Psychosocial adjustment of siblings of children with cancer: a systematic review.

Abstract:

OBJECTIVES:To promote a broader understanding of the psychosocial impact of childhood cancer on siblings, a systematic review was undertaken. Directions for future research are proposed and clinical strategies are suggested for addressing the needs of these children. METHODS:Searches of Medline, PsycINFO and CINAHL revealed 65 relevant qualitative, quantitative, or mixed methods' papers published between 1997 and 2008. These papers were rated for scientific merit and findings were extracted for summary. RESULTS:Siblings of children with cancer do not experience elevated mean rates of psychiatric disorders, but a significant subset experiences post-traumatic stress symptoms, negative emotional reactions (e.g. shock, fear, worry, sadness, helplessness, anger, and guilt), and poor quality of life in emotional, family, and social domains. In general, distress is greater closer to time of diagnosis. School difficulties are also evident within 2 years of diagnosis. Qualitative studies reveal family-level themes such as loss of attention and status as well as positive outcomes including increased sibling maturity and empathy. CONCLUSIONS:Research regarding siblings of children with cancer continues to be methodologically limited. The conclusions of qualitative and quantitative studies differ considerably. We propose a research agenda to propel this field forward including greater attention to alterations in normative development (as opposed to psychiatric conditions), development of more appropriate quantitative measures, examination of potential moderators of adaptation, and use of prospective longitudinal designs. Siblings of children with cancer are a psychosocially at-risk group and should be provided with appropriate supportive services.

journal_name

Psychooncology

journal_title

Psycho-oncology

authors

Alderfer MA,Long KA,Lown EA,Marsland AL,Ostrowski NL,Hock JM,Ewing LJ

doi

10.1002/pon.1638

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

789-805

issue

8

eissn

1057-9249

issn

1099-1611

journal_volume

19

pub_type

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