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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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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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Hornshøj Pedersen S, Gustafsen SD, Juhler M, Guldager R. Parent perception of telemetric intracranial pressure monitoring in children - A qualitative case study. BRAIN & SPINE 2024; 4:102820. [PMID: 38764889 PMCID: PMC11099310 DOI: 10.1016/j.bas.2024.102820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 04/09/2024] [Accepted: 04/20/2024] [Indexed: 05/21/2024]
Abstract
Introduction Telemetric monitoring of intracranial pressure (ICP) in children with a complex cerebrospinal disorder might help parents distinguish acute and potential life-threatening symptoms of hydrocephalus from other illnesses. Research question What is patient and parent perceptions of system utility of telemetric ICP monitoring, and how does a long-term telemetric implant influence daily life of both patients and their families? Material and methods A qualitative case study design with a focus group interview including parents of children with a complex cerebrospinal fluid disorder and an implanted telemetric ICP sensor. Results Three parents participated. Based on thematic analysis, three themes were created: 'Daily living with telemetric ICP monitoring', 'Parenting a child with a CSF disorder', and 'The healthy sibling'. The ICP sensor provided the parents with security and made them trust their intuition, while the possibility of home monitoring ensured stability for the entire family and had a calming effect on healthy siblings. Home monitoring was seen as the system's greatest advantages, whereas size, weight, and functionality of the external monitoring equipment were highlighted as disadvantages. Discussion and conclusion All parents supported the telemetric ICP sensor as a valued tool in treatment guidance of their child and stated that advantages exceeded disadvantages. It was stated that the possibility of conducting ICP measurements at home reduced the need for acute hospital admissions, which consequently led to a more stable daily life for the entire family. Suggestions regarding technical improvements with focus on more compatible external monitoring equipment were raised by all parents included.
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Affiliation(s)
- Sarah Hornshøj Pedersen
- Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 8, 2100, Copenhagen E, Denmark
| | - Sara Duus Gustafsen
- Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 8, 2100, Copenhagen E, Denmark
| | - Marianne Juhler
- Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 8, 2100, Copenhagen E, Denmark
- Department of Neurosurgery, Aarhus University Hospital, Skejby, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Rikke Guldager
- Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 8, 2100, Copenhagen E, Denmark
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Łada-Maśko AB, Sajewicz-Radtke U, Radtke BM, Lipowska M. The role of family and individual factors in going through adolescence having a disabled sibling - analysis of a healthy child's functioning. A case-control study protocol. HEALTH PSYCHOLOGY REPORT 2024; 12:173-181. [PMID: 38628281 PMCID: PMC11016945 DOI: 10.5114/hpr/183546] [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: 01/15/2024] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Having a disabled sibling can be a source of extremely important and enriching experiences that foster the development of social and emotional competences, as well as broadening the child's perspective and knowledge. On the other hand, it also poses many challenges for the siblings, especially in adolescence. Thus, the aim of the proposed project is to investigate the specificity of the growing up process in young people with disabled siblings. PARTICIPANTS AND PROCEDURE A total of 160 dyads (320 participants) - an adolescent and one of his/her parents - will take part in this cross-sectional case-control study. Participants will be assigned to four groups, having a sibling with: 1) intellectual disability, 2) motor disability, 3) chronic somatic disease, and 4) the control group - having a sibling without any disability. Both the healthy adolescent and one of the parents will fill out a set of questionnaires regarding the study variables: Questionnaire of Relationships with Siblings, Parental Attitude Scale-2, KidScreen-27, Parentification Questionnaire for Youth, Teenage Rebellion Questionnaire, Child Behavior Checklist 6-18. RESULTS The primary outcomes include investigating the healthy adolescent functioning in three environments: family, peers and school. The proposed research model focuses both on the difficulties associated with having a disabled sibling (e.g. possible occurrence of disorders) and resources (e.g. higher quality of relationships in the family, especially in the sibling subsystem). CONCLUSIONS The proposed comprehensive approach to the issue of disability in the family from the perspective of a healthy child will allow for a better understanding of the mechanisms underlying the process of growing up with disabled siblings.
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Bezgin S, Özkaya Y, Akbaş Y, Elbasan B. An investigation of computer-game addiction, physical activity level, quality of life and sleep of children with a sibling with a chronic condition. Child Care Health Dev 2024; 50:e13228. [PMID: 38265131 DOI: 10.1111/cch.13228] [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: 06/02/2023] [Revised: 11/28/2023] [Accepted: 12/24/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND It is known that chronic condition also affects siblings without chronic illness. Healthy siblings of children with a chronic condition and aged 9-14 years and healthy children with a sibling without chronic illness and their parents were included in the study. AIM The aim of our study was to examine the internet-game addiction, physical activity, quality of life and sleep in children with a sibling with chronic condition and compare them with their peers with a healthy sibling. METHODS Computer game addiction, physical activity, sleep quality and quality of life were evaluated respectively by Computer Game Addiction Scale for Children, Child Physical Activity Questionnaire, Children's Sleep Disorder Scale and Children's Quality of Life Scale. RESULTS While the mean age of 75 children with chronically ill siblings was 10.65 ± 1.59 years, the mean age of 75 healthy children with healthy siblings was 10.46 ± 2.09 years. It was observed that children with a sibling with a chronic condition were more tend to computer-game addiction, had lower sleep quality, lower quality of life in terms of school functionality and psychosocial health compared to children with a healthy sibling (p < 0.05). CONCLUSIONS It was revealed that in families with children with a chronic condition, siblings with no health problems should also be evaluated in psychosocial terms and supported by appropriate approaches, such as to increase the level of physical activity.
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Affiliation(s)
- Sabiha Bezgin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey
| | - Yunus Özkaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey
| | - Yılmaz Akbaş
- Faculty of Medicine, Department of Child Neurology, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey
| | - Bülent Elbasan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Bennett SD, Rojas N, Catanzano M, Roach A, Ching BC, Coughtrey AE, Heyman I, Liang H, Project Team L, Shafran R. Feasibility, acceptability and preliminary effectiveness of a mental health drop-in centre for the siblings of young people attending a paediatric hospital. J Child Health Care 2023:13674935231206895. [PMID: 37850534 DOI: 10.1177/13674935231206895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Siblings of children with long-term conditions (LTCs) can have significantly elevated mental health needs, but these are often overlooked. A pragmatic single-arm feasibility pilot assessed feasibility, acceptability and preliminary effectiveness of a drop-in centre in a paediatric hospital addressing mental health needs of patients with LTCs, their carers and siblings. The drop-in centre accepted self-referral and supplemented existing provision offering a suite of interventions, including signposting, diagnostic assessments and/or guided self-help. This paper reports on feasibility, acceptability and preliminary outcomes of this centre for siblings. Eighteen siblings aged 2-17 used the centre. Sixteen of their parents completed the Strengths and Difficulties Questionnaires at baseline and 6 months post-baseline, and ten completed parent-reported PedsQL across two time points. Preliminary effectiveness results demonstrated a decrease in mental health symptoms with large effect size (score reduction of 3.44, 95% CI [1.25, 5.63], d = 0.84) and small effect on quality of life, with scores increasing from a median of 69.91, 95% CI [53.57, 91.67], to a median of 80.44, 95% CI [67.39, 89.13], r = 0.11 for these siblings. 88% of parents were satisfied with this provision for their sibling child. This study highlights the feasibility and value of assessing siblings for emotional and behavioural difficulties and providing them with an accessible, effective and acceptable intervention.
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Affiliation(s)
- Sophie D Bennett
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Natalia Rojas
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Matteo Catanzano
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna Roach
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Brian Cf Ching
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna E Coughtrey
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Holan Liang
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Lucy Project Team
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Huth K, Frankel H, Cook S, Samuels RC. Caring for a Child with Chronic Illness: Effect on Families and Siblings. Pediatr Rev 2023; 44:393-402. [PMID: 37391635 DOI: 10.1542/pir.2022-005649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Affiliation(s)
- Kathleen Huth
- Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Hilary Frankel
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY
| | - Stacey Cook
- Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Ronald C Samuels
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY
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Levkovich I, Labes M. "I wanted to hide but also to be found": the high school experiences of young adults who grew up in the same home as a sibling with depression. BMC Psychol 2023; 11:190. [PMID: 37386645 DOI: 10.1186/s40359-023-01234-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Depression is a mental health condition that can have far-reaching consequences for the entire family, not just for the affected individual. Siblings are particularly vulnerable in that the unremitting stress and guilt at home can affect multiple aspects of their lives, including relationships, added responsibilities, and health. This pressure may affect siblings' own emotional well-being and academic success. Most studies in this field have examined the impact of depression on the affected adolescents or their parents, whereas few have examined the impact on siblings. Sibling studies have been limited by lack of sample homogeneity, especially in the context of coping in high school. This study sought to examine the retrospective experiences of young adults who lived in the same house as a sibling with depression while they were in high school. METHODS This qualitative study examined 21 young adults (aged 18-29) who grew up with a sibling with depression. In-depth, semi-structured interviews were conducted from May to September 2022. The interviews were recorded and transcribed and underwent thematic analysis. RESULTS Three main themes emerged from the interviews: (1) "School as a place of refuge": The perspective of participants who grew up with a sibling with depression regarding their high school experience. (2) "I wanted the adults at school to see me": Relations between research participants and the school educational staff. (3) "I was afraid people would relate to me as the sibling of a crazy person": Participants' relationships with their peers. CONCLUSIONS This study sheds light on the experiences of adolescents who grew up with a sibling with depression. The findings point to feelings of being invisible, self-nullification, avoiding sharing with others, and transparency. The participants were afraid that if their peers found out about their sibling they would also be stigmatized and alienated. The study shows that adolescents living with a sibling with depression need support at school.
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Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tiv'on, 36006, Israel.
| | - Michal Labes
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tiv'on, 36006, Israel
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Coveney K, O'Donnell D, Stokes D, Kroll T. The experiences of siblings of children with chronic illness of health-related communication directed at them: a systematic review protocol and thematic synthesis of qualitative studies. HRB Open Res 2023. [DOI: 10.12688/hrbopenres.13676.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
The psychological, social and financial impact that chronic illness can have on a family and in particular the siblings of children with chronic illness (SCWCI) is well documented. Siblings are at risk of a variety of psychosocial and physical problems such as suffering from anxiety, experiencing headaches, appetite loss. However, the experiences with health-related communication of SCWCI is not well known. This may leave them with suboptimal information. The aim of this systematic review described in this protocol is to understand SCWCI experience of targeted health-related communication; detailing the communication strategies utilised, how helpful the information was and what they wish would be different. The Preferred Reporting Items for Systematic reviews and Meta-analysis for Protocols (PRISMA-P) checklist will be used to frame this protocol. Registration: PROSPERO (393998, 03 February 2023).
