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Nygård C, Clancy A, Kitzmüller G. Balancing on life's ladder: A meta-ethnography of the existential experiences of siblings of children with complex care needs. J Adv Nurs 2024; 80:2629-2646. [PMID: 38062620 DOI: 10.1111/jan.15991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/16/2023] [Accepted: 11/14/2023] [Indexed: 06/13/2024]
Abstract
AIM To synthesize and interpret existing qualitative research on the existential experiences of siblings of children with complex care needs. DESIGN Noblit and Hare's interpretive meta-ethnography. METHODS The study has been registered in the international prospective register for systematic reviews (PROSPERO). Noblit and Hare's 7-step procedure was followed and reciprocal translation was performed to analyse the data and develop a line of argument synthesis. DATA SOURCES A comprehensive systematic literature search of five databases, along with extensive manual searches, was completed in November 2022. The final sample comprised 18 studies published between 2010 and 2022. RESULTS A line of argument, expressed through an overarching metaphor, "balancing on life's ladder", illustrates the core findings of siblings' fluctuating experiences of existential well-being, and encapsulates four third-order themes: the emotional turmoil of siblings, interrupted family life, siblings strive to be themselves and siblings struggle to cope. CONCLUSION Growing up with a sibling with complex care needs made children feel invisible, lonely and struggling to find the courage to cope. By adopting a lifeworld approach, nurses can become aware of healthy siblings' unmet needs. Future research is needed on how nurses can contribute to siblings' existential well-being, in primary - and secondary health care settings. IMPLICATIONS The study provides insight into siblings' existential experiences and factors improving their well-being, enabling nurses to provide a more optimized lifeworld-led clinical practice. IMPACT Healthcare, nursing education and practice should be informed by the knowledge of existential issues. Nurses are well-positioned to work alongside families to provide family-centered care. Our findings have implications for health policies tailored to the needs of children with chronically ill siblings. REPORTING METHOD This review adheres to the Equator and improving reporting of meta-ethnography (eMERGe) guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution, because the data comprised previously published studies.
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Affiliation(s)
- Carina Nygård
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT, The Arctic University of Norway, Harstad, Norway
| | - Anne Clancy
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT, The Arctic University of Norway, Harstad, Norway
| | - Gabriele Kitzmüller
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT, The Arctic University of Norway, Narvik, Norway
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Jakubowski TL, Curtis SF, Saylor J. Sibling adjustment to diabetes and educational needs: A literature review. Nursing 2024; 54:52-56. [PMID: 38757999 DOI: 10.1097/nsg.0000000000000011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
ABSTRACT As cases of type 1 diabetes mellitus (T1DM) increase, so do their impact on sibling relationships. This literature review of four databases from 2010 to 2024 discusses findings from five studies and the themes that emerged: education needs and family functioning. Improvements in family-centered care and education are needed for siblings of children with T1DM.
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Affiliation(s)
- Tami L Jakubowski
- Tami Jakubowski is an associate professor of nursing at The College of New Jersey School of Nursing and Health Sciences, where Sara Curtis is a nursing student. Jennifer Saylor is the Associate Dean of Faculty and Student Affairs at the University of Delaware
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Thomas R, Pesut B, Siden H, Treschow M, Puurveen G. Developing competencies for volunteer navigators to support caregivers of children living with medical complexity: a mixed-method e-Delphi study. Palliat Care Soc Pract 2023; 17:26323524231209060. [PMID: 37954463 PMCID: PMC10634257 DOI: 10.1177/26323524231209060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/04/2023] [Indexed: 11/14/2023] Open
Abstract
Background Providing specially trained volunteer navigators is one promising strategy for supporting the increasing number of family caregivers who are caring for children living with medical complexity. Objective The objective of this study was to develop consensus on the role and competencies required for volunteer navigators who support caregivers of children living with medical complexity. Design This was a mixed-method study using modified e-Delphi and focus group methods. In phase 1, a modified e-Delphi survey with 20 family caregivers and a focus group with 4 family caregivers were conducted to develop consensus on their unmet needs and the potential roles of a volunteer to meet those needs. In phase 2, a modified e-Delphi survey was conducted with experts to develop consensus on the volunteer competencies required to meet the roles identified by family caregivers in phase 1. Results Findings from phase 1 resulted in 36 need-related items over 8 domains: communication, daily life and chores, emotional support, information and knowledge, respite, support with decision-making, and sharing the caregiving experience. Concerns about the volunteer role included the potential lack of commitment in the absence of remuneration, the complexity of the child's condition that was beyond the role of a volunteer, and a preference for support from individuals they knew. Findings from the phase 2 Delphi survey with professionals resulted in 22 competencies, derived from the roles identified in phase 1, that would be required of volunteers who wished to support these family caregivers. Conclusion This study provides insight into a role for volunteers in meeting the needs of family caregivers of children living with medical complexity. A volunteer with lived experience and adequate preparation can assist with meeting some of these important needs. Further research is required to better understand the feasibility and acceptability of such a role.
