Siblings Of Pediatric Cancer Patients Research Articles

A review of Japanese literature on the content and challenges of support for the siblings of pediatric cancer patients

A review of Japanese literature on the content and challenges of support for the siblings of pediatric cancer patients

The Impact of School Visits on Siblings of Children With Cancer.

Childhood cancer affects the entire family. Siblings experience similar stress to that of the ill child, including anger, depression, jealousy, guilt, and social isolation. School reentry programs are shown to be positive interventions for patients, it is hypothesized that similar outcomes exist for siblings. To examine the feasibility of studying the impact of the Ontario Oncology Nurse School Visitation Program on the well-being and school adjustment of siblings of pediatric cancer patients. Fourteen sibling participants and parents completed a semistructured interview and the PedsQL® questionnaire before and after a nurse school visit. School attendance was also compared and data were collected for logistics of study procedures. The mode of data collection was agreeable and easy to plan and execute. School attendance showed a reduction of days missed; there was no significant impact on PedsQL results but the interviews yielded positive feedback. The outlook for siblings improves with the support of family members and health care professionals. This pilot study provides hypotheses and design for future research.

A Systematic Review of Interventions with Siblings of Pediatric Cancer Patients

Purpose: The purpose of this study was to review interventions available to nurses caring for siblings of children with cancer. Methods: Searches of CINAHL, MEDLINE, PubMed, EMBASE, and RISS identified ten intervention studies published from January, 2000 to November, 2016. Results: Ten studies on interventions for siblings of pediatric cancer patients were identified as follows: 4 included camps, 4 included support groups, and 2 provided individual interventions. Theoretical frameworks were mainly cognitive behavioral theory and most studies were led by psychologists and multidisciplinary teams. The purpose of the interventions was primarily enhancing psychosocial adjustment. Siblings’ fear of disease, self-esteem, and social support were improved significantly after the interventions. Findings were inconsistent with regard to depression, anxiety, behavioral problems, post-traumatic stress, health-related quality of life, and siblings’ perceptions of the illness. Conclusion: Study findings showed the potential for enhancing emotional and behavioral outcomes in siblings of children with cancer. However, the number of studies was very small, and several methodological limitations were identified. In the future, more randomized controlled trials with larger samples are needed to extend the evidence base. Moreover, future research should identify sibling’s characteristics and circumstances most likely to bring benefits to the siblings.

Use of Complementary and Alternative Medicine in Siblings of Pediatric Cancer Patients in Germany. A Population-Based Survey

Use of complementary and alternative medicine (CAM) in children with cancer is common and probably increasing. However data concerning use of CAM in siblings of children with an oncologic disease are missing so far. We conducted a population-based survey over a one-year period with 233 participants. Of the 209 respondents (90% response rate) 20% reported CAM use from the time on when the sibling was diagnosed to have cancer, compared to a prevalence rate of 48% before cancer diagnosis. The most prevalent therapies were homeopathy, anthroposophic medicine and Bach flowers. The main reasons for use were to strengthen the immune system and to achieve physical stabilization. Socio-demographic factors associated with CAM use were higher parental education and higher family income. A majority of CAM users would recommend them. 66% of the users informed a physician about CAM use. No side effects were reported.Conclusions: There is a significant decrease in CAM use in siblings of pediatric cancer patients after ascertainment of cancer in the affected sibling. Being out of the focus seems to be the main reason for non-use. Nevertheless the 20% CAM users rate CAM as very effective and would recommend CAM use to other parents.

Experiences of siblings of pediatric cancer patients

Experiences of siblings of pediatric cancer patients

The self-reported experiences of siblings who have a brother or sister diagnosed with childhood cancer: a systematic review protocol of qualitative evidence

The self-reported experiences of siblings who have a brother or sister diagnosed with childhood cancer: a systematic review protocol of qualitative evidence

How Siblings of Pediatric Cancer Patients Experience the First Time After Diagnosis

Siblings of pediatric cancer patients have a higher risk of developing emotional, behavioral, and social problems. However, little is known about specific experiences of this population in the first time after diagnosis. The purpose of this qualitative study was to describe the experiences of siblings of pediatric cancer patients in different areas of life in the first half-year after the cancer diagnosis. Semistructured interviews were conducted with 7 siblings of pediatric cancer patients (ages 11-18 years). Siblings were asked about their experiences in the hospital, in school, in their family, with peers, and with the ill child. Content analysis was used to derive important themes from the interviews. Twenty-three categories of siblings' experiences were identified from the data. In all areas of life, siblings reported difficulties, such as absence of parents, dealing with the ill child's or other patients' suffering and appearance, or impaired school achievement. But the siblings also mentioned important resources such as peer relationship, helpful coping strategies, and increased family cohesion. The results of the present study lead to a list of important topics in different areas of life that might be helpful for healthcare professionals to have in mind when meeting with siblings of cancer patients. Integration of these findings should serve to improve sibling support and develop standardized sibling interventions.

