TY - JOUR
T1 - Psychosocial functioning and risk factors among siblings of children with cancer
T2 - An updated systematic review
AU - Long, Kristin A.
AU - Lehmann, Vicky
AU - Gerhardt, Cynthia A.
AU - Carpenter, Aubrey L.
AU - Marsland, Anna L.
AU - Alderfer, Melissa A.
N1 - Funding Information: Alex's Lemonade Stand Foundation for Childhood Cancer (Psychosocial Launch Grant, PI: Kristin Long) Funding Information: Funding for this project was provided by Alex's Lemonade Stand Foundation for Childhood Cancer (Psychosocial Launch Grant, PI: Kristin Long). Publisher Copyright: Copyright © 2018 John Wiley & Sons, Ltd. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/6
Y1 - 2018/6
N2 - Objectives: Siblings' psychosocial adjustment to childhood cancer is poorly understood. This systematic review summarizes findings and limitations of the sibling literature since 2008, provides clinical recommendations, and offers future research directions. Method: MEDLINE/Pubmed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO were searched for articles related to siblings, psychosocial functioning, and pediatric cancer. After systematic screening, studies meeting inclusion criteria were rated for scientific merit, and findings were extracted and synthesized. In total, 102 studies were included (63 quantitative, 35 qualitative, 4 mixed-methods). Results: Methodological limitations are common. Mean levels of anxiety, depression, and general adjustment are similar across siblings and comparisons, but symptoms of cancer-related posttraumatic stress are prevalent. School-aged siblings display poorer academic functioning and more absenteeism but similar peer relationships as peers. Quality of life findings are mixed. Adult siblings engage in higher levels of risky health behaviors and may have poorer health outcomes than comparisons. Risk factors for poor sibling adjustment include lower social support, poorer family functioning, lower income, non-White race, and shorter time since diagnosis, but findings are inconsistent. Qualitative themes include siblings' maturity, compassion, and autonomy, but also strong negative emotions, uncertainty, family disruptions, limited parental support, school problems, altered friendships, and unmet needs. Conclusion: Despite methodological limitations, research indicates a strong need for sibling support. Clinical recommendations include identifying at-risk siblings and developing interventions to facilitate family communication and increase siblings' social support, cancer-related knowledge, and treatment involvement. Future longitudinal studies focusing on mechanisms and moderators of siblings' adjustment would inform timing and targets of psychosocial care.
AB - Objectives: Siblings' psychosocial adjustment to childhood cancer is poorly understood. This systematic review summarizes findings and limitations of the sibling literature since 2008, provides clinical recommendations, and offers future research directions. Method: MEDLINE/Pubmed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO were searched for articles related to siblings, psychosocial functioning, and pediatric cancer. After systematic screening, studies meeting inclusion criteria were rated for scientific merit, and findings were extracted and synthesized. In total, 102 studies were included (63 quantitative, 35 qualitative, 4 mixed-methods). Results: Methodological limitations are common. Mean levels of anxiety, depression, and general adjustment are similar across siblings and comparisons, but symptoms of cancer-related posttraumatic stress are prevalent. School-aged siblings display poorer academic functioning and more absenteeism but similar peer relationships as peers. Quality of life findings are mixed. Adult siblings engage in higher levels of risky health behaviors and may have poorer health outcomes than comparisons. Risk factors for poor sibling adjustment include lower social support, poorer family functioning, lower income, non-White race, and shorter time since diagnosis, but findings are inconsistent. Qualitative themes include siblings' maturity, compassion, and autonomy, but also strong negative emotions, uncertainty, family disruptions, limited parental support, school problems, altered friendships, and unmet needs. Conclusion: Despite methodological limitations, research indicates a strong need for sibling support. Clinical recommendations include identifying at-risk siblings and developing interventions to facilitate family communication and increase siblings' social support, cancer-related knowledge, and treatment involvement. Future longitudinal studies focusing on mechanisms and moderators of siblings' adjustment would inform timing and targets of psychosocial care.
KW - family
KW - oncology
KW - pediatric cancer
KW - psychosocial adjustment
KW - sibling
UR - http://www.scopus.com/inward/record.url?scp=85048311447&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/pon.4669
DO - https://doi.org/10.1002/pon.4669
M3 - Review article
C2 - 29441699
SN - 1057-9249
VL - 27
SP - 1467
EP - 1479
JO - Psycho-Oncology
JF - Psycho-Oncology
IS - 6
ER -