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Wolff B, Magiati I, Roberts R, Skoss R, Glasson EJ. Psychosocial Interventions and Support Groups for Siblings of Individuals with Neurodevelopmental Conditions: A Mixed Methods Systematic Review of Sibling Self-reported Mental Health and Wellbeing Outcomes. Clin Child Fam Psychol Rev 2023; 26:143-189. [PMID: 36175605 PMCID: PMC9879846 DOI: 10.1007/s10567-022-00413-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 01/31/2023]
Abstract
Siblings of persons with neurodevelopmental conditions (NDCs) have increased risk of poorer psychosocial functioning. This systematic review evaluated quantitative and qualitative evidence on sibling mental health and wellbeing outcomes following psychosocial interventions and the risk and protective factors associated with post-intervention outcomes. From 2025 identified studies published from 1991 to 2022 across ten databases, 24 studies were included. The largest immediate post-intervention improvements were in self-esteem, social wellbeing and knowledge of NDCs. The most sustained improvements in intervention groups at follow-up periods were in emotional and behavioural adjustment and NDC knowledge. There were positive, but small, differences in favour of the intervention groups on knowledge of NDCs, self-esteem, coping and the sibling relationship as compared to waitlist control groups. Psychosocial interventions for siblings are heterogeneous, and more data, including consideration of unique family circumstances, are needed to improve reporting and replicability, to measure effectiveness and tailor necessary supports.
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Affiliation(s)
- Brittany Wolff
- School of Psychological Science, The University of Western Australia, Perth, Australia.
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia.
| | - Iliana Magiati
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Rachel Skoss
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
- Institute for Health Research, The University of Notre Dame Australia, Perth, Australia
- School of Population and Global Health, The University of Western, Perth, Australia
| | - Emma J Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
- Discipline of Psychiatry, Medical School, The University of Western Australia, Perth, WA, Australia
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Fredriksen T, Marie Vatne T, Bjartveit Haukeland Y, Tudor M, Fjermestad KW. Siblings of children with chronic disorders: Family and relational factors as predictors of mental health. J Child Health Care 2023; 27:145-159. [PMID: 34727780 DOI: 10.1177/13674935211052157] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Siblings of children with chronic disorders are at increased risk of mental health problems. Predictors of siblings' mental health require further study to identify children in need of interventions and to design effective intervention programs. Siblings of children with chronic disorders (n = 107; M age = 11.5 years; SD = 2.1, 54.6% girls) and their parents (n = 199; 50.3% mothers) were included in a survey study. Siblings and parents completed questionnaires on mental health. Siblings completed questionnaires on parent-child communication, relationships with parents, and an adjustment measure on the sibling situation. Multiple linear regression analyses were applied to identify predictors of siblings' mental health. Sibling-reported relationship with parents was a significant predictor of sibling mental health reported by siblings, fathers, and mothers (R2 = 0.26 - R2 = 0.46). Siblings' adjustment was significantly associated with fathers' report of siblings' mental health (r = .36), but not mothers' report (r = .17). Siblings' relationships (d = 0.26) and communication (d = 0.33) with mothers were significantly better than with fathers. We conclude that the sibling-parent relationship is a significant factor in identifying siblings at risk and that family-based intervention programs should be developed.
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Affiliation(s)
- Trude Fredriksen
- Department of Psychiatry, 60516Innlandet Hospital Trust, Brumunddal, Norway
| | | | | | - Megan Tudor
- MIND Institue, University of California, Davis, Sacramento, CA, USA
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Heaton J, Wainstein T, Elliott AM, Austin J. The experiences of adolescent siblings of children with rare genetic conditions: "It's made me who I am". J Genet Couns 2023; 32:224-234. [PMID: 36123145 DOI: 10.1002/jgc4.1636] [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: 01/27/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 11/06/2022]
Abstract
Childhood genetic conditions impact not only the child who is diagnosed but also the day-to-day lives of all members of a family. However, our understanding of the perspectives and needs of unaffected adolescents in families affected by rare genetic conditions is limited. To address this gap, we conducted semi-structured interviews with 10 participants aged 14-20 years, all of whom had a sibling with a rare genetic condition. An interpretive description approach was used to develop a framework that described how participants' experiences of having a sibling with a rare genetic condition shaped the formation of their identity. This experience influenced identity formation both directly, and indirectly through four other phenomena: (1) normalization, of both their own experiences and their siblings' differences; (2) knowledge seeking, regarding their sibling's condition and what uncertainties remained; (3) caretaking, which limited some opportunities and was associated with uncertainty around the future; and (4) social experience, including their relationship with their affected sibling, with their peers, and with the rest of their family participants felt that they were isolated and lacked appropriate supports. The results of this study can help to inform a family-centered approach to genetic counseling and highlight the importance of tailored supports for this population.
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Affiliation(s)
- Julia Heaton
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tasha Wainstein
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Alison M Elliott
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Women's Health Research Institute, Vancouver, British Columbia, Canada
| | - Jehannine Austin
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Wolff B, Magiati I, Roberts R, Pellicano E, Glasson EJ. Risk and resilience factors impacting the mental health and wellbeing of siblings of individuals with neurodevelopmental conditions: A mixed methods systematic review. Clin Psychol Rev 2022; 98:102217. [PMID: 36368218 DOI: 10.1016/j.cpr.2022.102217] [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: 02/08/2022] [Revised: 08/01/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This pre-registered systematic review synthesised and evaluated the existing literature on self-reported mental health and wellbeing of siblings of individuals with neurodevelopmental conditions (NDCs). METHODS From 2437 identified studies published 2000-2022, 81 studies were included: 14 population- or cohort-based, 39 quantitative, 7 mixed method, and 21 qualitative outcome studies. RESULTS Seven sibling mental health (any psychiatric disorder, anxiety, depression, bipolar disorder, schizophrenia, internalising and externalising difficulties) and five wellbeing indicators were identified (quality of life, emotional adjustment, social wellbeing, somatic/physical wellbeing, and resilience/growth). Overall, siblings had increased risk of any psychiatric disorder, but they also reported experiences of growth and resilience, primarily in qualitative studies. 41 risk factors and 24 resilience factors associated with these outcomes were identified; the most frequently cited risk factor was symptom severity of the NDC sibling, while the most common resilience factor was adaptive/active coping at the individual sibling level. Studies showed high methodological heterogeneity and 90 different self-report measures were used. CONCLUSIONS Sibling mental health indictors are heterogeneous and cumulative risk factors may result in poorer wellbeing. There is a need for consistent reporting of family and sibling characteristics, a strengths-based approach to assessment, and identification of protective and resilience-promoting factors.
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Affiliation(s)
- Brittany Wolff
- School of Psychological Science, The University of Western Australia, Perth, Australia; Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia.
| | - Iliana Magiati
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | | | - Emma J Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia; Discipline of Psychiatry, Medical School, The University of Western Australia, Perth, WA, Australia
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Kelada L, Wakefield CE, Drew D, Ooi CY, Palmer EE, Bye A, De Marchi S, Jaffe A, Kennedy S. Siblings of young people with chronic illness: Caring responsibilities and psychosocial functioning. J Child Health Care 2022; 26:581-596. [PMID: 34271837 DOI: 10.1177/13674935211033466] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Siblings of young people with chronic illness commonly undertake caring responsibilities for their affected brother/sister, which may encourage maturation, yet may also be perceived as a burden. Our study determined (1) siblings' caring responsibilities, (2) siblings' current emotional distress and psychosocial functioning, and (3) how siblings' caring responsibilities and psychosocial functioning related to familial relationships and coping strategies. Siblings completed questionnaires which contained Sibling Inventory of Behavior, Sibling Inventory of Differential Experiences, PedsQL, emotion thermometers, Brief COPE, and a checklist of caregiving responsibilities. We analyzed the data with t-tests and multi-level models. Forty-five siblings (mean age = 15.40 years, SD = 3.31 years; 60.0% female) participated. Siblings who had caring responsibilities (n = 26, 57.8%) reported lower anxiety symptoms, lower need for help, greater use of problem-focused coping, and more companionship and teaching/directiveness with their affected brother/sister than siblings without caring responsibilities. Siblings reported lower psychosocial and physical functioning when they perceived their parents provided them with less affection than their affected brother/sister. Family-based psychosocial interventions may aim to improve the sibling-parent relationship (including expressing affection) and the sibling-sibling relationship. Future interventions may also focus on increasing siblings' use of problem-focused coping strategies.
