister were on chronic dialysis or had received or were waiting for a renal transplant. The interviews were analysed using a grounded theory approach. The children also completed the Spence Children's Anxiety Scale (SCAS), which revealed no statistically significant evidence that they were exhibiting chronic clinical anxiety. Qualitative data indicated that siblings had a variety of concerns concerning their own health and that of their siblings and worried about the effects on family routine and separation from parents. The siblings felt more protective towards their chronically ill sibling and felt that they themselves needed to be more grown up. The study has implications for our clinical practice in that our psychosocial assessment of families needs to include an assessment of sibling needs and siblings should be involved when preparing patients for chronic renal failure treatment. The importance of maintaining family routines should be emphasised, as well as trying to involve siblings in unit activities.
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Affiliation(s)
- Suzanne Batte
- Children and Young People's Kidney Unit, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
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Hopia H, Paavilainen E, Astedt-Kurki P. The diversity of family health: constituent systems and resources. Scand J Caring Sci 2005; 19:186-95. [PMID: 16101846 DOI: 10.1111/j.1471-6712.2005.00340.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to explore changes in family health associated with child's chronic illness and hospitalization. The aim was to answer the following questions: (i) What kind of changes do families experience when a child in the family is afflicted by a chronic illness; and (ii) What kind of changes do families experience when their child is admitted to hospital? The data were collected in 2002 in interviews with 29 such families whose children were receiving treatment or who had previously received treatment on the paediatric wards of two hospitals in Finland. Data were collected until reaching theoretical saturation, in which no additional data are found. Data analysis was based on the grounded theory method, proceeding to the stage of axial coding. Family health was formed out of two different dimensions: the constituent systems and the resources of family health. The constituent systems describe the impact of the child's chronic illness and period of hospitalization at the level of both individual family members and the family as a whole. These systems were described by five categories: (i) ill child at the centre of family attention, (ii) siblings in a minor role, (iii) the child's illness governs parental well-being, (iv) the roller coaster of the couple relationship and (v) the whole family is ill. The resources promoting and maintaining family health were divided into six different categories: (i) creative and maintaining mental images, (ii) active involvement, (iii) internal coping means, (iv) reinforcement of coping means, (v) awareness and change of values and (vi) social network shares emotional burden and responsibility for care. The results of the study show that family health is highly vulnerable when a child has to be admitted to hospital because of a chronic condition. They should help nursing staff gain a clearer picture of the depth and diversity of family health and support the resources that promote family health. Future research should study the methods of family nursing used in the care of families with children with chronic conditions.
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Affiliation(s)
- Hanna Hopia
- Department of Nursing Science, University of Tampere, Tampere, Finland.
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