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Kittelsen TB, Castor C, Lee A, Kvarme LG, Winger A. "What about me?": lived experiences of siblings living with a brother or sister with a life-threatening or life-limiting condition. Int J Qual Stud Health Well-being 2024; 19:2321645. [PMID: 38404038 PMCID: PMC10898268 DOI: 10.1080/17482631.2024.2321645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/18/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND There is a lack of knowledge regarding siblings' experiences of being a brother or sister of a child with a life-threatening or life-limiting condition. Siblings' perspectives are often expressed through their parents and not by siblings themselves. METHOD This study has a qualitative design within hermeneutic phenomenology. Thirteen siblings (ages 3-29) of children with cancer or genetic conditions participated in semi-structured interviews. Analyses followed a thematic analysis guided by van Manen's lifeexistentials. RESULTS One overall theme, "What about me?", illustrates that siblings of children with LT/LL conditions are dealing with their own challenges and needs in the situation while also struggling to receive attention from their parents. The overall theme derives from three subthemes: living with heavy strains, feeling disregarded, and having needs of one's own. CONCLUSION The study revealed that siblings' own needs compete with the needs of the ill child, resulting in the risk of siblings taking a step back rather than expressing what they might actually need themselves. These findings can inform healthcare professionals on the importance of educating and supporting parents and the surrounding community close to the sibling, for example, by helping schoolteachers understand how to meet siblings' needs.
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Affiliation(s)
- Trine Brun Kittelsen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Anja Lee
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital HF, Oslo, Norway
| | - Lisbeth Gravdal Kvarme
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Anette Winger
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Rinaldo C, Stenmarker M, Øra I, Pergert P. Living with the threat of losing a child: Parents' experiences of the transplantation process with a severely ill child who received stem cells from a sibling. J Pediatr Nurs 2024; 77:e495-e502. [PMID: 38762421 DOI: 10.1016/j.pedn.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE When a child needs a hematopoietic stem cell transplant, the seriousness of the child's illness is highlighted. The purpose of this study was to explore parents' experiences of the transplantation process when two children in the family are involved, one severely ill child as the recipient and the other as the donor. METHODS In this qualitative study, interviews were conducted with 18 parents of 13 healthy minor donors after successful stem cell transplants. Qualitative content analysis was used to explore parents' experiences. FINDINGS The parents described they were living with the threat of losing a child. They lived with an uncertain future as they were confronted with life-changing information. Whether the ill child would survive or not could not be predicted; thus, parents had to endure unpredictability, and to cope with this they chose to focus on positives. Finally, the parents managed family life in the midst of chaos, felt an inadequacy and a perception that the family became a fragmented although close team during hospital stays. They expressed a need for both tangible and emotional support. CONCLUSIONS When a child needs a stem cell transplant, the parents feel inadequate to their healthy children including the donating child. It is obvious that they experience an uncertain future and struggle to keep the family together amid the chaos. PRACTICE IMPLICATIONS Considering these results, psychosocial support should be mandatory for parents in connection with pediatric HSCT, to enable a process where parents can prepare for the outcome, whether successful or not.
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Affiliation(s)
- Carina Rinaldo
- Astrid Lindgren children's hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
| | - Margaretha Stenmarker
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Paediatrics, Futurum Academy of Health and Care, Jönköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Sweden.
| | - Ingrid Øra
- Department of Clinical Sciences, Lund University, Lund, Sweden.
| | - Pernilla Pergert
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
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Holm M, Lundberg T, Lövgren M, Ljungman L. Parenting a child with cancer and maintaining a healthy couple relationship: Findings from the Family Talk Intervention. Pediatr Blood Cancer 2024; 71:e30709. [PMID: 37817346 DOI: 10.1002/pbc.30709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/07/2023] [Accepted: 09/22/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Despite the challenges that caring for a child with cancer brings for parents, little knowledge is available concerning the effects on the parents' couple relationship. Furthermore, few interventions have been designed to support parents in their couple relationship. The aim of this paper was, therefore, to explore parents' experiences of their couple relationship while having a dependent child with cancer and the support they received from a family-based intervention, the Family Talk Intervention (FTI). METHODS Data for this paper were taken from semi-structured interviews performed in a pilot study of the FTI in the context of pediatric oncology. In total, 22 couples were interviewed after participating in the FTI. The interviews were transcribed and analyzed using qualitative content analysis. RESULTS Parents described how maintaining a couple relationship while living with childhood cancer could be very challenging and was not given the highest priority. The FTI was considered a way of providing important support to the couple and a chance for them to sit down together and listen to each other's perspectives on the situation. Parents described that the FTI had helped them gain an increased mutual understanding, sometimes also helping them to realize that they needed more extensive professional support in their relationship. CONCLUSIONS Living with childhood cancer and upholding a healthy couple relationship is challenging for parents. The FTI has the potential to support couples, mainly by providing opportunities for parents to communicate with each other. However, some couples may be in need of a tailored clinical intervention.
