The effects of childhood cancer on siblings

When a child is diagnosed with cancer, it is usually devastating for the entire family. Childhood cancer creates an enormous amount of stress that can result in a variety of family problems and negative outcomes for each family member. The family typically faces role changes and financial burdens. For example, parents spend less time at home that subsequently leads to less family time together (Byrne, 1994). Although numerous prior studies have focused on describing the impact of this disease on the affected child and his or her parents (Van Dongen-Melman, De Groot, Hahlen, & Verhulst, 1995), far less research has attempted to identify the effects of childhood cancer on siblings.     

Stress and coping in siblings of childhood cancer patients

The purpose of this study was to identify and describe cognitive and behavioral coping strategies used by siblings of pediatric oncology patients. Fifteen families with 26 siblings between 7 and 11 years of age were studied. Parent data were obtained from an open-ended interview and a questionnaire. Sibling data included open-ended interviews using psychosocial assessments through puppet play, kinetic family drawings, cartoon story telling, a sentence completion test, and a limited number of direct questions. Content analysis of sibling data revealed major stressor themes of loss, fear of death, and change. Further analysis of sibling data pertinent to coping efforts led to the development of a taxonomy of cognitive and behavioral coping efforts.     

Impact of childhood cancer on Korean families

A health care system that includes institutions such as the home, clinic, or hospital as well as interpersonal relationships between providers and receivers of health care is a part of any culture. Clinical issues are a part of all cultures, and cross-cultural comparisons are useful in understanding health care. With immigration and travel, a better understanding of the situation of families who have a child with cancer in various countries, different health care systems, and different cultures is needed. Understanding the situation for families with a child who has cancer in South Korea will lead one to a better understanding of a Korean family who has immigrated to the west and has a child develop cancer or is in need of treatment.     

Mental health-care utilization in survivors of childhood cancer and siblings: the Swiss childhood cancer survivor study

Purpose

We aimed to (1) describe the utilization of mental health-care in survivors and siblings, the association with severity of distress, and visits to other professionals in distressed survivors not utilizing mental health-care; and (2) identify factors associated with utilization of mental health-care in distressed survivors.

Methods

Within the Swiss Childhood Cancer Survivor Study, we sent postal questionnaires to all participants aged <16 years at diagnosis (1976–2003), who survived ≥5 years after diagnosis and were aged ≥16 years at study. Survivors and siblings could indicate if they utilized mental health-care in the past year. Psychological distress was assessed with the Brief Symptom Inventory-18 (BSI-18). Participants with scores T?≥?57 on two of three scales or the Global Severity Index were considered distressed.

Results

We included 1,602 survivors and 703 siblings. Overall, 160 (10 %) and 53 (8 %), utilized mental health-care and 203 (14 %) and 127 (14 %) were considered distressed. Among these, 69 (34 %) survivors and 20 (24 %) siblings had utilized mental health-care. Participants with higher distress were more likely to utilize mental health-care. Distressed survivors not utilizing mental health-care were more likely to see a medical specialist than nondistressed. In the multivariable regression, factors associated with utilizing mental health-care were higher psychological distress and reporting late effects.

Conclusions

Our results underline the importance of developing interventional programs and implementing psychological screening in follow-up of survivors. It is also important to systematically address siblings' needs. In follow-up, patients at risk should be informed about existing possibilities or advised to visit mental health professionals.     

Impact of childhood cancer on family care in Taiwan

Based on the results of a study on 75 families of children with cancer in Taiwan, the author, with assistance from nurses, physicians and the Chinese community, initiated the development of a Childhood Cancer Foundation. The author summarizes the study, the outcome of the study, and recommends several readings for nurses working with Chinese families.     