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Affiliation(s)
- Robyn Thomas
- The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Barbara Pesut
- The University of British Columbia Okanagan, 1147 Research Way, Kelowna, BC V1V 1V7, Canada
| | - Hal Siden
- The University of British Columbia, Canuck Place Children’s Hospice and BC Children’s Hospital, Vancouver, BC, Canada
| | - Michael Treschow
- The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Gloria Puurveen
- The University of British Columbia Okanagan, Kelowna, BC, Canada
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Chan KKL, Shorey S. Experiences and needs of children with siblings diagnosed with Type 1 diabetes: A mixed studies systematic review. J Pediatr Nurs 2022; 63:1-8. [PMID: 34929508 DOI: 10.1016/j.pedn.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
PROBLEM The lives of family members for children with Type 1 diabetes mellitus (T1DM) after often shaped around the diagnosis as long-term/life-long care is needed. The combination of illness symptoms, treatment cost, and caregiving demands for T1DM negatively affects family functioning. While the experiences and needs of both parents and children suffering from T1DM are well documented, literature on healthy siblings of children with T1DM remains scarce. PURPOSE This systematic review aims to consolidate and examine the experiences and needs of siblings of children with T1DM. ELIGIBILITY CRITERIA Qualitative and quantitative studies exploring the experiences and needs of children under 18 years old whose siblings are diagnosed with T1DM. SAMPLE Six electronic databases (PubMed, CINAHL, PsycINFO, EMBASE, Scopus and ProQuest) were searched from inception till July 2021. Thirteen studies met the inclusion criteria and were subjected to narrative synthesis. RESULTS Four themes were generated from the synthesis: (1) emotional responses to sibling's condition, (2) stepping out of comfort zone, (3) changes in family dynamics, and (4) takeaways and a way forward. CONCLUSIONS The impact of T1DM diagnosis on siblings of children with T1DM suggest a need for healthcare providers to provide them better emotional and informational support, and allow them more involvement in the care for their sibling with T1DM. IMPLICATIONS Findings from this review will be able to inform policymakers on the development of future support programmes for children with T1DM and their families and encourage clinicians to revise T1DM care plans to be more family-centered. PROSPERO number: CRD42020204985.
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Affiliation(s)
- Kathlynn Kai Ling Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore.
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Milo F, Ranocchiari S, Lucidi V, Tabarini P. Coping with cystic fibrosis: An analysis from the sibling's point of view. Child Care Health Dev 2021; 47:825-833. [PMID: 34156117 DOI: 10.1111/cch.12890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 04/20/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) is a chronic, life-threatening condition that results in life-long morbidity and premature mortality. CF has a significant impact on healthy siblings' adaptation and well-being. Siblings of patients with a chronic disease may experience psychological difficulties, such as anxiety, depression symptoms and troubles in adaptation. This study aimed to explore the participants' experiences of growing up with a CF patient diagnosed at a paediatric age and their adaptation strategies. METHODS We enrolled eight CF siblings (adolescents and young adults) in a 6-month focus group sessions programme. Each session had two phases (psychoeducational and experiential). Transcripts were analysed and grouped through grounded theory analysis to elaborate on data-driven theory. RESULTS We identified 14 subthemes by which the raw data could be organized. All the subthemes were gathered together according to the axial coding process into six themes (illness, changes, communication, avoidance, normalization, and protection and care). We then grouped the six themes into two main themes ('Growing up with a CF brother or sister' and 'Finding the right distance') and conceptualized the grounded theory 'Keeping the right distance'. The participants described the evolving process of maintaining a balance between the illness of their brother or sister, family organization and their own needs. CONCLUSIONS Knowing siblings' experiences and their common strategies to deal with the experience of having a brother or sister with a chronic health condition may be useful to ensure more tailored and specific interventions.