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Affiliation(s)
- Maja Holm
- Department of Nursing Sciences, Sophiahemmet University, Stockholm, Sweden
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
| | - Tina Lundberg
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
| | - Malin Lövgren
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Advanced Pediatric Home Care, Karolinska University Hospital, Stockholm, Sweden
| | - Lisa Ljungman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Dinkelbach L, Köhler M, Galushko M, Pieper L, Kuhlen M, Danneberg M, Dechert O, Trocan L, Janßen G. Psychosocial Well-Being of Siblings of Pediatric Patients in Palliative Home Care. J Pain Symptom Manage 2023; 66:630-637.e1. [PMID: 37643651 DOI: 10.1016/j.jpainsymman.2023.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/17/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023]
Abstract
CONTEXT Despite the proposed high burden of siblings of children and adolescents with life-limiting conditions receiving pediatric palliative care (PPC) at home, little is known about their psychosocial well-being. METHODS In this prospective, cross-sectional trial siblings of patients of a large pediatric palliative home care team were asked to answer the KINDL survey of health-related quality of life, the strengths and difficulties questionnaire (SDQ) to assess problems and resources of children and adolescents as well as the LARES questionnaire, a potential tool for early screening of distress in siblings of chronically ill children. The results of the KINDL total and subdomains as well of the SDQ-subdomains were compared to recent German normative data using multiple t-tests. RESULTS In total, 44 siblings (28 female; age 7-18 years, mean 11.8 ± 3.03) of 29 families participated in this study. The subgroup which matches the age range of current normative data of 11-17 years old siblings (n = 25) reported a significant lower total quality of life as measured by KINDL in comparison to normative data. Subscale analyses revealed a significant lower physical and psychological well-being and self-esteem. Siblings of PPC patients yielded significant higher scores in the subdomain prosocial behavior compared to normative data as measured by the SDQ. CONCLUSIONS Siblings of children receiving PPC in a home care setting are at risk for a relevant impairment of their health-related quality of life. Future studies should address the potential for possible interventions specific for this population-at-risk.
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Affiliation(s)
- Lars Dinkelbach
- Department of Pediatric Oncology (L.D., M.K., M.G., L.P., M.K., O.D., L.T., G.J.), Hematology and Clinical Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany; Department of Pediatrics III (L.D.), University Children's Hospital Essen, University of Duisburg-Essen, Essen, Germany.
| | - Marc Köhler
- Department of Pediatric Oncology (L.D., M.K., M.G., L.P., M.K., O.D., L.T., G.J.), Hematology and Clinical Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Maren Galushko
- Department of Pediatric Oncology (L.D., M.K., M.G., L.P., M.K., O.D., L.T., G.J.), Hematology and Clinical Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Leonie Pieper
- Department of Pediatric Oncology (L.D., M.K., M.G., L.P., M.K., O.D., L.T., G.J.), Hematology and Clinical Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Michaela Kuhlen
- Department of Pediatric Oncology (L.D., M.K., M.G., L.P., M.K., O.D., L.T., G.J.), Hematology and Clinical Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany; Pediatric and Adolescent Medicine (M.K.), Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Mareike Danneberg
- Department of Pediatric Oncology (L.D., M.K., M.G., L.P., M.K., O.D., L.T., G.J.), Hematology and Clinical Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Oliver Dechert
- Department of Pediatric Oncology (L.D., M.K., M.G., L.P., M.K., O.D., L.T., G.J.), Hematology and Clinical Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Laura Trocan
- Department of Pediatric Oncology (L.D., M.K., M.G., L.P., M.K., O.D., L.T., G.J.), Hematology and Clinical Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Gisela Janßen
- Department of Pediatric Oncology (L.D., M.K., M.G., L.P., M.K., O.D., L.T., G.J.), Hematology and Clinical Immunology, Centre for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
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