Children's Perspectives on Living With a Sibling With a Chronic Illness.

ABSTRACT

CONTEXT Clinical guidance emphasizes the importance of considering the whole family when caring for a child with a pediatric chronic illness (PCI). However, there is a lack of research specific to sibling experience. Parental accounts are used in studies to examine family experiences; consequently, the direct voices of siblings are neglected. OBJECTIVE: The meta-synthesis was used to explore the experiences of siblings of children with PCIs to understand their perspectives; in particular, we observed what they feel had influenced their emotional well-being, to target interventions. DATA SOURCES We searched PsychInfo, Cumulative Index to Nursing and Allied Health Literature, PubMed, and Academic Search Complete databases from inception to April 2016. STUDY SELECTION We selected qualitative articles used to examine children's perspectives of living with a sibling with a PCI. Twelve articles were reviewed. DATA EXTRACTION We observed participants' characteristics, qualitative methodology, analysis, and themes. RESULTS: The thematic synthesis identified 2 overarching themes providing new insights. The first theme, "changing relationships," had 2 subthemes "changing family relationships" and "changing relationship to self." The second theme, "managing changes," had 3 subthemes "coping and acceptance," "support from friends, peers, and support groups," and "negative reactions from others." LIMITATIONS: Studies were often descriptive with little explicit qualitative analysis. CONCLUSIONS: The findings are used to outline how changes in family relationships often result in reduced communication and a suppression of healthy siblings' needs. Siblings develop strategies to help them cope with and accept their circumstances, including finding new prosocial ways of meeting their needs in the form of skills and roles they develop.