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Affiliation(s)
- Lauren Kelada
- School of Women's and Children's Health, 146817UNSW Sydney, Kensington, NSW, Australia.,Kids Cancer Centre, 63623Sydney Children's Hospital, Randwick, NSW, Australia
| | - Claire E Wakefield
- School of Women's and Children's Health, 146817UNSW Sydney, Kensington, NSW, Australia.,Kids Cancer Centre, 63623Sydney Children's Hospital, Randwick, NSW, Australia
| | - Donna Drew
- Kids Cancer Centre, 63623Sydney Children's Hospital, Randwick, NSW, Australia
| | - Chee Y Ooi
- School of Women's and Children's Health, 146817UNSW Sydney, Kensington, NSW, Australia.,MiCF Research Centre, 63623Sydney Children's Hospital, Randwick, NSW, Australia.,Department of Gastroenterology, 63623Sydney Children's Hospital, Randwick, NSW, Australia
| | - Elizabeth E Palmer
- School of Women's and Children's Health, 146817UNSW Sydney, Kensington, NSW, Australia.,Centre for Clinical Genetics, 63623Sydney Children's Hospital, Randwick, NSW, Australia
| | - Ann Bye
- School of Women's and Children's Health, 146817UNSW Sydney, Kensington, NSW, Australia.,Department of Neurology, 63623Sydney Children's Hospital, Randwick, NSW, Australia
| | - Sandra De Marchi
- Tumbatin Clinic, 63623Sydney Children's Hospital, Randwick, NSW, Australia
| | - Adam Jaffe
- School of Women's and Children's Health, 146817UNSW Sydney, Kensington, NSW, Australia.,Respiratory Department, 63623Sydney Children's Hospital, Randwick, NSW, Australia
| | - Sean Kennedy
- School of Women's and Children's Health, 146817UNSW Sydney, Kensington, NSW, Australia.,Department of Neurology, 63623Sydney Children's Hospital, Randwick, NSW, Australia
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15
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Martinez B, Pechlivanoglou P, Meng D, Traubici B, Mahood Q, Korczak D, Colasanto M, Mahant S, Orkin J, Cohen E. Clinical Health Outcomes of Siblings of Children with Chronic Conditions: A Systematic Review and Meta-Analysis. J Pediatr 2022; 250:83-92.e8. [PMID: 35810772 DOI: 10.1016/j.jpeds.2022.07.002] [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: 04/04/2022] [Revised: 06/11/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of the study was to assess clinical mental and physical health outcomes of siblings of children with chronic health condition(s) compared with siblings of healthy children or normative data. STUDY DESIGN We searched Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL through August 9, 2021. We included English-language studies that reported clinically diagnosable mental or physical health outcomes among siblings of children (<18 years old) with a chronic health condition, included a comparison group, and used an experimental or observational study design. Two reviewers extracted data and independently assessed risk of bias using the Newcastle Ottawa Scale. RESULTS Of 9899 screened studies, 34 were included; 28 studies reported on mental health, 3 reported on physical health, and 3 reported on mortality. Siblings of children with chronic conditions had greater depression rating scale scores than their comparison groups (standardized mean difference = 0.53; 95% CI = 0.38-0.68; P < .001 [6 studies]), whereas anxiety scores were not substantially increased (standardized mean difference = 0.21; 95% CI = -0.02 to 0.43; P = .07 [7 studies]). The effects for confirmed psychiatric diagnoses (7 studies), mortality (3 studies), or physical health outcomes (3 studies) could not be meta-analyzed given the limited number of studies and between-study heterogeneity. CONCLUSION Siblings of children with chronic health conditions may be at an increased risk of depression. Our findings suggest the need for targeted interventions to support the psychological well-being of siblings of children with chronic health conditions.
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Affiliation(s)
- Benjamin Martinez
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Petros Pechlivanoglou
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Quenby Mahood
- Hospital Library and Archives, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Daphne Korczak
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Marlena Colasanto
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada
| | - Sanjay Mahant
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Julia Orkin
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Eyal Cohen
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada.
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16
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Qureshi SA, Reaume SV, Bedard C, Ferro MA. Mental health of siblings of children with physical illness or physical-mental comorbidity. Child Care Health Dev 2022; 49:456-463. [PMID: 36098996 DOI: 10.1111/cch.13061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/12/2022] [Accepted: 09/10/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study examined the mental health of siblings of children with physical illness (PI), with or without co-occurring mental illness. METHODS The sample included children aged 2 to 16 years with a chronic PI and their aged-matched healthy siblings (n = 169 dyads). Physical-mental comorbidity (PM) was present if children screened positive for ≥1 mental illness on the Mini International Neuropsychiatric Interview for Children and Adolescents. Parents completed the Strengths and Difficulties Questionnaire (SDQ) to measure child and sibling mental health. RESULTS Within child-sibling dyads, siblings of children with PI had significantly worse mental health related to conduct problems (d = 0.31), peer problems (d = 0.18) and total difficulties (d = 0.20). Siblings of children with PM had significantly better mental health related to emotional problems (d = 0.42), hyperactivity/inattention (d = 0.23) and total difficulties (d = 0.32). Siblings of children with PI had similar mental health compared with child population norms used in the development of the SDQ. In contrast, siblings of children with PM had significantly worse mental health across all SDQ domains, with the exception of prosocial behaviour. After adjusting for parent psychopathology and family functioning, no statistically significant differences between siblings of children with PM versus siblings of children with PI were found. CONCLUSIONS Differences in mental health exist between children with PI or PM versus their healthy siblings. However, differences between siblings of children with PI versus siblings of children with PM can be explained by parental and family factors (e.g. marital status, education and income). Findings reinforce family-centred care approaches to address the needs of children with PI or PM and their families.
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Affiliation(s)
- Saad A Qureshi
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Shannon V Reaume
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Chloe Bedard
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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17
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Hutchison S, House J, McDermott B, Simic M, Baudinet J, Eisler I. Silent witnesses: the experience of having a sibling with anorexia nervosa. J Eat Disord 2022; 10:134. [PMID: 36068560 PMCID: PMC9450355 DOI: 10.1186/s40337-022-00655-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/19/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study explored the experience of having a sibling with anorexia nervosa and the sibling perspectives on service provision. METHOD Four focus groups were conducted with 14 siblings (8 female, 6 male, age 11-19 years) of adolescents with anorexia nervosa or related restrictive eating disorders. Group discussions were transcribed and analysed using thematic analysis. RESULTS Four themes and eight sub-themes were generated. These illustrated siblings feel greatly affected by the way the family needs to change to support someone with anorexia nervosa. Feelings of ambivalence and acceptance were also evident. They described silencing their own emotions and needs so as not to trouble others, and distancing themselves from their families in order to cope. Some female (but no male) siblings identified an impact on their own perceptions of eating and body image. Siblings generally felt that services had not attended to their needs, and that they had not been appropriately included in treatment. CONCLUSIONS Data from this study suggest the sibling experience needs to be more carefully considered and included in treatment. This may include a more explicit invitation to sessions and a more active discussion about their own needs and useful involvement in treatment sessions. Findings point to ways siblings may be better supported, such as peer support groups.
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Affiliation(s)
- Suzanne Hutchison
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Jennifer House
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Beth McDermott
- Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE5 8AZ, UK
| | - Mima Simic
- Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE5 8AZ, UK
| | - Julian Baudinet
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK. .,Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE5 8AZ, UK.
| | - Ivan Eisler
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.,Maudsley Centre for Child and Adolescent Eating Disorders (MCCAED), Maudsley Hospital, De Crespigny Park, Denmark Hill, London, SE5 8AZ, UK
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18
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Kirchhofer SM, Orm S, Haukeland YB, Fredriksen T, Wakefield CE, Fjermestad KW. A systematic review of social support for siblings of children with neurodevelopmental disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 126:104234. [PMID: 35468570 DOI: 10.1016/j.ridd.2022.104234] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/25/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Social support is a protective factor for siblings of children with neurodevelopmental disorders. AIMS We reviewed studies on social support received by siblings of children with neurodevelopmental disorders. METHODS AND PROCEDURES We conducted a pre-registered systematic review (CRD42020207686), searching PsycINFO, MEDLINE, Web of Science, and Scopus. OUTCOMES AND RESULTS Fifteen articles were eligible for the review, 13 of which used cross-sectional designs. Two studies investigated sibling social support after an intervention. Multiple variables were negatively related to social support (e.g., sibling depression, loneliness, stress). Variables that were positively related to social support included prosocial behavior, competence (academic, social, and activity-related), problem-focused coping, and family quality of life. Potential moderators of the relationship between social support and psychosocial adjustment included the type of disorder of the affected sibling and the type of social support provider. We conclude with an overview of the reliability and validity of the seven social support measurements used across the studies. CONCLUSIONS AND IMPLICATIONS Lower levels of social support are associated with more negative psychosocial adjustment among siblings of children with neurodevelopmental disorders. We encourage future researchers to further investigate ways to increase social support for siblings to improve outcomes.
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Affiliation(s)
- Solveig M Kirchhofer
- Department of Psychology, University of Oslo, Norway; Nic Waals Institutt, Child and Adolescent Mental Health Services, Lovisenberg Hospital Trust, Oslo, Norway.
| | - Stian Orm
- Department of Psychology, University of Oslo, Norway; Innlandet Hospital Trust, Lillehammer, Norway
| | | | - Trude Fredriksen
- Department of Psychology, University of Oslo, Norway; Innlandet Hospital Trust, Lillehammer, Norway
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW, Australia; Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Krister W Fjermestad
- Department of Psychology, University of Oslo, Norway; Frambu Resource Centre for Rare Disorders, Nordre Follo, Norway
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19
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Gómez-de-Regil L, Estrella-Castillo DF, Cicero-Ancona M. Anxiety/Depression Predominance in Liaison-Psychiatry Users of a South-East Mexico Tertiary Hospital. Healthcare (Basel) 2022; 10:healthcare10071162. [PMID: 35885689 PMCID: PMC9322849 DOI: 10.3390/healthcare10071162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
Patients at tertiary hospitals may find themselves in need of mental health support due to the distress associated with the illness that may or not lead to a psychiatric condition. Here is an overview of the clinical cases treated by the liaison psychiatry service of a public tertiary hospital from Southeast Mexico during its first years of operation (2008–2018), with the purpose of gathering information about the status and needs of this population. A sample of 304 clinical records of patients treated for the first time by the psychiatry service was reviewed, and the distribution by demographic characteristics, diagnosis of mental illness and medical area of reference was analyzed. Anxiety and depression symptoms were the most frequent. Most patients were women, lived in Merida and returned after the first appointment. The neurology service referred most patients, yet most attended directly. General tertiary hospitals should prioritize integrating ad hoc mental and physical health care. Adult women with a profile of anxiety and/or depression would be the first target group. Some areas of opportunity for further research and improvement of mental health services are: preventive services for anxiety and depression, follow-up of patients, attention to relatives of patients at intensive care units, implementation of telehealth alternatives, training on mental health screening and inter- and intra-institutional collaboration.
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Affiliation(s)
- Lizzette Gómez-de-Regil
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida 97130, Mexico;
- Correspondence:
| | | | - Miguel Cicero-Ancona
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida 97130, Mexico;
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20
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Priboi C, Gantner B, Holmer P, Neves da Silva L, Tinner EM, Roser K, Michel G. Psychological outcomes and support in grandparents whose grandchildren suffer from a severe physical illness: A systematic review. Heliyon 2022; 8:e09365. [PMID: 35592660 PMCID: PMC9111890 DOI: 10.1016/j.heliyon.2022.e09365] [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: 01/19/2022] [Revised: 03/18/2022] [Accepted: 04/29/2022] [Indexed: 12/04/2022] Open
Abstract
Objective When a child is facing a severe physical illness, the entire family is affected. Grandparents provide invaluable emotional and practical support to families dealing with this situation, but little is known about the psychological impact on them. We aimed to synthesize the evidence on 1) the psychological outcomes experienced by grandparents when a grandchild is seriously ill and 2) the psychological support needed and used by grandparents. Methods We systematically searched four databases with the search terms "grandchild", "grandparents", "psychological outcomes" and "severe diseases", and we used narrative synthesis to analyze the extracted data. Results Our search identified 3319 records of which 12 were included in the analysis. Grandparents reported experiencing a wide spectrum of feelings, with fear being the most prevalent feeling. Grandparents rarely accessed professional services due to their lack of knowledge about available programs or because of the absence of formal services addressing their needs. In consequence, grandparents asked and received informal support from other family members, friends or their church community. Conclusion Grandparents need to be better informed about their grandchild's disease and the available support services in order to reduce their psychological burden and to better attend to the needs of the other family members.
