Family consequences of potentially traumatic pediatric medical events: Implications for trauma-informed care.

Abstract

Extensive research demonstrates that pediatric medical events can be traumatic for patients, caregivers, and siblings, but the aftereffects of these potentially traumatic events for the family and its members are not well documented. Through focus groups with patients, caregivers, and siblings, this qualitative study examined the perceived consequences of potentially traumatic medical events for individual family members and the family as a whole. Sixteen focus groups (6 caregiver, 5 patient, 5 sibling) were conducted. Participants included 44 caregivers, 24 patients, and 14 siblings from 28 families with children treated in cardiology, endocrinology, oncology, orthopedics, or pulmonology. Constantcomparison and directed-content analysis were used to analyze the resulting data. Six themes regarding the family consequences of potentially traumatic medical events emerged: (a) family members experience strong emotional reactions and distressing thoughts, (b) family members experience trauma-related reactions and behaviors, (c) family patterns and routines change, (d) family conflict arises, (e) family members feel different from their peers and strive for normalcy, and (f) family members construct positive narratives about these events and experience positive consequences and emotions. These findings reveal the consequences of potentially traumatic medical events that extend beyond traumatic stress symptoms. Moreover, the impact of these consequences is seen within both individual family member responses and responses within the family system as a whole. Understanding both individualand family-level consequences of medical events is important in order to provide family-centered, trauma-informed care for children with illness or injury and their family members.

Sibling Adjustment to Childhood Chronic Illness: An Integrative Review

“…HS experienced deviations from their normal routine in a variety of aspects of life. Almost all HS gained more independence and responsibility leading to an increase in maturity (Brennan et al, 2013; Christofferson et al, 2020; Gorodzinsky et al, 2013; Hollidge, 2000; Williams et al, 2009; Woodgate et al, 2016) which many siblings perceived as a contribution to the ill child’s recovery (Long et al, 2015). HS were expected to help, and appreciated being involved in providing care for the ill child (Plumridge et al, 2011; Prchal & Landolt, 2012; Wennick & Huus, 2012).…”

“…Strong and overwhelming negative emotions arose from having a sibling diagnosed with a chronic illness, including sadness, anger, embarrassment, guilt, self-blame, helplessness, and loneliness (Bursnall et al, 2018; D’Urso et al, 2017; Ejerkov et al, 2015; Kroner et al, 2018; Lobato et al, 2005; Nabors & Liddle, 2017; Plumridge et al, 2011; Prchal & Landolt, 2012; Velleman et al, 2016; Williams et al, 2009). Fear, shock, and worry (Christofferson et al, 2020; Nabors et al, 2019) were experienced when limited information was received from family and health care professionals about the diagnosis (D’Urso et al, 2017). HS also experienced loss of belonging and security due to the feeling of vulnerability (Bursnall et al, 2018; Long et al, 2015).…”

“…Fathers provided continuity and sense of normality at home, while mothers typically accompanied the hospitalized child (D’Urso et al, 2017). Time spent with family decreased when siblings’ brother or sister was diagnosed with chronic illness as parents and siblings reported more parental attention was paid toward the ill child (Christofferson et al, 2020; Kroner et al, 2018; Long et al, 2015; Velleman et al, 2016; Wennick & Huus, 2012; Woodgate et al, 2016). Less attention led siblings to feel isolated and rejected by the family system as difficulties in inclusion and normalcy arose.…”

“…Less attention led siblings to feel isolated and rejected by the family system as difficulties in inclusion and normalcy arose. Parents felt an inability to promote positive sibling adjustment (Branstetter et al, 2008; Bursnall et al, 2018; Long et al, 2015, 2017) Despite such hardships, resilience arose as HS had greater appreciation for the opportunity to spend time with family and experienced greater closeness and a stronger bond between family members during that time (Christofferson et al, 2020; D’Urso et al, 2017; Hagstrom & Toft, 2019; Long et al, 2015; Prchal & Landolt, 2012; Williams et al, 2009, 2010)…”

Impact of Social Distancing on the Mental Health of Parents and Children in Qatar

“…Family members who have lost loved ones due to the pandemic often experience intense feelings of anger and resentment (Goyal et al, 2020) and may feel shame, guilt, or stigma related to family members who are infected or in quarantine (Brooks et al, 2020). A study reported post-traumatic stress disorder and depression among family members, as well as a breakdown in inter-family communication (Christofferson et al, 2020). Another study showed that children who were isolated or whose parents were isolated during the epidemic had a higher chance of developing acute stress disorder, coping disorders, and grief (Shah et al, 2020).…”