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Affiliation(s)
- Francesco Milo
- Clinical Psychology Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Silvia Ranocchiari
- Hospitality, Volunteering and Cultural Mediators, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Paola Tabarini
- Clinical Psychology Unit, Bambino Gesù Children's Hospital, Rome, Italy
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Erdim NK, Koyuncu Z, Keleş H, Durcan G, Kadak MT, Doğangün B, Celkan T. Impact of having a sibling with cancer or type I diabetes mellitus on psychopathology and self-conscious emotions in adolescents: a comparative study including controls. Support Care Cancer 2021; 30:635-645. [PMID: 34363110 DOI: 10.1007/s00520-021-06456-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND OBJECTIVE: Having a child diagnosed with cancer is stressful for the whole family and may cause significant psychological impact on parents and siblings. Chronic, life-altering diseases may also have similar effects in siblings due to the daily life changes in the family to accommodate the child with chronic disease. We investigated the impact of having a sibling with cancer or type 1 diabetes mellitus (T1DM) on the psychological features of adolescents, with particular focus on self-conscious emotions such as guilt and shame-which are associated with the development of psychopathologies. METHOD Sixty-four children who were siblings of patients diagnosed with cancer (CS group), 54 children who were siblings of patients diagnosed with T1DM (DMS group), and 200 adolescents with siblings who did not have any chronic disease (control group) were included in the study. The CS group was also divided into two subgroups with respect to cancer type (leukemia and non-leukemia). Feelings of guilt and shame were evaluated via the Test of Self-Consciousness Affect for Adolescents (TOSCA-A). The Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI) were used to determine the levels of depression and anxiety symptoms. Comparisons between groups were performed and within-group directional relationships between scores were analyzed. RESULTS Guilt scores were significantly higher in CSs than controls (p = 0.009), and the guilt scores of CSs and DMSs were similar (p = 0.508). Other subdimension scores obtained from the TOSCA-A and the CDI and STAI scores were similar in all three groups. In the CS group, externalization scores of siblings with leukemia were significantly higher than that of siblings with non-leukemia cancer. Although shame scores were similar in the CS, DMS, and control groups, shame scores were found to be positively correlated with CDI and STAI total scores in each group (p < 0.05 for all), whereas guilt scores did not demonstrate any significant correlations. CONCLUSION Our results support prior studies in showing that CSs feel a greater level of guilt compared to adolescents without disease-stricken siblings, whereas, interestingly, CSs and DMSs were found to experience similar levels of guilt. Despite lack of significant increase in the CS and DMS groups, shame levels were positively correlated with depression and anxiety scores in all groups, but the lower correlation coefficients for the CS group indicate the presence of other factors influencing this relationship. We believe our results warrant the need for future studies evaluating the needs of the siblings of children with other chronic diseases, preferably with longitudinal follow-up to determine situations associated with need for psychosocial support.
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Affiliation(s)
| | - Zehra Koyuncu
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Kocamustafapasa Street No: 53, Cerrahpasa, Fatih/Istanbul, 34098, Turkey.