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Affiliation(s)
- Cristina Priboi
- University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland
| | - Barbara Gantner
- University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland
- Lucerne Cantonal Hospital, Spitalstrasse 6000, 16 Lucerne, Switzerland
| | - Pauline Holmer
- University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland
| | | | - Eva Maria Tinner
- Bern University Hospital, Freiburgstrasse 18, 3010, Bern, Switzerland
- Cantonal Hospital Baselland, Rheinstrasse 26, 4410, Liestal, Switzerland
- University of Basel, Petersplatz 1, 4001, Basel, Switzerland
| | - Katharina Roser
- University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland
| | - Gisela Michel
- University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland
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21
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Pruette CS, Ranch D, Shih WV, Ferris MDG. Health Care Transition in Adolescents and Young Adults With Chronic Kidney Disease: Focus on the Individual and Family Support Systems. Adv Chronic Kidney Dis 2022; 29:318-326. [PMID: 36084978 DOI: 10.1053/j.ackd.2022.02.004] [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: 07/09/2021] [Revised: 02/03/2022] [Accepted: 02/15/2022] [Indexed: 11/11/2022]
Abstract
Health care transition (HCT) from pediatric to adult-focused services is a longitudinal process driven by the collaboration and interactions of adolescent/young adult patients, their families, providers, health care agencies, and environment. Health care providers in both pediatric and adult-focused settings must collaborate, as patients' health self-management skills are acquired in the mid-20s, after they have transferred to adult-focused care. Our manuscript discusses the individual and family support systems as they relate to adolescents and young adults with chronic or end-stage kidney disease. In the individual domain, we discuss demographic/socioeconomic characteristics, disease complexity/course, cognitive capabilities, and self-management/self-advocacy. In the family domain, we discuss family composition/culture factors, family function, parenting style, and family unit factors. We provide a section dedicated to patients with cognitive and developmental disability. Furthermore, we discuss barriers for HCT preparation and offer solutions as well as activities for HCT preparation.
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Affiliation(s)
| | - Daniel Ranch
- Department of Pediatrics, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health at San Antonio, San Antonio, TX
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22
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Using Communication Tools to Explore Young Siblings’ Experiences of Having a Brother or Sister with Pediatric Palliative Care Needs. CHILDREN 2022; 9:children9050641. [PMID: 35626818 PMCID: PMC9139212 DOI: 10.3390/children9050641] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 12/30/2022]
Abstract
Siblings of children with palliative care needs often suffer feelings of being neglected, and their needs for information and involvement are frequently unmet. This study aims to explore the experiences and feelings of siblings of children with palliative care needs, and to determine what is important to them. Nine siblings, aged 6–14 years, were interviewed using four different communication tools: See-Hear-Do pictures, including the empty body as a separate element, Bear cards, and words originating from previous sibling research. Data were analyzed using conventional content analysis. Five categories emerged concerning aspects that the siblings described about their situation and things that they found important: being part of a special family; school—a place for leisure, friends, and learning; relentless feelings of guilt and self-blame; losses and separations; and awareness of death—not if, but when. Siblings of children with rare diseases expressed an awareness that their brother or sister would die, although still felt they were part of a special, happy family. Siblings of children with palliative care needs due to an accident described relentless feelings of self-blame and guilt. The needs of siblings may vary depending on the condition that resulted in the ill sibling’s palliative care needs.
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23
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Bichard E, McKeever S, Bench S, Wray J. Experiences of siblings of children with congenital heart disease during Coronavirus disease 2019; A qualitative interview study. J Pediatr Nurs 2022; 63:96-101. [PMID: 35065871 PMCID: PMC8767808 DOI: 10.1016/j.pedn.2021.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE To explore siblings' perceptions of having a brother or sister with congenital heart disease in the UK during the COVID-19 pandemic. DESIGN AND METHODS Siblings of children with congenital heart disease aged 8-17 years old were interviewed via video call technology between September 2020 and February 2021. We conducted reflexive thematic analysis of these interviews to generate themes. FINDINGS Interviews took place with 17 siblings, predominantly of white ethnicity n = 15 (86%). Most siblings interviewed were first born in the family n = 15 (88%), and most children with CHD were the youngest n = 15(88%). Four themes were generated; My sibling is vulnerable, what does this mean for my family, I have a responsibility to protect my brother or sister, our family time during the pandemic and adjustment and adaptations to pandemic life. CONCLUSIONS Siblings identified difficult aspects of the pandemic and these related to concerns about their brother's or sister's vulnerability, family impact, and keeping their sibling safe. They also identified adjustments they made to keep their family functioning throughout the COVID-19 pandemic. Despite the worry and uncertainty siblings experienced, they valued increased family cohesion which helped to mitigate some challenges of the restrictions imposed in the UK. PRACTICE IMPLICATIONS Honest and open communication is valued by siblings. It is vital to ensure siblings receive the support they need to ensure they keep up with their schooling and social commitments as pandemic related restrictions ease.
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Affiliation(s)
- Elizabeth Bichard
- Institute of Health and Social Sciences, London South Bank University, 103, Borough Road, London SE1 OAA, United Kingdom.
| | - Stephen McKeever
- Department of Nursing, School of Health Sciences, The University of Melbourne, Victoria 3010, Australia
| | - Suzanne Bench
- Institute of Health and Social Sciences, London South Bank University, 103, Borough Road, London SE1 OAA, United Kingdom
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital, London WC1N 3JH, United Kingdom
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24
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The Social Networks and Social Support of Siblings of Children with Cancer. CHILDREN 2022; 9:children9010113. [PMID: 35053738 PMCID: PMC8774421 DOI: 10.3390/children9010113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 11/17/2022]
Abstract
Siblings of children with cancer need support to ameliorate the challenges they encounter; however, little is known about what types and sources of support exist for siblings. This study addresses this gap in our understanding of the social networks and sources of support for adolescents with a brother or sister who has cancer. Additionally, we describe how the support siblings receive addresses what they feel are the hardest aspects of being a sibling of a child with cancer. During semi-structured interviews, siblings (ages 12–17) constructed ecomaps describing their support networks. Data were coded for support type (emotional, instrumental, informational, validation, companionship) and support provider (e.g., mother, teacher, friend). Network characteristics and patterns of support were explored. Support network size ranged from 3 to 10 individuals (M = 6 ± 1.9); siblings most frequently reported mothers as sources of support (n = 22, 91.7%), followed by fathers (n = 19, 79.2%), close friends (n = 19, 79.2%) and siblings (with or without cancer) (n = 17, 70.8%). Friends and brothers or sisters most often provided validation and companionship while instrumental and informational supports came from parents. This study provides foundational knowledge about siblings’ support networks, which can be utilized to design interventions that improve support for siblings of children with cancer.
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25
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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: 0] [Impact Index Per Article: 0] [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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Kelada L, Wakefield CE, De Graves S, Treadgold C, Dumlao G, Schaffer M, O'Brien T. Evaluation of an In-Hospital Recreation Room for Hospitalised Children and Their Families. J Pediatr Nurs 2021; 61:191-198. [PMID: 34118590 DOI: 10.1016/j.pedn.2021.05.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 05/09/2021] [Accepted: 05/27/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Many children's hospitals have established 'recreation rooms' to help reduce distress among hospitalised children and families. We investigated recreation rooms in two Australian children's hospitals to determine: 1) families' first use of the room (including discovery and delays); 2) characteristics of families accessing the room; 3) parents' positive and negative associations with the room; and 4) parents' most and least valued aspects of the room. METHOD Using a concurrent mixed methods design, parents completed questionnaires (Restorative Experiences Tool, Parenting Stress Index-Short Form, Paediatric Quality of Life Inventory) and an optional interview. We analysed data using t-tests and multiple regressions (questionnaires) and content analysis (interviews). RESULTS Parents (n = 123) commonly reported delays in accessing the recreation room (n = 74, 60.2%). Parents' distress was positively related to their frequency of room use (r = 0.28, p = .001). Families of hospitalised children with lower physical (r = -0.36, p < .001) and psychosocial (r = -0.31, p = .001) functioning used the room more frequently than families of children with higher functioning. Parents reported more positive than negative associations with the rooms for themselves (t(121) = 20.92, 95% CI = 4.34-5.25), their hospitalised child (t(117) = 23.91, 95% CI = 5.00-5.90), and any siblings (t(79) = 15.76, 95% CI = 4.28-5.52). Thirteen parents completed the interviews. We identified three themes: 1) respite; 2) social support and reduced isolation; and 3) need for greater accessibility (particularly for infants/toddlers). CONCLUSIONS Respite and social support provided within the recreation rooms may be particularly important for highly distressed parents and families of children with lower psychosocial and physical functioning. Dedicated areas for different age groups may help to improve accessibility of the recreation rooms.
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Affiliation(s)
- Lauren Kelada
- School of Women's and Children's Health, UNSW Sydney, Australia; Kids Cancer Centre, Sydney Children's Hospital, Australia.