A two-session psychological intervention for siblings of pediatric cancer patients: a randomized controlled pilot trial

BackgroundSince siblings of pediatric cancer patients are at risk for emotional, behavioral, and social problems, there is considerable interest in development of early psychological interventions. This paper aimed at evaluating the effectiveness of a two-session psychological intervention for siblings of newly diagnosed pediatric cancer patients.MethodsThirty siblings age 6-17 years were randomly assigned to an intervention group or an active control group with standard psychosocial care. The manualized intervention provided to siblings in the first 2 months after the cancer diagnosis of the ill child included medical information, promotion of coping skills, and a psychoeducational booklet for parents. At 4 to 6 weeks, 4 months, and 7 months after the diagnosis, all siblings and their parents completed measures (from standardized instruments) of social support, quality of life, medical knowledge, posttraumatic stress symptoms, and anxiety.ResultsAt follow-up siblings in the intervention group showed better psychological well-being, had better medical knowledge, and reported receiving social support from more people. However, the intervention had no effects on posttraumatic stress symptoms and anxiety.ConclusionsThe results of this pilot trial suggest that a two-session sibling intervention can improve siblings' adjustment, particularly psychological well-being, in the early stage after a cancer diagnosis.Trial RegistrationClinicalTrials.gov NCT00296907

The Camp Experience for Siblings of Pediatric Cancer Patients

Siblings of pediatric cancer patients experience difficulties coping and adapting to the experience of a cancer diagnosis. A variety of emotional and behavioral changes as well as somatic complaints have been reported. Children describe many negative changes after their sibling is diagnosed with cancer. Many social supports and therapeutic interventions have been proposed for siblings, one of which is a camp experience. The literature has demonstrated that camps have a positive impact and offer siblings of children with cancer a supportive peer environment. Camp encourages discussion with peers and health care providers and facilitates participation in activities that improve knowledge, social confidence, and self-esteem. Nurses can help siblings by recommending camp experiences, volunteering at camps, and adding a camp experiences to existing sibling support programs.

Psychological interventions with siblings of pediatric cancer patients: a systematic review

Siblings of pediatric cancer patients have been shown to be at risk for developing emotional, behavioral, and social problems. There is a need for psychological interventions in this population. Several researchers have previously documented and evaluated their interventions with siblings. This paper aimed at reviewing the existing reports of evaluated psychological interventions with siblings of pediatric cancer patients and at outlining future directions. Research was conducted on several online bibliographic databases. Articles were selected on the basis of predefined criteria. If possible, effect sizes (ES) were calculated. Fourteen studies representing 11 different sibling interventions met criteria for inclusion. One individual intervention, three camps, and seven groups were found. Objectives of interventions concentrated mainly on enhancing siblings' coping and improving their medical knowledge. In terms of outcome measures, most of the studies focused on psychological adjustment variables. Findings showed significant improvements in siblings' depression symptomatology, medical knowledge, and health-related quality of life. Findings were inconsistent with regard to anxiety, behavioral problems, social adjustment, self-esteem, and posttraumatic stress symptoms. Depending on the outcome variables, small to large ES were found. Satisfaction with the intervention was high in both siblings and parents. There is tentative evidence that psychological interventions with siblings of childhood cancer patients can effectively reduce psychological maladjustment and improve medical knowledge about cancer. However, the number of studies is small, and several methodological shortcomings have to be noted. In future, more randomized controlled trials need to be conducted in larger samples to extend the evidence base.

Projective Drawings as Measures of Psychosocial Functioning in Siblings of Pediatric Cancer Patients From the Camp Okizu Study

This research was conducted at a summer camp for siblings of children with cancer. Participants included 77 siblings (ages 6-17 years) and their parents. Before attending camp, 18 of the siblings had experienced the death of their brother or sister with cancer. Projective measures were administered before attending camp and 3 months after camp. These included the Human Figure Drawing (HFD) and the Kinetic Family Drawing-Revised (KFD-R). Siblings were administered both the HFD and KFD-R; parents were given the KFD-R. On the HFD, siblings' emotional distress scores decreased significantly pre- to postcamp. On the KFD-R, nonbereaved siblings and parents showed significant improvement in family environment scores. Bereaved siblings and parents also showed improvement (although nonsignificant). These results support Camp Okizu's effectiveness in increasing siblings' emotional well-being yet underscore the need to implement interventions to address family communication for both bereaved and nonbereaved families.