| | | | - Gizem Durcan
- Department of Child and Adolescent Psychiatry, Bakirkoy Research and Training Hospital of Psychiatry, Istanbul, Turkey
| | - Muhammed Tayyib Kadak
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Kocamustafapasa Street No: 53, Cerrahpasa, Fatih/Istanbul, 34098, Turkey
| | - Burak Doğangün
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Kocamustafapasa Street No: 53, Cerrahpasa, Fatih/Istanbul, 34098, Turkey
| | - Tiraje Celkan
- Department of Pediatric Hematology and Oncology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Warner-Czyz AD, Wiseman KB, Nelson JA. Quantitative and Qualitative Perspectives of Siblings of Children With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2854-2869. [PMID: 34121421 DOI: 10.1044/2021_jslhr-20-00624] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The sibling relationship teaches children to navigate social interactions with their peers. However, the presence of an exceptionality, such as hearing loss, in one child can affect the dynamic of this relationship. This article examines quantitative and qualitative effects of having a brother or sister with a cochlear implant (CI) on siblings with typical hearing (TH) to determine how children with TH perceive their sibling with a CI and how having a CI user in the family affects the sibling's activities, emotions, and parental attention. Method Participants include 36 siblings with TH (M age = 11.6 years) of CI users (M age = 11.9 years) who completed quantitative measures of their perspectives of their brother/sister with CIs and the effect of hearing loss on themselves. Siblings with TH also could express their opinions via open-ended prompts. Results Overall, siblings with TH express positive perspectives of their brother/sister with CIs and report having a CI user in the family does not affect them much, particularly if the CI user has adequate communication skills. Responses to both quantitative and qualitative items converge on the close relationship between siblings but diverge relative to differential attention from parents (i.e., open-ended responses suggest parents spend more time with the CI user than the sibling with TH). Additionally, siblings acknowledge the presence of social communication deficits of the CI user in real-world situations. Conclusion This nuanced look at relationships among the parent, CI user, and sibling with TH highlights the importance of understanding the family system when working with children with hearing loss.
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Affiliation(s)
- Andrea D Warner-Czyz
- Department of Speech, Language, and Hearing, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson
- Callier Advanced Hearing Research Center, The University of Texas at Dallas
| | - Kathryn B Wiseman
- Department of Speech, Language, and Hearing, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson
| | - Jackie A Nelson
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson
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Pals RAS, Coyne I, Skinner T, Grabowski D. A delicate balance between control and flexibility: Experiences of care and support among pre-teenage children with type 1 diabetes and their families. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:369-391. [PMID: 33338277 DOI: 10.1111/1467-9566.13223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/20/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
For children with type 1 diabetes, the period of adolescence is associated with higher blood glucose levels and increased psychological distress compared to other age groups. Focusing on pre-teens (9-12 years) with type 1 diabetes and their families has been suggested as key to understanding and reducing these challenges. The aim of this study was to explore: 1, how diabetes affects family life, 2, experiences of and needs for support and 3, how care responsibilities are negotiated among pre-teens with type 1 diabetes and their families. Data were obtained from four interactive workshops with pre-teens (n = 17), their parents (n = 26) and their siblings (n = 14). Dialogue tools, for example quotes and picture cards, were used to facilitate discussion and reflection concerning family life with type 1 diabetes. Data analysis resulted in three themes: 1, diabetes takes up 'a lot of space', 2, giving and receiving support and 3, balancing control and flexibility. While diabetes took up significant space in the families, family members protected each other from their respective frustrations. The findings point to the significance of considering all key family members and their interactions in diabetes interventions. This includes balancing control and flexibility, negotiating responsibilities and building trust.