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Sydney, Australia; Kids Cancer Centre, Sydney Children's Hospital, Australia
| | | | - Claire Treadgold
- School of Women's and Children's Health, UNSW Sydney, Australia; Research & Evaluation, Starlight Children's Foundation, Australia
| | - Gadiel Dumlao
- School of Women's and Children's Health, UNSW Sydney, Australia; Kids Cancer Centre, Sydney Children's Hospital, Australia
| | - Maria Schaffer
- School of Women's and Children's Health, UNSW Sydney, Australia; Kids Cancer Centre, Sydney Children's Hospital, Australia
| | - Tracey O'Brien
- School of Women's and Children's Health, UNSW Sydney, Australia; Kids Cancer Centre, Sydney Children's Hospital, Australia
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Haukeland YB, Fjermestad KW, Mossige S, Vatne TM. Parent-child communication about emotions during SIBS: a joint intervention for siblings and parents of children with chronic disorders. NORDIC PSYCHOLOGY 2021. [DOI: 10.1080/19012276.2021.1986850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Krister Westlye Fjermestad
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Frambu Competence Center for Rare Disorders, Siggerud, Norway
| | - Svein Mossige
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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Nguyen L, Davis H, Bellefeuille S, Havens J, Jack SM, Di Rezze B, Ketelaar M, Gorter JW. Canadian Resources for Siblings of Youth With Chronic Health Conditions to Inform and Support With Healthcare Management: A Qualitative Document Analysis. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:724589. [PMID: 36188805 PMCID: PMC9397918 DOI: 10.3389/fresc.2021.724589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
Background: As children and adolescents with a chronic health condition (CHC) age and transition to adulthood, many will increasingly assume responsibilities for the management of their healthcare. For individuals with CHCs, family members including siblings often provide significant and varied supports. There are a range of resources in Canada to support siblings of individuals with a CHC, but these resources are not synthesized and the extent to which they relate to healthcare management remains unclear. Purpose: The purpose of this document review was to identify, describe, and synthesize the types of resources currently available to provide general information and healthcare management information about how siblings can provide support to individuals with CHCs in Canada. Methods: Print and electronic resources were systematically identified and retrieved from the websites of organizations, treatment centers, and children's hospitals that are part of Children's Healthcare Canada. Each unique resource was treated as a text document. Documents that met the following inclusion criteria were included: addressed the topic of siblings of individuals with a CHC and written in English. Data were extracted from included documents and qualitative conventional content analysis was conducted. Throughout the process of this review, we partnered with a Sibling Youth Advisory Council. Results: The systematic search yielded 1,628 non-duplicate documents, of which 163 documents met the inclusion criteria. Of the total of 163 documents, they were delivered in the following formats: 17 (10%) general informational products (e.g., booklets, videos) about a CHC and sibling relationships, 39 about support programs and workshops (24%), 34 news articles (21%) that described the roles of siblings, and 6 (3%) healthcare management informational products (e.g., toolkit, tipsheets), 31 blogs (19%) and 39 interviews (24%) with parents and siblings. In the blogs and interviews, siblings and parents described how siblings developed knowledge and skills for healthcare management, as well as their role and identity over time. Significance: This study identified that there are limited resources available about healthcare management for siblings of CHC in Canada. Resources are needed to facilitate conversations in the family about the role of siblings with healthcare management of their sibling with a CHC.
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Affiliation(s)
- Linda Nguyen
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Sibling Youth Advisory Council, Hamilton, ON, Canada
- *Correspondence: Linda Nguyen
| | - Hanae Davis
- Sibling Youth Advisory Council, Hamilton, ON, Canada
| | | | | | - Susan M. Jack
- School of Nursing, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Briano Di Rezze
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Marjolijn Ketelaar
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Centre of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Jan Willem Gorter
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University and McMaster Children's Hospital, Hamilton, ON, Canada
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Somanadhan S, Brinkley A, Larkin PJ. Living through liminality? Situating the transitional experience of parents of children with mucopolysaccharidoses. Scand J Caring Sci 2021; 36:614-624. [PMID: 34406667 DOI: 10.1111/scs.13026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mucopolysaccharidoses (MPS) are rare inherited metabolic disorders that come under category three of life-limiting conditions. Children born with this condition show no symptoms at birth, but its effects show as a progressive disease in subsequent years. The severity of the condition varies according to the specific type, ranging from very mild symptoms to, in most cases, complex healthcare needs, including mental and physical disabilities. AIMS This study aimed to elucidate the meanings of the transition experience of being a parent of a child with MPS. Van Gennep's three-stage rite of passage theory and Turner's theory of liminality were utilised to understand these families' transition experiences are learning to live with their child's ongoing progressive illness trajectory. METHODS A qualitative design utilising hermeneutic phenomenology was used. Longitudinal qualitative in-depth interviews were carried out with eight parents at a three-time point over 17-months period. RESULTS This study provided an interpretation of the lived experience of parents of children and young adults with MPS. As such, it embraces a liminal experience of living with a rare life-limiting illness and the unique passage to becoming a parent of a child with MPS. Parents reported their experience of transition from being the parent of a normal healthy child to be the parent of a child with MPS. They described their transition experience as multi-faceted and complex, neither linear nor time-bound, but rather cyclical. CONCLUSION The rites of passage conceptual framework helped to identify specific and significant unmet supportive and social care needs of these families and their children. This information will enhance the development of a substantial support system to meet the family's emotional, psychological and social needs during the illness transitions from diagnosis and throughout their illness journey.
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Affiliation(s)
- Suja Somanadhan
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Aoife Brinkley
- Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Philip J Larkin
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Vernon-Roberts A, Lopez RN, Lewindon P, Lemberg DA, Bowcock NL, Alex G, Otley A, Jacobson K, Roberts AJ, Evans HM, Gearry RB, Day AS. Assessment of Disease-related Knowledge Among Children With Inflammatory Bowel Disease and their Family Using IBD-KID2: Evaluating Tool Generalizability. JPGN REPORTS 2021; 2:e093. [PMID: 37205959 PMCID: PMC10191511 DOI: 10.1097/pg9.0000000000000093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/06/2021] [Indexed: 05/21/2023]
Abstract
Children with inflammatory bowel disease (IBD) and their families benefit from improved knowledge of their disease and treatment. Knowledge levels of individual family members are infrequently studied but may identify where education is best directed. We aimed to assess disease-specific knowledge among children with IBD, parents, and siblings, using a validated assessment tool (IBD-KID2), and to establish generalizability of IBD-KID2. Methods Children with IBD and family members were recruited from tertiary IBD clinics in New Zealand, Australia, and Canada. All participants completed IBD-KID2 online at baseline, and the children with IBD again after 2 weeks to assess reliability. Results Participants included 130 children with IBD, 118 mothers, 55 fathers, and 37 siblings. Children with IBD had a mean score of 9.1 (SD 2.9) (maximum 15 points), significantly lower than parents (P < 0.005) and higher than siblings (P < 0.005). Scores of children with IBD were positively associated with current age (P < 0.005), age at diagnosis (P = 0.04) and fathers education level (P = 0.02). Significant score correlations were seen between children with IBD and their mother (P < 0.005) but not father. Sibling scores were not correlated with either parent. Test-retest reliability was high. The cohorts from each country were comparable, and no difference in group scores was seen between countries. Conclusion IBD-KID2 is a generalizable and reliable tool for the assessment of disease and treatment knowledge for children with IBD and their families. Score correlations between parents and children with IBD suggest transfer of knowledge, but sibling knowledge is low and targeted education may be beneficial.
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Affiliation(s)
- Angharad Vernon-Roberts
- From the Department of Paediatrics, University of Otago (Christchurch), Christchurch, New Zealand
| | - Robert N Lopez
- Department of Paediatric Gastroenterology, Queensland Children's Hospital, Brisbane, Australia
| | - Peter Lewindon
- Department of Paediatric Gastroenterology, Queensland Children's Hospital, Brisbane, Australia
| | - Daniel A Lemberg
- Department of Paediatric Gastroenterology, Sydney Children's Hospital, Australia
| | - Nerissa L Bowcock
- Department of Paediatric Gastroenterology, School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - George Alex
- Department of Paediatric Gastroenterology, Royal Children's Hospital, Melbourne, Australia
| | - Anthony Otley
- Department of Pediatrics, Dalhousie University, Nova Scotia, Canada
| | - Kevan Jacobson
- Department of Paediatric Gastroenterology, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Amin J Roberts
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
| | - Helen M Evans
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
| | - Richard B Gearry
- Department of Medicine, University of Otago (Christchurch), Christchurch, New Zealand
| | - Andrew S Day
- From the Department of Paediatrics, University of Otago (Christchurch), Christchurch, New Zealand
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31
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Alrø AB, Høyer L, Dreyer P. A Child with Home Mechanical Ventilation Affects the Family: A Danish Study shows that well Siblings may become Shadow Children. J Pediatr Nurs 2021; 59:19-24. [PMID: 33412361 DOI: 10.1016/j.pedn.2020.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/20/2020] [Accepted: 12/20/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Having a child with chronic respiratory illness and home mechanical ventilation (HMV) may not only affect the ill child, but also the family, including well siblings' everyday life and physical and mental well-being. PURPOSE To explore the perspectives of parents to a child with HMV on well siblings' lives. DESIGN AND METHODS A qualitative phenomenological-hermeneutic approach using semistructured interviews with eight families, that included a child on HMV and well siblings. Data were collected from March to June 2019 at a Danish University Hospital. RESULTS Three main themes emerged: Tying emotional bonds with both children, Protection of everyday life for well siblings and A different family life - sharing attentiveness. The findings showed that being a parent to an HMV child and well siblings is complex to manage, and may make parents feel inadequate towards their children. CONCLUSIONS Parents feel inadequate in being parents to both the HMV child and well siblings, often transferring adult responsibilities to the well sibling, and sometimes leaving the well siblings in the shadow. IMPLICATIONS Clinical practice needs to expand interventions to support parents and well siblings by using a more family-centred care approach, not only during admission, but also in a long-term perspective.
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Affiliation(s)
- Anette Bjerregaard Alrø
- Aarhus University Hospital, Department of Intensive Care / Respiratory Center West, Aarhus, N, Denmark.
| | - Linea Høyer
- Regional Hospital West Jutland, Department of Psychiatry, Herning, Denmark..
| | - Pia Dreyer
- Aarhus University, Institute of Public Health, Aarhus C, Denmark and Bergen University, Norway, and Aarhus University Hospital, Department of Intensive Care, Aarhus, N, Denmark..
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32
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Mitchell AE, Morawska A, Vickers-Jones R, Bruce K. A Systematic Review of Parenting Interventions to Support Siblings of Children with a Chronic Health Condition. Clin Child Fam Psychol Rev 2021; 24:651-667. [PMID: 34184174 DOI: 10.1007/s10567-021-00357-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
This systematic review summarises the parenting intervention literature for parents of children who have a sibling with a chronic health condition, and evaluates intervention efficacy for improving parent (parenting skills, parenting efficacy) and child (emotional and behavioural adjustment, condition knowledge, quality of life) outcomes. Electronic databases were searched to identify relevant papers published in English from inception until May 2020. Reference lists of eligible papers were further searched for relevant articles. Six papers (two controlled trials, four uncontrolled trials) evaluating four separate intervention programs met inclusion criteria. All included parent- and child-focused intervention components. Results showed an overall trend for pre- to post-intervention improvement in children's behavioural and emotional adjustment and health condition knowledge. Few studies examined effects on parent outcomes, and there was no evidence of change on these measures. Overall, results suggest that parenting interventions may help to improve siblings' emotional and behavioural adjustment and condition knowledge; however, all of the interventions combined parent- and child-directed intervention components, making it difficult to determine which intervention elements drive change. Further research is needed to test mechanisms by which parenting interventions may improve outcomes for siblings of children with chronic health conditions, and to establish the efficacy of this approach.
