Siblings of children with cancer : opening the opportunities for participation



Chung, Joanna Y. Y.

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University of Guelph


Psychological adjustment of siblings of children with cancer is not well understood. Faced with paediatric cancer, all family members are affected by changes in routines and relationships due to the demands of the illness and treatment regimens. Quantitative and qualitative research methods were used to examine the following: psychological adjustment of siblings; congruency between parent and sibling reports of sibling adjustment; the role of siblings' perceptions of communication, relationships, global self-worth in their psychological adjustment; and evaluation of the Siblings Coping Together program (Barrera, Greenberg, & Booth, 1996). Forty siblings and one parent per family participated in this study. Twenty-five siblings and parents completed pre- and post-assessment measures for program evaluation. Ten siblings and eleven parents completed a semi-structured interview. Of the 40 siblings, 10% identified themselves as having emotional/internalising difficulties (anxiety, depression), 2.5% as having low global self-worth, and 2.5% as having externalising behaviour difficulties. Parents identified 15% as experiencing significant internalising behavioural difficulties. Compared to an Ontario normative sample of siblings (Cadman, Boyle, & Offord, 1992), these siblings were at increased risk for adjustment difficulties. A low level of congruity was found between parent and sibling ratings of sibling psychological adjustment, emphasising the importance of using both sibling and parent reports for research and clinical purposes. Siblings with lower global self-worth scores were at risk for increased depressive symptoms. Being female and having negative appraisals of interpersonal relations were associated with greater depressive symptoms in siblings. Pre- and post-group assessments showed significant decreases in sibling reported depressive symptoms, intrapersonal difficulties, parent reported sibling state anxiety, and an increase in parent reported sibling fear of disease. Positive findings were supported by qualitative themes: siblings found a legitimate place in the treatment process; increased communication between siblings and parents; increased sibling understanding of cancer, its treatment and its effects; and improved sibling mood and behaviour. The combined findings suggest that siblings of children with cancer are at an increased risk of developing psychological adjustment difficulties, and psychological group intervention programs facilitate improved psychological adjustment, and increased illness-related participation and communication, which might benefit siblings and their families.



psychological adjustment, siblings, children, cancer, paediatric cancer