Adaption strategies used by siblings to childhood cancer patients

Abstract

Objective Siblings of childhood cancer patients experience social challenges. The results presented in this article are part of a larger qualitative study aiming to generate empirical knowledge about social consequences of childhood cancer from the family's perspective. Methods Data were collected through interviews, observational studies, and questionnaires. The study included 68 childhood cancer patients, 39 siblings, and 39 parents from a total of 78 families. Grounded theory informed the data analysis. Results Major life changes caused by childhood cancer entail an emotional hierarchy regarding the accommodation of each family member's need for help. This study identified a dynamic three‐variable, four‐adaption model for adaption strategies among siblings towards their parents, based on the sibling's perspective: (1) receives help without asking; (2) receives help after asking; (3) receives no help despite asking; and (4) receives no help and does not ask. Three variables are elaborative to understand the dynamic in adaption strategies: the patient's prognosis, the course of the disease, and the current situation of the diagnosed child. Even though the adaptions are reported by siblings, both patients and parents are aware of and concerned about the siblings' challenges. Conclusions These results have implications for practice and have the potential to improve social and health care professionals' awareness and ability to offer support and information needed by the families and the siblings. The knowledge presented in this article should be considered basic health care information in line with other information such as treatment protocols.

Social support and siblings of children with cancer: A scoping review

“…All of the qualitative studies in this review included at least one theme in the results that reflected some change in social support (e.g., the availability of parents, changes in friendships, reduced instrumental support, or lack of information regarding the diagnosed child). Of these, 10 aimed to understand the experience of cancer 13,26,41,42,53–58 . Results of these studies demonstrate many common challenges for siblings, including changes in social support.…”

“…Siblings experienced low levels of emotional support resulting in emotional strain related to fear, jealousy, and worry about parents and their sibling with cancer 13,26,41,54,56,58 . This was often compounded by receiving little informational support about their sibling's diagnosis and treatment and becoming particularly troublesome when confronted by questions from peers 26,53,57 . Siblings noted less companionship and time with friends 13,26,53,55 .…”

“…Of these, 10 aimed to understand the experience of cancer. 13,26,41,42,[53][54][55][56][57][58] Results of these studies demonstrate many common challenges for siblings, including changes in social support.…”

“…13,26,41,54,56,58 This was often compounded by receiving little informational support about their sibling's diagnosis and treatment and becoming particularly troublesome when confronted by questions from peers. 26,53,57 Siblings noted less companionship and time with friends. 13,26,53,55 However, these changes in social support were not permanent, and three studies identified reports of improved support and family relationships upon the completion of cancer treatments.…”

“…36 The family environment, specifically perceived low-levels of attention from parents, has been associated with higher rates of unmet support needs among siblings. 51 Two studies 37,57 found that a lack of awareness from parents regarding sibling needs impacted siblings' ability to have their needs met. Both found that when siblings perceive that parents are overwhelmed, they are less likely to ask for the support they need and put other family members' needs before their own.…”