Outcomes of a nursing intervention for siblings of chronically ill children: a pilot study. Supportive groups for siblings of pediatric oncology patients: impact on anxiety. Evaluation of a camp program for siblings of children with cancer. The effects of group therapy on siblings of pediatric oncology patients.
To evaluate the outcomes of a structured, educational, and support group intervention (ISEE, Intervention for Siblings: Experience Enhancement) for siblings of children with chronic illness (cancer, cystic fibrosis, diabetes, and spina bifida), including a session with parents about sibling needs; and to describe sibling and parent perceptions of sibling experiences at home.
                One-group, pretest-posttest pilot study.
                A convenience sample of 22 siblings and parents.
                A Midwestern university medical center.
                Knowledge of Illness Test, parent ratings on a global, single item, 10-point scale.
                Sibling test scores increased significantly after intervention, compared to baseline. Parents' average evaluation rating was 9 on a 10-point scale. Parents supported their positive ratings with verbatim descriptions. Sibling and parent perceptions of sibling experiences were congruent, suggesting the sources of potential adjustment problems in siblings, and were consistent with the literature.
                A randomized, clinical trial with a larger sample size is needed to evaluate the intervention further. Childhood cancer can have a substantial emotional impact on the siblings of the sick child. In order to help these siblings adjust to the illness, supportive groups were started in 1994 at our medical center. The program is based on a model of psychosocial support; the aim of the group is to enhance control strategies and, thus, to reduce anxiety. It consists of five sessions and is offered to siblings aged 7-18. The study objective is to evaluate the effect of group participation on sibling anxiety. The State Trait Anxiety Inventory for Children was administered to 24 siblings before and after group participation. Results showed that siblings experience less anxiety after participating in the group. Before group participation, a majority of the siblings were more anxious compared with normal peers. The sibling's age and sex, whether the ill child is in treatment, survival perspective, and time since diagnosis were not related to anxiety reduction. The continuation of the group is supported by its positive impact on siblings. Results must nevertheless be interpreted cautiously, considering the small number of siblings participating in the study, the lack of a control group and the restriction to one outcome measure.
                Copyright 2001 John Wiley & Sons, Ltd. In recent years, specialized camping programs for chronically ill children, members of their family, or both have proliferated. Although these programs are popular, little systematic evaluation of risk-benefit has been undertaken. In a naturalistic study we evaluated the effect of a 5-day residential camping program to determine the effect of the program on the level of medical knowledge, on the perceptions of how the cancer experience affected the individual, and on the participant's mood state. Analysis of questionnaire data from 90 campers before and after their participation in the program revealed that desirable changes occurred in each of these areas and were sustained for at least 3 months after the program. Siblings reported by parents to have behavioral problems with onset since the diagnosis of the cancer seemed to benefit particularly from this type of program. No substantial negative effects were found regardless of the camper age, adaptational status, or previous camp experience. The stress and psychological difficulties of siblings of children with cancer is well documented. Siblings must cope with a myriad of emotions, isolation from the family, and many changes in daily life. Therefore, a need exists to determine the effects of psychosocial interventions on siblings of cancer patients. The support group is one psychosocial intervention that has been suggested as a method to relieve stress and enhance coping. A quasi-experimental design was selected to determine the effects of participation in a support group on the social adjustment of siblings of children with cancer. Conclusions suggest that a support group provides siblings with the opportunity to decrease their sense of isolation, ventilate negative feelings, and learn from each other. Additionally, descriptive data suggest a need for ongoing follow-up with siblings to help them manage the stresses emerging from the impact of the diagnosis and treatment on the family. Implications of this study suggest that nurses should organize support groups for siblings and/or refer them to existing groups. Also, this study suggests the need to work with siblings and educate parents regarding sibling concerns.
Different methods of communicating with children and adolescents about a family member's cancer have not been widely evaluated in controlled trials. There is weak evidence to suggest that some interventions, such as structured group interventions, may lead to improvements in knowledge and understanding, in coping, anxiety, adjustment and wellbeing. More research is needed to investigate the comparative value of these interventions.