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Affiliation(s)
- Amy E Mitchell
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, 13 Upland Road, St Lucia, QLD, 4072, Australia.
| | - Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, 13 Upland Road, St Lucia, QLD, 4072, Australia
| | - Raine Vickers-Jones
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, 13 Upland Road, St Lucia, QLD, 4072, Australia
| | - Kathryn Bruce
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, 13 Upland Road, St Lucia, QLD, 4072, Australia
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33
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Agerskov H, Thiesson HC, Pedersen BD. Siblings of children with chronic kidney disease: A qualitative study of everyday life experiences. J Ren Care 2021; 47:242-249. [PMID: 34042287 DOI: 10.1111/jorc.12389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/12/2021] [Accepted: 05/04/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Chronic kidney disease in children has an impact on all family members. Healthy siblings, in particular, may experience negative psychological and emotional symptoms. Little attention has been paid to how they experience everyday family life and the impact of their sibling's disease. OBJECTIVES To explore perspectives on and experiences of everyday life among siblings of children with chronic kidney disease. DESIGN An explorative study with a qualitative method. PARTICIPANTS Seven siblings (7-13 years) of children with chronic kidney disease (5-16 years) were included. APPROACH The study took a phenomenological-hermeneutical approach. Semistructured individual interviews were conducted. The data were analysed using Ricoeur's theory of narrative and interpretation, on three levels: naïve reading, structural analysis and critical interpretation and discussion. FINDINGS Three themes emerged: The illness is in the background or comes to the fore, being concerned for and taking care of the sick sibling and the importance of bonds with relatives or other significant adults. CONCLUSION In everyday life, participants experienced that their sick sibling's illness was either in the background or came to the fore. They needed to adapt to periods of hospitalisation. They felt a need to be attentive to, take care of and have concern for the sick brother or sister. Conflicts caused feelings of loneliness; however, having knowledge about the disease provided security and meaning. Being introduced to the healthcare professionals was significant. It was important to have close relationships with friends and other adults, which gave rise to feelings of self-confidence and being supported.
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Affiliation(s)
- Hanne Agerskov
- Department of Nephrology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Univerisity of Southern Denmark, Odense, Denmark.,Family Focused Healthcare Research Center (FaCe), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Helle C Thiesson
- Department of Nephrology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Univerisity of Southern Denmark, Odense, Denmark
| | - Birthe D Pedersen
- Department of Clinical Research, Univerisity of Southern Denmark, Odense, Denmark
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Creating a Pathway for Psychosocial Support in Siblings of Youth with a Chronic Illness: Findings from an International Summit. J Dev Behav Pediatr 2021; 42:331-339. [PMID: 33395147 DOI: 10.1097/dbp.0000000000000902] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 11/01/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Serious childhood illnesses such as cancer affect all family members. Siblings experience strong emotions and disruptions to their routines as families reorganize to confront the disease and manage treatment. Addressing siblings' psychosocial needs is a standard of care in pediatric oncology, but siblings' needs are rarely met because of systematic barriers in our health care system. Thus, we aimed to re-envision sibling care. We used an appreciative inquiry approach to inform systematic screening of siblings' psychosocial risk and unmet needs as a first step toward providing appropriate support. METHOD Sibling-focused researchers, clinicians, policymakers, advocates, and families of youth with cancer (N = 29) convened for a 2-day community stakeholder-centered international summit to create a vision for standardizing and optimizing sibling-focused psychosocial screening and assessment as a pathway to care, including crafting a research agenda and articulating best clinical practices. RESULTS Summit attendees created a detailed framework for best practices in universal sibling psychosocial screening and pathways to support. The framework emphasizes links between hospital- and community-based care. It highlights the need to prepare systems to feasibly and effectively attend to siblings' needs and recommends incorporating siblings into family-based psychosocial screening at cancer diagnosis, systematically conducting sibling-focused psychosocial screening during and after cancer treatment, and connecting siblings with community-based resources. CONCLUSION A systematic approach to sibling psychosocial services expands the idea of family-centered care to include siblings and ensures that siblings' needs are adequately recognized and met. This framework was created in the context of cancer but is applicable across illness groups.
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Camps for Children with Cancer and Their Families: A Systematic Review of Psychosocial and Physical Impacts. J Dev Behav Pediatr 2021; 41:145-156. [PMID: 31567721 DOI: 10.1097/dbp.0000000000000728] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Camps for children with cancer and their families aim to promote positive psychosocial and physical outcomes for attendees. However, evidence for this is inconsistent, and previous reviews have not delineated between camps for children (patient/survivors and siblings) and family camps (including parents/guardians). Such understanding is necessary to understand the evidence-based benefits of each type of camp. Our systematic review summarizes the findings and limitations of the recent literature for children's camps and family camps. METHODS We searched MEDLINE/PubMed, PsycINFO, Social Work Abstracts, and Google Scholar for relevant articles published between 2013 and 2018. RESULTS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, we included 19 articles (from 15 studies) in the review. Evidence for the impact of camps was mixed. All articles reported positive outcomes, yet 3 quantitative articles also reported nonsignificant changes. Camps for children (representing 2151 children with cancer/survivors) appeared to facilitate social skills, self-esteem, and physical activity. Family camps (representing 96 families) may provide families the opportunity to reconnect. Both types of camp provide attendees with social support and fun/respite. In 2 qualitative articles, some parents attending family camps reported tension between families of children on treatment and bereaved families. The literature is limited by small sample sizes and the lack of multisite, longitudinal, and controlled study designs. CONCLUSION The recent literature provides evidence for some positive, short-term psychosocial and physical outcomes of camps. Future research should use rigorous quasiexperimental designs and should assess the long-term impact of camp attendance.
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36
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Hjorth E, Lövgren M, Kreicbergs U, Sejersen T, Asaba E. "Suddenly we have hope that there is a future": two families' narratives when a child with spinal muscular atrophy receives a new drug. Int J Qual Stud Health Well-being 2021; 16:1904722. [PMID: 33789523 PMCID: PMC8216061 DOI: 10.1080/17482631.2021.1904722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Purpose: This study aims to explore negotiations of hope in everyday life for families where a child with spinal muscular atrophy (SMA) has received a new drug treatment.Methods: A narrative design was used, drawing on interviews and participant observations in two families with children with SMA, types 1-2, to situate family experiences of hope in everyday life. Narrative analysis was used on the data.Results: Results are presented as stories, with details about situations and contexts, to illustrate how hope was used by families to reconstruct their own family narratives.Conclusions: Hope was negotiated and struggled with in different ways by different family members, but contributed to each person's own way of dealing with the disease and outlook for the future.
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Affiliation(s)
- Elin Hjorth
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Malin Lövgren
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,The Department of Women's and Children's Health, Paediatric Oncology and Haematology, Childhood Cancer Research Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Ulrika Kreicbergs
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,The Department of Women's and Children's Health, Paediatric Oncology and Haematology, Childhood Cancer Research Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Sejersen
- The Department of Women's and Children's Health, Paediatric Neurology, Karolinska Institutet, Karolinska University Hospital, Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Eric Asaba
- Division of Occupational Therapy, Department of Neurobiology Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.,Research, Education, Development, and Innovation Unit, Stockholms Sjukhem Foundation, Stockholm, Sweden.,Occupational Therapy & Occupational Science Research Group, Department of Health Sciences, Lund University, Lund, Sweden
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37
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Mulligan S, Guerin S, McKiernan A, Brown A, Hartnett M, Gray D, Kiernan G. The core features and outcomes of a specialised camp programme for children with life-limiting conditions and their families: A qualitative multi-perspective approach. J Child Health Care 2020; 24:515-528. [PMID: 31594387 DOI: 10.1177/1367493519875593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous research has reported that the families of children with enduring and life-limiting health conditions are at risk of negative psychosocial effects. Adjunct to medical interventions, specialist camp programmes have been developed to promote familial adjustment. However, limited research has been carried out in this area. The aim of this study was to describe the core features and outcomes of a specialised camp programme for children with life-limiting conditions (LLC) and their family. Semi-structured interviews were conducted with four professionals, three volunteers involved in facilitating the programme and two mothers representing families that attended the programme. Multiple perspectives were sought to gain a detailed understanding of the programme and outcomes. Data were analysed through an inductive thematic approach. There was considerable overlap among participant groups on the core features and outcomes of the programme. Thematically, core features are described in terms of familial togetherness, peer interaction, safety and positive experiences. Noted outcomes include lasting memories, continued peer relations for parents and siblings and enhancement of relationships between family members and professionals. Findings suggest that specialised camp programmes may provide families of children with LLC with positive experiences that support adjustment, although further research is required.
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Affiliation(s)
- Shane Mulligan
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Suzanne Guerin
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | | | - Anna Brown
- LauraLynn, Ireland's Children's Hospice, Dublin, Ireland
| | | | - Dee Gray
- LauraLynn, Ireland's Children's Hospice, Dublin, Ireland
| | - Gemma Kiernan
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
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38
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Le Boudec A, Akre C, Barrense-Dias Y, Berchtold A, Suris JC. Siblings of youths with chronic conditions: a school-based survey. Int J Adolesc Med Health 2020; 33:173-180. [PMID: 33125338 DOI: 10.1515/ijamh-2018-0247] [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: 10/25/2018] [Accepted: 01/13/2019] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to explore the differences between youths with a sibling affected by a chronic condition or a disability (SCCD) and their peers with healthy siblings. METHOD Using data from the second wave of GenerationFRee study, we compared adolescents from each gender with healthy siblings to adolescents with SCDD on demographical, familial, internalizing and externalizing behavior variables. Subsequently we repeated the analysis excluding from each group adolescents who suffered from a chronic condition or disability themselves. RESULTS At the bivariate and multivariate level, among those with SCDD, healthy females reported more somatic symptoms, healthy males more violent behaviors, and both genders lived more often in non-intact families. When considering both healthy and unhealthy adolescents, at bivariate analysis female adolescents with SCDD were more likely to have a poorer relationship to their mother, to be unhealthy, to smoke, to be at risk for disordered eating and to report somatic symptoms. At multivariate level, only the association with SCDD and smoking remained. Male adolescents with SCDD, at both bivariate and multivariate analyses, were more likely to be unhealthy and to live in larger and non-intact families. CONCLUSION Healthy adolescents with an SCDD are more at risk of somatic symptoms and violent behaviors than their peers with healthy siblings. Health professionals in contact with adolescents should always consider them with a systemic approach. Parents should be informed about the potential effect on the siblings of a CDD child, but also reassured, as adolescents with SCDD are not different from their peers with healthy siblings.