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Affiliation(s)
- Regitze Anne Saurbrey Pals
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Imelda Coyne
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Timothy Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Department of Rural Health, La Trobe University, Bendigo, Victoria, Australia
- Department of Rural Health, The Australian Centre for Behavioural Research in Diabetes, Melbourne, Victoria, Australia
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Overgaard M, Lundby-Christensen L, Grabowski D. Disruption, worries and autonomy in the everyday lives of adolescents with type 1 diabetes and their family members: A qualitative study of intrafamilial challenges. J Clin Nurs 2020; 29:4633-4644. [PMID: 32964576 DOI: 10.1111/jocn.15500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/19/2020] [Accepted: 09/06/2020] [Indexed: 11/27/2022]
Abstract
AIM To explore daily life with type 1 diabetes in families with an adolescent with type 1 diabetes. BACKGROUND Management of adolescent type 1 diabetes is carried out in the context of everyday life, thus involving and affecting the entire family. Type 1 diabetes causes disruption of family life, but the specific experiences and challenges of adolescents with type 1 diabetes, siblings and parents are not well-explored. Specifically, research is lacking on the siblings' experience of adolescents with type 1 diabetes. DESIGN A qualitative design using participatory workshops. METHODS A sample of 21 families comprising adolescents with type 1 diabetes (aged 8-18) (N = 20), their parents (N = 29) and siblings (N = 10) participated in four workshops exploring everyday life in families with adolescent diabetes from the perspective of all family members. Data were analysed using systematic text condensation. The COREQ checklist was used preparing the manuscript. RESULTS Family life with type 1 diabetes was characterised by three overarching themes: (a) the perpetual challenges and disruptive nature of life with diabetes, (b) different ways of worrying about diabetes and (c) diabetes autonomy and emancipation from parents. All family members' lives were marked by these aspects, however in different ways and to varying degrees. CONCLUSIONS Our findings emphasise that type 1 diabetes is indeed a family illness affecting all family members. The study provides insight into the unique experiences of adolescents with diabetes, their parents and siblings, all of whom encounter diabetes-related challenges in their daily lives. RELEVANCE TO CLINICAL PRACTICE The findings call for the inclusion of all family members of adolescents with type 1 diabetes in both research and healthcare practice. Family-oriented approaches targeting adolescents with diabetes as well as their parents and siblings will enable provision of nursing care that can meet the needs of the entire family.
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Eichengreen A, Zaidman-Zait A. Relationships Among Deaf/Hard-of-Hearing Siblings: Developing a Sense of Self. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2020; 25:43-54. [PMID: 31875906 PMCID: PMC7225570 DOI: 10.1093/deafed/enz038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 08/20/2019] [Accepted: 09/01/2019] [Indexed: 06/10/2023]
Abstract
While sibling relationships are known to be important for children's social and emotional well-being, little is known about sibling relationships when both siblings are deaf or hard-of-hearing (DHH). In-depth interviews were conducted with 10 young DHH adults (20-30 years old) who had studied in mainstream schools to explore their retrospective experiences of growing up with a DHH sibling. Interviews were analyzed using interpretive phenomenological analysis. Findings revealed two superordinate themes: (1) sibling relationship and sense of self and (2) family coping and relationships, with each superordinate theme containing several subthemes. Findings highlighted the various ways sibling relationships contribute to siblings' psychological development, identity formation, and coping with deafness. Potential challenges were identifed, as well as the role of parents' attitudes and coping with hearing loss in promoting supportive sibling relationships. Parents and professionals should be aware of the valuable and unique aspects of DHH siblingship and attend to imporatnt relationship asepcts such as sibling communication, sibling comparisons, and parental differential treatment.
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Havill N, Fleming LK, Knafl K. Well siblings of children with chronic illness: A synthesis research study. Res Nurs Health 2019; 42:334-348. [PMID: 31418465 DOI: 10.1002/nur.21978] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/20/2019] [Indexed: 11/12/2022]
Abstract
Well siblings of chronically ill children experience family disruptions that profoundly affect them. Previous research focusing on well siblings' experiences has often produced inconsistent findings, likely the result of varying study designs and samples. The purposes of this synthesis research study were twofold: (a) to assess the applicability of existing grounded theory of sibling response to a child's cancer to a wider range of childhood conditions; and (b) to refine the existing theory to reflect the experiences of the broader sample. Data for the synthesis came from a National Institute of Nursing Research-funded mixed-methods synthesis examining the intersection of childhood chronic illness and family life. The current analysis was based on well sibling results extracted from 78 research reports published between 2000 and 2014. An existing grounded theory, Creating a Tenuous Balance (CTB), was discovered at the outset of analysis and used as the primary framework for coding and synthesizing results. The focus of most studies was siblings' responses to 14 chronic conditions, with cancer being the most often studied. Results reflected siblings' perspectives of their experiences as well as perspectives of parents and the ill child. The analysis substantiated all four patterns of sibling behavior included in CTB, with the patterns of adapting to changes in personal and family life, and handling strong emotions being especially challenging aspects of the sibling experience. Moreover, the results expanded several aspects of CTB. The analysis provided evidence of the applicability of the theory to a varied group of chronic conditions and enabled us to identify important areas for developing interventions to support siblings.