Siblings of Pediatric Cancer Patients

This study used both quantitative and qualitative methodologies to assess the pediatric health-related quality of life (HRQOL) in siblings (n = 77) of cancer patients attending summer camp. On quantitative measures [Pediatric Quality of Life Inventory (PedsQL) parent and child versions], siblings reported statistically significant improvements in HRQOL from pre-to post-camp. The parent sample, as a whole, did not report a statistically significant improvement in the siblings' HRQOL; however, statistically significant improvements were found when the analysis controlled for the responses of bereaved parents.On the qualitative measures (Sibling Qualitative Interview and Camp Okizu Satisfaction Surveys), both children and parents described the positive impact of camp. Using grounded theory, we identified the major themes and found that the positive emotional and social experiences captured by the quotes were paralleled in the quantitative findings of improved HRQOL in psychosocial domains on the PedsQL.These findings suggest the beneficial effects of camp as a psychological intervention and illustrate the value of integrating quantitative and qualitative methodological approaches in research.

Coping and Family Functioning Predict Longitudinal Psychological Adaptation of Siblings of Childhood Cancer Patients

To assess associations of coping and family functioning with psychosocial adjustment in siblings of pediatric cancer patients at 1, 6, 12, and 24 months after diagnosis. Eighty-three siblings (ages 7-19 years) participated. Effects on anxiety, quality of life, behavioral-emotional problems, and emotional reactions to the illness were investigated. Data-analysis was performed with multilevel mixed modeling. Psychosocial functioning was impaired at 1 month but ameliorated over time. Adjustment problems were associated with high family adaptation and cohesion, older age, and female gender. Lower anxiety, insecurity, loneliness, and illness involvement were related to siblings' ability to remain optimistic. Insecurity and illness involvement were positively related to reliance on the medical specialist and a tendency to seek information about the illness. Siblings of pediatric cancer patients are most affected by the illness in the first months. Children at risk may be identified according to sibling age and gender and according to long-term family adaptation processes and sibling coping abilities.

Camp Okizu: Preliminary Investigation of a Psychological Intervention for Siblings of Pediatric Cancer Patients

This research was conducted at a summer camp for siblings of children with cancer. The camp is designed to address emotional problems, provide peer interaction and validation, and bolster siblings' self-esteem. Standardized measures assessing posttraumatic stress, anxiety, quality of life, and self-esteem were administered to 77 siblings (ages 6-17) prior to attending camp and again 3 months after camp. From pre- to post-camp, the siblings reported statistically significant decreases in symptoms of posttraumatic stress and anxiety, and statistically significant improvements in quality of life and self-esteem. These preliminary findings are encouraging and suggest the value of camp as a psychological intervention and provide a model for other pediatric cancer facilities designing intervention programs for siblings.

Siblings of pediatric cancer patients. Coping, risk factors and psychological health

Elk jaar wordt bij circa vierhonderd kinderen kanker vastgesteld. De psychosociale gevolgen van kanker op de kinderleeftijd worden een steeds belangrijker punt van zorg vanwege de vooruitgang die geboekt wordt in de behandeling van kinderen met kanker. Ook de broers en zussen van een kind met kanker hebben te maken met deze gevolgen.

A Group Intervention for Siblings of Pediatric Cancer Patients

A group intervention to reduce emotional and behavioral problems in siblings of children with cancer was evaluated. Forty-seven siblings aged 6 to 14 years participated in seven groups, with 4 to 9 siblings in each group. Groups consisted of eight weekly two-hour sessions guided by a manual. Four assessments were conducted: two before the intervention and two after the intervention. Children completed self-report measures of anxiety, depression, and behavior; parents reported on siblings' anxiety and behavior. After the intervention, siblings reported significantly reduced symptoms of anxiety and depression, and parents reported significant reductions in siblings' anxiety and behavior problems. An interaction between intervention, age, and gender indicated that adolescent girls had more depressive symptoms than adolescent boys did before the intervention and younger girls did after the intervention. The findings suggest that group intervention benefits siblings of children with cancer, with age and gender influencing this effect.

Quality of life and psychological adaptation in siblings of paediatric cancer patients, 2 years after diagnosis.