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Affiliation(s)
- Audraine Le Boudec
- Research group on Adolescent Health, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Christina Akre
- Research group on Adolescent Health, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Yara Barrense-Dias
- Research group on Adolescent Health, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - André Berchtold
- Institute of Social Sciences & NCCR LIVES, University of Lausanne, Lausanne, Switzerland
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Jaaniste T, Tan SC, Aouad P, Trethewie S. Communication between parents and well-siblings in the context of living with a child with a life-threatening or life-limiting condition. J Paediatr Child Health 2020; 56:1521-1526. [PMID: 32936516 DOI: 10.1111/jpc.15138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 11/29/2022]
Abstract
Effective parent-child communication may serve to buffer the potential negative impacts of stressful situations on a child. Children who have a brother or sister with a life-threatening or life-limiting medical condition may turn to their parents for help with comprehending the situation, to help maintain their own ability to function across various life areas or to receive emotional support. There is a need for more investigation into the nature and importance of parent-child communication in the context of living with a seriously ill brother or sister. The current paper presents a framework of parent-sibling communication in the context of living with a seriously unwell child, distinguishing the focus of communication (illness-related vs. non-illness-related) and the purpose of communication (information-provision vs. emotional support). Such a framework offers a holistic approach to exploring some of the challenges of communication between parents and well-siblings. The state of current knowledge regarding the focus and purpose of communication between parents and well-siblings is reviewed, and implications for research and possible clinical applications discussed.
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Affiliation(s)
- Tiina Jaaniste
- Department of Palliative Care, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Sarah C Tan
- Department of Palliative Care, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Phillip Aouad
- Department of Palliative Care, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Susan Trethewie
- Department of Palliative Care, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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Experiences of caregiving and quality of healthcare among caregivers of patients with complex chronic processes: A qualitative study. Appl Nurs Res 2020; 56:151344. [PMID: 32907769 DOI: 10.1016/j.apnr.2020.151344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 07/12/2020] [Accepted: 08/22/2020] [Indexed: 11/20/2022]
Abstract
Aim To explore the perceptions of main caregivers regarding caring for chronic complex patients in two different regions of Spain. BACKGROUND Spain is a country with an ageing population and a high number of people with chronic diseases. It is well known that the role of the caregiver is important to ensure quality of life and appropriate care. METHODS Qualitative design using focus groups. Five focus groups, from two different regions, were conducted with 22 caregivers of people with chronic complex diseases to explore their personal experience, examine the quality of care received by the patient and their family and to develop strategies for the improvement of the quality of health care. The focus groups were audio and video recorded. The transcriptions of the focus group sessions were exported to qualitative software analysis MAXQDA 2018.2. The qualitative content analysis was based on different analytical cycles. RESULTS In general terms, caregivers would refer to accepting the care of their family members, but they highlight many negative aspects such as tiredness, lack of help and overload of care. They indicated general satisfaction with the health system but indicated that help was insufficient and that strategies to better address the situations of the complex chronic patient should be improved. The main categories observed were: Conclusions. Complex chronic illnesses are increasingly common at present, generating important consequences on the lives of patients and that of their caregivers. The design of any health strategy for facing the dilemma of chronic illnesses, must necessarily include the vision of the caregivers.
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[Evaluation of a Manualized Group Program for Siblings of Children with Diseases or Disabilities]. Prax Kinderpsychol Kinderpsychiatr 2020; 69:203-217. [PMID: 32394821 DOI: 10.13109/prkk.2020.69.3.203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Evaluation of a Manualized Group Program for Siblings of Children with Diseases or Disabilities This study evaluates a manualized group program for siblings of children with life-threatening/life-limiting diseases or disabilities. The program aims to activate resources and to reduce emotional and behavioral problems, using cognitive-behavioral methods and experience-based interventions. In this multi-center study, 13 GeschwisterTREFFs were conducted by 11 study sites in Germany. Prior to and after the intervention 97 siblings aged 7 to 14 years and their parents were examined with standardized questionnaires. At baseline, the siblings of children with diseases or disabilities showed significant more emotional and behavioral problems compared to the respective norm samples. After the intervention, the siblings reported declined problem behavior scores that were mostly in the range of the particular norm values. Furthermore, the children indicated a significant improvement of self-esteem, self-efficacy, school competences and relations to their siblings. However, parents reported more problem behavior and less health-related quality of life of their children at both assessments. The present multi-center study showed the interventions' feasibility in different settings and confirmed expected improvements of target variables during the intervention period. Randomized-controlled trails are warranted to verify our results.
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Samuelsson M, Wennick A. An Exploratory Study of the Everyday Life of Swedish Children on Home Parenteral Nutrition and Their Families. J Pediatr Nurs 2020; 52:e84-e89. [PMID: 32044196 DOI: 10.1016/j.pedn.2020.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Improved survival rates of preterm infants and critically ill children has resulted in an increasing number of children growing up on HPN. However, how the child and the child's family experience HPN is sparsely studied. PURPOSE Thus, this study aims to elucidate the everyday life experiences of children with intestinal failure on HPN from the perspective of the child and the child's family. DESIGN AND METHODS We used a qualitative inductive study that included semi-structured interviews from 13 family members in six families, and we analyzed them using content analysis. RESULTS The family members' experiences had an overall theme, having to take on a full-time (nursing) responsibility, and fell into three categories: family restrictions, family adjustments, and family uncertainty. CONCLUSION Families on HPN had to shoulder an in-home round-the-clock (nursing) responsibility that came with a daily logistical challenge. The complexity of HPN complicates the possibility of external support, so the families choose to keep the burden within the family; consequently single-parent households have limited possibilities for relief and recovery. PRACTICE IMPLICATIONS To minimize the intrusion of the treatment in family's everyday life and, thereby, support the families, health care professionals might find it beneficial to obtain an inventory of the everyday life needs of each specific family when first introducing HPN. Further, by encouraging close kin to participate in the HPN education these families may be unburdened some more. In addition, it is essential that professionals follow the families protocol for management and not the other way around.
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Affiliation(s)
- Maria Samuelsson
- Skåne University Hospital, Malmö, Sweden; Department of Pediatrics, Malmö, Sweden; Malmö University, Faculty of Health and Society, Department of Care Science, Malmö, Sweden.
| | - Anne Wennick
- Malmö University, Faculty of Health and Society, Department of Care Science, Malmö, Sweden
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Bortes C, Strandh M, Nilsson K. Sibling Ill Health and Children's Educational Outcomes. THE JOURNAL OF SCHOOL HEALTH 2020; 90:407-414. [PMID: 32105351 PMCID: PMC7187141 DOI: 10.1111/josh.12887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/29/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The presence of health problems in a child is known to be negatively associated with later academic achievement, but less is known about the educational outcomes for siblings of children in poor health. The study investigated how having a sibling with health problems affects a healthy sibling's academic achievement. METHODS We utilized medical and social microdata from Swedish administrative population registers. Our sample consisted of N = 115,106 individuals (51.3% boys) born in 1990 in Sweden. We compared children with ill siblings to children whose siblings did not have poor health. Siblings' hospital admissions and the academic achievements of the healthy sibling during their final year of compulsory education (at the age of 15-16) were analyzed using linear and logistic regression in relation to individual health- and family-related confounders. RESULTS Sibling hospitalization was significantly associated with lower overall grade points (β = -10.73, p < .001) and an increased odds ratio (OR) of ineligibility for upper secondary education (OR = 1.42, 95% confidence interval = 1.31-1.52, p < .001). CONCLUSIONS School and health personnel should also consider the needs of healthy siblings during their work with children in poor health, because they too can be disadvantaged.
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Affiliation(s)
- Cristian Bortes
- Umeå University, Department of Social Work, Faculty of Social SciencesUmeåSE‐901 87Sweden
| | - Mattias Strandh
- Umeå University, Department of Social Work, Faculty of Social Sciences, Umeå SE‐901 87, Sweden; Karlstad University, Centre for Research on Child and Adolescent Mental HealthKarlstadSE‐651 88Sweden
| | - Karina Nilsson
- Umeå University, Department of Sociology, Faculty of Social SciencesUmeåSE‐901 87Sweden
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Ay Kaatsız MA, Öz F. I'm Here, Too: Being an Adolescent Sibling of a Pediatric Cancer Patient in Turkey. J Pediatr Nurs 2020; 51:e77-e84. [PMID: 31653467 DOI: 10.1016/j.pedn.2019.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to determine experiences and needs of Turkish adolescent siblings of children with cancer (SCC) and to identify if there is a country/culture-specific risk factor for these siblings. DESIGN AND METHOD In this qualitative study hermeneutic phenomenological approach was used. Eighteen eligible siblings were selected purposively from two hospitals in Ankara, Turkey. Interviews were conducted with a semi-structured form. Content and thematic analyses were used to analyze the data. RESULTS The data revealed three levels of themes. The main theme was based on "I am here, too". From the first moment of diagnosis, siblings need to be visible and noticed by others. They seek ways to make sense of the disease as they experience dramatic changes in all aspects of their lives (high level themes - first encounter with the disease and changes in life). They expect their parents and relatives to support them (expectations) when they turn to various methods to cope with the changes (coping styles). CONCLUSIONS The lack of protective psychosocial care is a basic risk factor for adolescent SCC in Turkey. Despite its various limitations, the strongest aspect of this study is that it is the first publication that determines the experiences of Turkish SCC in their own words. In addition to supporting recent findings about siblings' experiences, obtaining some country-specific findings is a strength of the present study. PRACTICE IMPLICATIONS Providing psychosocial risk assessment of the siblings' immediately after diagnosis is necessary. It can be helpful to inform parents about the risks.