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Affiliation(s)
- Nancy Havill
- Division of Nursing, University of North Carolina Hospitals, Chapel Hill, North Carolina
| | - Louise K Fleming
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathleen Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Akgül S, Alikaşifoğlu A, Özon A, Gönç N, Düzçeker Y, Örs S, Derman O, Kanbur N. Can having a sibling with type 1 diabetes cause disordered eating behaviors? J Pediatr Endocrinol Metab 2018; 31:711-716. [PMID: 29874193 DOI: 10.1515/jpem-2017-0533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/16/2018] [Indexed: 12/15/2022]
Abstract
Background Adolescents with type 1 diabetes mellitus (T1DM) are at an increased risk of eating disturbances. The aim of this study was to evaluate whether the risk of a disordered eating behavior (DEB) also applies to the well sibling sharing the same environment. Methods Well siblings were included if they were 10-18 years old, had a sibling with a T1DM diagnosis for at least 6 months and lived with the sibling during the illness. The control group was comprised of healthy participants recruited from the outpatient clinic with no family history of T1DM. Participants completed a four-part questionnaire concerning their eating behaviors that was developed by the study team. This survey aimed to evaluate the dietary habits and eating patterns. All participants completed the Eating Attitudes Test-26 (EAT-26) and a 24-h food dietary recall. Any participant with a high EAT-26 score or that seemed to be at risk according to the questionnaire was re-evaluated. Results Eight cases (33.3%) in the well sibling group had either a total and/or subgroup pathological score. Three of them were found to have DEB and one case was diagnosed with anorexia nervosa (AN). In the control group, five cases (17.2%) had either a total and/or subgroup pathological score. Three of these cases were found to have DEB, no cases were diagnosed with an eating disorder. There were no statistically significant differences in the EAT-26 scores between the groups. Conclusions Although a direct relationship was not observed, the probability of having a pathologic EAT-26 score was higher in the group with a sibling with T1DM.
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Affiliation(s)
- Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Ayfer Alikaşifoğlu
- Department of Pediatrics, Division of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Alev Özon
- Department of Pediatrics, Division of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Nazlı Gönç
- Department of Pediatrics, Division of Pediatric Endocrinology, Hacettepe University, Ankara, Turkey
| | - Yasemin Düzçeker
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Sine Örs
- Division of Nutrition, Hacettepe University, Ankara, Turkey
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Nuray Kanbur
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
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Lovén I. Labor market consequences of growing up with a sibling with type 1-diabetes. Soc Sci Med 2017; 178:1-10. [PMID: 28189818 DOI: 10.1016/j.socscimed.2017.01.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 01/25/2017] [Accepted: 01/30/2017] [Indexed: 12/16/2022]
Abstract
Economic research on child health and future labor market outcomes has mainly focused on children with impaired health themselves, and only recently begun to assess spillover effects for siblings. Yet, the challenge to accommodate a family's routines within the requirements of a complex and time-consuming disease is most likely to spillover on siblings. While the burden of ill health and managing a disease may have adverse effects, living with a disease may still give families useful experiences and skills that favor future labor market outcomes. Therefore, the potential labor market impacts of growing up with a sick sibling could be both positive and negative. This study investigates differences in the progression of annual labor earnings between siblings of children with type 1-diabetes and population controls. The data is based on detailed Swedish longitudinal registers, covering annual labor earnings in the years 1990-2010 for 764 siblings of 764 children with diabetes and 5506 population controls born in 1962-1971, and follow individuals between ages 19-48. The results indicate that brothers of children with type 1-diabetes have lower earnings growth than controls, while sisters' earnings growth appears unaffected. Consequently, spillovers from one family member to another might differ within a family.
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Affiliation(s)
- Ida Lovén
- Faculty of Medicine, Department of Clinical Sciences, Lund University, Medicon Village, SE-223 81 Lund, Sweden.
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