Several studies have been conducted on sibling psychosocial adaptation to cancer in a brother or sister, but little is known on how the long-term adaptation of siblings to the illness develops. The concept quality of life has primarily been applied in research on the effects of chronic illness on the affected patient, but has not yet been studied in siblings. To investigate the prevalence of self-reported psychosocial problems in siblings of pediatric cancer patients, 2 years after the onset of the illness. Two Dutch quality of life questionnaires, the TACQOL and the DUCATQOL are used, as well as generic non-health-related measures of emotional and behaviour problems (CBCL-YSR) and anxiety (STAI-C). Participants were 103 siblings aged 7-18 years old. Fifty seven Siblings participated in a prospective and 46 in a retrospective study group. Siblings aged 7-11 report lower overall quality of life than children in the norm group. No differences in mean scores were found on any of the other domains that were investigated. When the prevalence of problems was investigated, however, relatively more siblings compared to normative data had scores in the impaired group based on the 20th percentile norm. A relatively high number of siblings aged 7-11 reported impaired emotional (42%), social (34%) and total quality of life (47%) (DUCATQOL) and physical problems (26%) (TACQOL). Relatively many adolescent siblings (26%) reported significant internalising problems on the CBCL-YSR. Although acute emotional distress reactions seem to have normalised in most siblings as has been suggested in the literature, emotional distress of having a brother or sister with cancer may continue beyond diagnosis for a subgroup of children. Young siblings seem to be affected in their quality of life, whereas a subgroup of adolescent siblings experience clinically relevant internalising problems. The results support the use of quality of life measures for siblings. Predictors of long-term adaptation in siblings need to be investigated.

Preliminary Investigation of a Group Intervention for Siblings of Pediatric Cancer Patients

This manuscript describes the Siblings Coping Together program, a group intervention that addresses emotional and behavior problems of siblings of children with cancer and presents preliminary findings. The program is manualized and consists of 8 weekly 2-hr sessions. Each session focuses on a predetermined theme with specific goals and activities. Seventeen siblings participated in a pre- and post group pilot evaluation. Data were collected from children and parents using standardized instruments, a satisfaction questionnaire, and a group process log completed by therapists. Siblings' reports suggest a trend in the reduction of anxiety and depressive symptoms post intervention, siblings and parents reported satisfaction with the intervention group, and the results of the analysis of the group log illustrated trends in group development. This preliminary study exemplifies key group intervention components for this population and supports the need for further systematic evaluation of the intervention program.

Sibling Adaptation to Childhood Cancer Collaborative Study

Cross-cultural aspects of siblings' adaptation to childhood cancer were examined in two studies as part of a cooperative multi-institutional investigation in Israel and the United States. Study 1 compared the behavioral adaptation of Israeli siblings of patients with childhood cancer with matched clinically referred and normal Israeli children. Study 2 compared the behavioral adaptation of case-matched samples of Israeli and American siblings and assessed the contribution of family relations and parental coping to the siblings' behavioral adjustment. Israeli patients' siblings and normal samples scored significantly lower on the Child Behavior Checklist (CBCL) than the clinically referred sample did, indicating fewer behavior problems, with no differences between the sibling and normal samples. The CBCL scores of the Israeli and American samples did not differ significantly on the Externalizing and Internalizing subscales and the Total Behavior Problem score. Significant correlations were found in both the Israeli and American samples between the parental coping and family relations variables and the CBCL summary scores, indicating that greater internal family support and emotional expressiveness and lower conflict were associated with less behavior disturbance in the sibling. The authors consider cross-cultural and methodologic issues when interpreting similarities and differences among Israeli and American siblings of pediatric cancer patients.

A structured group intervention for siblings of children with cancer

The current study describes the development and evaluation of a structured group intervention for school-aged and adolescent siblings of childhood cancer patients. Twenty-three siblings participated in a six-week program in which parallel groups of younger (ages 7–11) and older (ages 12–17) siblings were conducted. Defined topics were selected from the clinical and research literature and on the basis of a pre-intervention survey, and were addressed at each session. Methods included facilitated group discussion, art therapy techniques, role playing, and informal social interaction. Pre- and postmeasures of cancer-related knowledge, feelings and attitudes towards cancer, and overall mood state were administered. Results indicated statistically and clinically significant improvements in interpersonal problems, intrapsychic preoccupation, disease-related communication, mood, and cancer-related knowledge. Consent and attendance rates, as well as post-intervention satisfaction ratings highlight the subjective need felt by siblings and parents for direct, focused work with this population. Salient issues for siblings of pediatric cancer patients, specific techniques, group dynamics and processes, and staff and parent responses to the intervention program are discussed. The need for replicable, empirically validated interventions for family members of seriously-ill children is emphasized.