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Affiliation(s)
- Melike Ayça Ay Kaatsız
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey.
| | - Fatma Öz
- Faculty of Health Sciences, Nursing Department, Lokman Hekim University, Ankara, Turkey
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Dinleyici M, Çarman KB, Özdemir C, Harmancı K, Eren M, Kirel B, Şimşek E, Yarar C, Duyan Çamurdan A, Şahin Dağlı F. Quality-of-life Evaluation of Healthy Siblings of Children with Chronic Illness. Balkan Med J 2019; 37:34-42. [PMID: 31647208 PMCID: PMC6934013 DOI: 10.4274/balkanmedj.galenos.2019.2019.7.142] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Chronic disease of children can cause changes in the health-related quality of life (HrQoL) of the family members. Aims: To evaluate the HrQoL of healthy siblings of children with chronic disease. Study Design: Cross-sectional study. Methods: The study included healthy sibling of children with chronic disease (cerebral palsy, epilepsy, diabetes, celiac disease, hematologic/oncologic disease, or asthma) and healthy sibling of healthy children to evaluate the quality of life. We used the Pediatric Quality of Life Inventory questionnaire; the physical health and psychosocial health scores were calculated using the responses of the sibling and parent. The primary endpoint was the comparison of HrQoL scores of healthy siblings of children with chronic disease and that of healthy siblings of healthy children. Results: This study included a respective healthy sibling of 191 children with chronic disease and healthy sibling of 100 healthy children. The physical health, psychosocial health, and total health scores of healthy siblings of children with chronic disease were significantly lower than that of healthy siblings of healthy children (p<0.001). Among the healthy siblings of children with chronic disease, the lowest psychosocial health score was found in the siblings of children with cerebral palsy, hematologic/oncologic disease, and asthma (p<0.001). The global impact on the quality of life for healthy siblings of children with chronic disease was significantly higher in the self-report of the children than that of the parents (30.4% versus 15.1%, p<0.05). Conclusion: Most healthy siblings of children with chronic disease are physically and psychosocially affected and there is low parental awareness of this condition. This can increase the risk of emotional neglect and abuse of these children. Therefore, special support programs are needed for the families of children with chronic diseases.
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Affiliation(s)
- Meltem Dinleyici
- Department of Social Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Kürşat Bora Çarman
- Department of Pediatric Neurology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Canan Özdemir
- Department of Pediatric Hematology and Oncology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Koray Harmancı
- Department of Pediatric Allergy and Immunology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Makbule Eren
- Department of Pediatric Gastroenterology and Hepatology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Birgül Kirel
- Department of Pediatric Endocrinology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Enver Şimşek
- Department of Pediatric Endocrinology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Coşkun Yarar
- Department of Pediatric Neurology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Aysu Duyan Çamurdan
- Department of Social Pediatrics, Gazi University School of Medicine, Ankara, Turkey
| | - Figen Şahin Dağlı
- Department of Social Pediatrics, Gazi University School of Medicine, Ankara, Turkey
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Moen ØL, Opheim E, Trollvik A. Parents Experiences Raising a Child with Food Allergy; A Qualitative Review. J Pediatr Nurs 2019; 46:e52-e63. [PMID: 30857930 DOI: 10.1016/j.pedn.2019.02.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/27/2019] [Accepted: 02/27/2019] [Indexed: 11/16/2022]
Abstract
PROBLEM Food allergies are one of the fastest growing public health concerns without a cure, affecting approximately 8% of the world's child population. Being the parent of a child with allergies may lead to concerns, and affect everyday life in the family. The aim was to synthesize and describe parents' experiences of living with food allergies in families when one of the children has a food allergy. ELIGIBILITY CRITERIA A systematic search using subject terms and text words was performed in Cinahl (Ebsco), Swemed+, Medline (OVID) and Scopus in October 2017. The search was limited to parents with children and adolescents, for the years from 2006 to October 2017. SAMPLE One hundred and forty articles were screened and 24 were included. RESULTS A meta-summery of the results from the included studies were conducted. The parents lived in fear, after their child had their first reaction and had become allergic, a life threatening experience. They tried to live an ordinary family life and parents had to learn how to be one-step ahead and understand early signs. The family's social life was also influenced. Parents asked for support and information from health professionals and more knowledge and skills increased parents' manageability. CONCLUSION Parents need support and a seamless encounter with health professionals, with multidisciplinary collaboration and knowledge sharing to develop the parents' self-efficacy. IMPLICATIONS Health professionals must provide information and support parents on their path through the health-care system in having a child with a food allergy.
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Affiliation(s)
- Øyfrid Larsen Moen
- Faculty of Medicine and Health Sciences, Department of Health sciences, Norwegian University of Science and Technology (NTNU), Norway.
| | - Elin Opheim
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Norway.
| | - Anne Trollvik
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Norway.
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Hill K, Brenner M. Well siblings' experiences of living with a child following a traumatic brain injury: a systematic review protocol. Syst Rev 2019; 8:81. [PMID: 30940180 PMCID: PMC6446255 DOI: 10.1186/s13643-019-1005-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 03/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this systematic review is to synthesize the available evidence identified through a systematic search on well siblings' experiences of living with a child following a traumatic brain injury (TBI). Brain injuries in children have been referred to as the "silent epidemic" of current times. Brain injuries in children are also recognized as a global public health concern, with the impact on children, effects on family life, and caregiving markedly misunderstood and underestimated. It is widely recognized that a serious brain injury impacts on the whole family, both immediate and extended regardless of the age of the individual who experiences the brain injury. While some research refers to parental experiences of children with TBIs and caregivers experiences, there is a dearth of literature relating to the impact on well siblings and their perspectives. Well siblings' experiences regarding the impact of living with a child post-TBI are not well understood. In order to advance the delivery of family nursing care in the home, an understanding of the well siblings' experiences is fundamental. METHODS The search will be conducted using seven medical and healthcare databases for articles published up until February 2019. Two reviewers will independently screen the articles for inclusion and assess for study quality using the standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Two reviewers will extract data from each study and carry out data analysis to uncover themes within the literature. Data synthesis of findings will be carried out using JBI-QARI. DISCUSSION It is anticipated that the findings of the proposed review will be of interest to health and social care professionals, particularly those working in units where children have suffered TBIs, their well siblings, and families. The aim is to identify well siblings' experiences which can inform enhanced care delivery to the families of children following a TBI. The findings of this review will provide evidence to aid professionals with the assessment of siblings' needs to enhance their sense of self within the family unit. Future directions, in addition to potential limitations of the approach, will be discussed. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2018 CRD42018111036.
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Affiliation(s)
- Katie Hill
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Maria Brenner
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Dyadic analysis of siblings' relationship quality, behavioural responses, and pain experiences during experimental pain. Pain 2019; 159:1569-1579. [PMID: 29672448 DOI: 10.1097/j.pain.0000000000001244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Research on family factors in paediatric pain has primarily focused on parents; the role of siblings has been largely ignored. This study examined whether sibling relationship quality was related to siblings' behaviours during experimental pain, and whether the behaviours of an observing sibling were related to children's pain outcomes. Ninety-two sibling dyads between 8 and 12 years old completed both observational and questionnaire measures of sibling relationship quality. Children took turns completing the cold-pressor task (CPT) in a counterbalanced order with their sibling present. Pain outcomes (intensity, fear, and tolerance) were recorded for each sibling, and the behaviour of the observing and participating siblings during the CPT were coded as attending, nonattending, and coping/encouragement. Structural equation modelling, using the actor-partner interdependence model, was conducted to analyse the dyadic data. While participating in the CPT with their sibling present, greater levels of warmth and positivity in the sibling relationship were related to children engaging in more nonattending behaviours and less attending behaviours. Greater levels of attending behaviours by the observing child was related to the sibling having a lower pain tolerance, and greater levels of coping/encouragement behaviours by the observing child was related to the sibling reporting greater pain intensity and fear during the CPT. Children with warmer/positive sibling relationships were more likely to respond to acute pain by shifting the focus away from their pain experience (eg, through distraction) when a sibling was present. Pain-focused behaviours by an observing sibling are related to greater child pain and fear during experimental pain.
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Promoting resilience in vulnerable populations: focus on opioid-exposed children, siblings of children with special healthcare needs and support for children through school-based interventions. Curr Opin Pediatr 2019; 31:157-165. [PMID: 30531404 DOI: 10.1097/mop.0000000000000722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Resilience is an important factor in withstanding the health consequences of childhood adversity. This article discusses recent literature related to promoting resilience in opioid-exposed children and siblings of children with special healthcare needs. It also addresses ways that school systems can foster childhood resilience. RECENT FINDINGS Rising rates of opioid-exposed newborns have necessitated the development of multiple strategies to address the medical and social needs of this vulnerable pediatric population. Siblings of children with special healthcare needs are a growing but sometimes overlooked group who have unique challenges that can be supported by healthcare providers. School programs that reward positive behavior and encourage self-regulation through activities like physical activity and mindfulness can foster an environment for improved youth resiliency. SUMMARY New research has led to the development of resources that help pediatric providers assess the needs of their vulnerable patient populations and foster resilience through attention to these patients' medical, emotional and social needs. Patients benefit from national policy efforts and local school programs that each promote resilience.
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Rafferty KA, Hutton K, Heller S. "I Will Communicate With You, But Let Me Be In Control": Understanding How Parents Manage Private Information About Their Chronically Ill Children. HEALTH COMMUNICATION 2019; 34:100-109. [PMID: 29072494 DOI: 10.1080/10410236.2017.1384432] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Parents have a significant role in the management of a child's chronic condition. Parents are often the only consistent individuals managing a child's health across his or her childhood and adolescence (e.g., present for all appointments and medical procedures). Many of the responsibilities required of parents involve communication work, where parents must strategically and actively design messages as they interact with medical professionals, other family, and friends. Using communication privacy management theory, we analyzed interviews conducted with 35 parents to understand the motivations and strategies involved in their regulation of information about their child's chronic condition. These findings have important practical implications because parental involvement in a chronically ill child's care has direct effects on familial adaptation and adjustment.
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Affiliation(s)
- Katherine A Rafferty
- a Department of Psychology, Communication Studies Program , Iowa State University
| | - Kara Hutton
- a Department of Psychology, Communication Studies Program , Iowa State University
| | - Sarah Heller
- a Department of Psychology, Communication Studies Program , Iowa State University
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