Donor-Patient Relationship in Pediatric Bone Marrow Transplantation

Wiley, Frances M.; Lindamood, M. Muriel; Pfefferbaum-Levine, Betty

doi:10.1177/104345428400100304

Cited by 18 publications

(28 citation statements)

References 6 publications

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“…Siblings play a crucial role in identity development, by way of personal exchanges through which they define one another (Bank & Kahn, 1982). Research also highlights the importance of the sibling bond (Packman et al, 1997b;Wiley et al, 1984). The pediatric bone marrow transplantation (BMT) literature has shown that the sibling bond between the patient and sibling donor actually intensifies following BMT (MacLeod et al, 2003;Packman et al, 1997b;Wiley et al, 1984) where one sibling's provision of a life-saving measure for a brother or sister connects them in a unique way.…”

Section: Uniqueness Of Sibling Relationshipsmentioning

confidence: 97%

Sibling Bereavement and Continuing Bonds

et al. 2006

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Historically, from a Freudian and medical model perspective, emotional disengagement from the deceased was seen as essential to the successful adaptation of bereavement. A major shift in the bereavement literature has occurred and it is now generally accepted that despite the permanence of physical separation, the bereaved remains involved and connected to the deceased and can be emotionally sustained through continuing bonds. The majority of literature has focused on adults and on the nature of continuing bonds following the death of a spouse. In this article, the authors demonstrate how the continuing bonds concept applies to the sibling relationship. We describe the unique continued relationship formed by bereaved children and adolescents following a sibling loss, highlight the factors that influence the siblings continuing bonds expressions, and offer clinical interventions. In our view, mental health professionals can play an important role in helping parents encourage activities that may facilitate the creation and maintenance of continuing bonds in their children.

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Section: Uniqueness Of Sibling Relationshipsmentioning

confidence: 97%

Sibling Bereavement and Continuing Bonds

et al. 2006

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“…The donor selection procedure establishes a new relationship between the siblings and affects the entire family system (Wiley et al, 1984). At the time of tissue typing, siblings may compete for the role of donor, causing nondonors to feel excluded.…”

Section: Review Of the Literaturementioning

confidence: 99%

Psychosocial Adjustment of Adolescent Siblings of Hematopoietic Stem Cell Transplant Patients

Packman

Gong

VanZutphen

et al. 2004

J Pediatr Oncol Nurs

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Hematopoietic stem cell transplantation (HSCT) is a widely practiced therapy for many life-threatening childhood disorders. The authors investigated the psychosocial effects of HSCT on siblings of pediatric HSCT patients (n = 44; 21 donors, 23 nondonors, ages 6 to 18 years). Donor siblings reported significantly more anxiety and lower self-esteem than did nondonors. Nondonors showed significantly more school problems. Approximately one third of all siblings reported moderate to severe posttraumatic stress. The study drew on the developmental theory of Erik Erikson and the psychosocial model of posttraumatic stress. As part of the study, the authors used the Measures of Psychosocial Development (MPD), a self-report measure based on Eriksonian constructs. The MPD was used to assess the psychosocial adjustment of 12 siblings who were adolescents (> or =13 years) at the time the study was conducted. In this article, findings are presented from the MPD as well as salient findings from the larger study.

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“…22 Nondonor siblings experience ambivalent feelings of both disappointment and relief, and may express guilt about these feelings of relief. 21 Wiley et al 21 suggested that the relationship between donor and recipient can change towards increased intimacy between the two. Rappaport 23 noted that the success of the transplant depends, in part, on the histocompatibility of donor and recipient; thus, the donor often perceives failure of engraftment as a case of 'my marrow wasn't good enough.'…”

Section: Studies On Siblings Of Pediatric Bmt Patientsmentioning

confidence: 99%

Section: Studies On Siblings Of Pediatric Bmt Patientsmentioning

confidence: 99%

“…21 The donor selection procedure was thought to establish a new relationship between the siblings and affect the entire family system. 21 At the time of tissue typing, siblings may compete for the role of donor, causing nondonors to feel excluded. 22 Nondonor siblings experience ambivalent feelings of both disappointment and relief, and may express guilt about these feelings of relief.…”

Section: Studies On Siblings Of Pediatric Bmt Patientsmentioning

confidence: 99%

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Psychosocial impact of pediatric BMT on siblings

Packman

1999

Bone Marrow Transplant

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Summary:Although bone marrow transplantation (BMT) has become standard therapy for many life-threatening disorders of childhood, there is little research on the psychosocial impact of BMT on siblings of children undergoing BMT. Such siblings face issues common to any family with a chronic illness. However, the psychological impact on the family is intensified because two family members, usually children, are subjected to intrusive medical procedures. Investigators had earlier noted that sibling donors may be at risk for behavioral problems and anxiety, while nondonors may experience ambivalent feelings of disappointment and relief. It was suggested that psychosocial stages of BMT may parallel the medical transplant process, with high levels of stress experienced pre-BMT, during hospitalization, and postdischarge. Our own group has recently conducted more systematic investigations on the psychosocial effects of BMT on donor vs nondonor siblings of surviving pediatric BMT patients. We found that sibling donors showed significantly more anxiety, lower self-esteem, and more adaptive skills in school than nondonors. Nondonors, on the other hand, showed significantly more school problems. One third of the siblings in each group reported a moderate level of post-traumatic stress. Taken together, our research indicates that BMT affects the life of the child at home and at school and that posttraumatic stress symptomatology is a component of the psychological reaction in siblings. The psychosocial adjustment of siblings is a critical area of investigation in BMT populations. Parents need to know that the BMT process affects every member of the family system, and both parents and professionals need to direct more emotional support and attention to siblings. Studies are needed that focus on interventions designed to reduce levels of sibling psychosocial maladjustment. The psychosocial developmental model of posttraumatic stress disorder is a viable theoretical model that may be used to guide future research.

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Donor-Patient Relationship in Pediatric Bone Marrow Transplantation

Cited by 18 publications

References 6 publications

Sibling Bereavement and Continuing Bonds

Sibling Bereavement and Continuing Bonds

Psychosocial Adjustment of Adolescent Siblings of Hematopoietic Stem Cell Transplant Patients

Psychosocial impact of pediatric BMT on siblings

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