Predicting school-age behavior problems: the role of early childhood risk factors

PURPOSE: To examine the impact of early childhood risk factors on school-age child behavior. Identifying the relationships of risk factors in early childhood contributing to behavior problems in school age-children can effectively target interventions during pediatric primary care encounters. METHODS: An 8-year longitudinal, retrospective secondary analysis using a sample of children (N = 721) from the National Longitudinal Survey of Youth 1979 (NLSY79). RESULTS: A logistic regression model prediction was significant (R2 = 0.62, p < .001) though modest with overall behavior problems predicted at 62.5% with sensitivity problems. Adjusted odds ratios indicate a young boy with a difficult temperament was two times more likely to have behavior problems at school age. The same boy with a less able mother was eight times more likely to have problem behavior at school age. IMPLICATIONS FOR PRACTICE: There are significant risk factors in early childhood that predict school-age behavior problems even in a non-clinical sample. All families deserve ongoing behavioral screening and assessment.     

Self-concept of siblings of children with cancer

Childhood cancer can have detrimental effects on the psychosocial well-being of healthy siblings of children with cancer. The limited research done over the past 40 years has identified adjustment difficulties such as poor self-concept, depression, sorrow, anxiety, and feelings of loneliness in children who have a sibling with cancer. To date, clinical research investigating self-concept is scarce as it relates to siblings of children with cancer. The purpose of this study was to examine self-concept in siblings of children with cancer who attended summer camp. A nonprobability purposive sample consisted of 50 school-age siblings of children with cancer. Using the Personal Attribute Inventory for Children (PAIC) to measure children's self-concept, the researcher found that healthy siblings who attended summer camp scored higher on the PAIC than healthy siblings who did not attend camp. This research suggests that social support such as a camp experience may play an important function in coping with having a brother or sister with childhood cancer.     

Cognitive development in children with migraine and their healthy unaffected siblings

The discussion about neuropsychological sequalae from migraine occurring in adults is controversial. The purpose of our study was to examine whether children with migraine may be at risk for impaired intellectual development compared with their siblings free of migraine.     

Childhood cancer: siblings draw and tell

There is a growing awareness among health care professionals that the psychosocial needs of siblings of children with cancer are less adequately met than those of other family members. As part of a larger research study of 17 families of children with cancer, 20 healthy siblings, ages 3-11 years (7 males, 13 females), were tested using the Kinetic Family Drawing-Revised (Spinetta, McLaren, Fox, & Sparta, 1981) in one of two oncology clinics in a Southwestern state. Nine of the subjects participated in a sibling day. Data from the drawings and discussions with siblings confirm previous sibling research findings and reflect current social changes.     

A review of qualitative research on the childhood cancer experience from the perspective of siblings: a need to give them a voice.

Researchers are increasingly adopting the qualitative research paradigm to study the world of siblings of children with cancer. The purpose of this review article is to identify the contributions of qualitative research in advancing the understanding of the childhood cancer experience from the perspective of siblings. Articles were selected for inclusion if (1) written in English; (2) published in a peer-reviewed journal between 1979 and present or, if a doctoral dissertation, easily accessible to the authors; (4) cited a specific qualitative research design or some type of qualitative research method of data collection and analysis; and (4) involved siblings of children with cancer as sole research participants or as research participants within the context of the family. Twenty-seven qualitative research studies were reviewed. Three themes emerged from an analysis of the primary findings: (1) changing lives, (2) intense feelings, and (3) unmet needs. Limitations in the conceptualization, research design, and research methods of the qualitative studies are discussed. Suggestions that will help researchers in conducting qualitative research with siblings are also presented.     

Reference range of thyroid hormones in healthy school-age children: Country-wide data from India

ObjectiveThis study was planned to obtain normative data of thyroid functions in school-age children from different regions of India.Design and methodsStudents from 36 schools involving 13 states across four geographical zones of India were evaluated for goiter. Subjects who consented, underwent evaluation for serum FT3, FT4, TSH, anti-TPO antibodies and thyroid ultrasound. From this, a “reference population” was obtained by excluding those with personal or family history of thyroid disease, use of thyroid medications, goiter, hypoechogenicity or nodularity on ultrasound or positive anti-thyroid antibodies.ResultsOf 24,685 students clinically evaluated, 8665 formed part of the study. The reference population comprised 5343 subjects. The mean, median, 3rd and 97th percentiles of FT3, FT4 and TSH for each year (6–17 years) were obtained.ConclusionsThis community based study in Indian school-age children provides reference intervals for thyroid hormones and evidence against narrowing the TSH reference range.