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Vallee M, Chevignard M, Boissel A. The impact of childhood acquired brain injury on siblings: a scoping review. Brain Inj 2023; 37:503-516. [PMID: 36915031 DOI: 10.1080/02699052.2023.2184870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE (a) To analyze the extent and nature of research on the impact of childhood acquired brain injury (ABI) on siblings, (b) to synthetize in a descriptive way the results of these studies and propose perspectives of care/support. METHOD A literature search of 3 databases was performed up to August 2022. Studies addressing issues around siblings of children with ABI were included in the scoping review. RESULTS 25 articles were identified and analyzed. Results indicate that there is a paucity of research on this issue. However, interest in the subject has increased over past decades. Despite variable results, the current literature highlights the negative impact of ABI on family functioning and relationships. The trajectory and quality of life of siblings of children with ABI are modified. ABI causes intense and mixed emotions, psychological distress, behavioral difficulties and social stigma. Siblings have varied ways of coping with ABI and express particular needs that must be addressed. CONCLUSION There is a significant impact of childhood ABI on siblings' subsequent life. Existing studies on this subject are few, heterogeneous, and sometimes contradictory. Further studies on this theme therefore appear necessary in order to propose appropriate support for patients' siblings according to their age and situation.
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Affiliation(s)
- Mélodie Vallee
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France.,Laboratoire CRFDP, University of Rouen, Mont Saint Aignan, France
| | - Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France.,Sorbonne Université, Laboratoire d'Imagerie Biomédicale, LIB, Inserm, CNRS, Paris, France.,Sorbonne Université, GRC 24, Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
| | - Anne Boissel
- Laboratoire CRFDP, University of Rouen, Mont Saint Aignan, France
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Martinez B, Pechlivanoglou P, Meng D, Traubici B, Mahood Q, Korczak D, Colasanto M, Mahant S, Orkin J, Cohen E. Clinical Health Outcomes of Siblings of Children with Chronic Conditions: A Systematic Review and Meta-Analysis. J Pediatr 2022; 250:83-92.e8. [PMID: 35810772 DOI: 10.1016/j.jpeds.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/11/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of the study was to assess clinical mental and physical health outcomes of siblings of children with chronic health condition(s) compared with siblings of healthy children or normative data. STUDY DESIGN We searched Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL through August 9, 2021. We included English-language studies that reported clinically diagnosable mental or physical health outcomes among siblings of children (<18 years old) with a chronic health condition, included a comparison group, and used an experimental or observational study design. Two reviewers extracted data and independently assessed risk of bias using the Newcastle Ottawa Scale. RESULTS Of 9899 screened studies, 34 were included; 28 studies reported on mental health, 3 reported on physical health, and 3 reported on mortality. Siblings of children with chronic conditions had greater depression rating scale scores than their comparison groups (standardized mean difference = 0.53; 95% CI = 0.38-0.68; P < .001 [6 studies]), whereas anxiety scores were not substantially increased (standardized mean difference = 0.21; 95% CI = -0.02 to 0.43; P = .07 [7 studies]). The effects for confirmed psychiatric diagnoses (7 studies), mortality (3 studies), or physical health outcomes (3 studies) could not be meta-analyzed given the limited number of studies and between-study heterogeneity. CONCLUSION Siblings of children with chronic health conditions may be at an increased risk of depression. Our findings suggest the need for targeted interventions to support the psychological well-being of siblings of children with chronic health conditions.
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Affiliation(s)
- Benjamin Martinez
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Petros Pechlivanoglou
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Quenby Mahood
- Hospital Library and Archives, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Daphne Korczak
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Marlena Colasanto
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada; Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada
| | - Sanjay Mahant
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Julia Orkin
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Eyal Cohen
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada.
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Abela KM, Casarez RL, Kaplow J, LoBiondo-Wood G. Siblings' experience during pediatric intensive care hospitalization. J Pediatr Nurs 2022; 64:111-118. [PMID: 35287059 DOI: 10.1016/j.pedn.2022.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/21/2021] [Accepted: 02/15/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The impact on children who visit an ill sibling in the pediatric intensive care unit (PICU) is unknown. The aim of this study was to describe the experiences of siblings of acutely critically ill or injured children hospitalized in the PICU. DESIGN AND METHODS A qualitative approach using one-to-one interviews was conducted to gain an understanding of the experience of 9- to 17-year-old children who visited their siblings in the PICU. Thematic analysis was used to develop a description of the experiences of the siblings. FINDINGS Sixteen siblings (mean age, 12.5 years) indicated that visiting their critically ill sister or brother in the PICU can cause negative reactions. The data revealed two major themes within the overall sibling experience-stressors, coping-and nine subthemes. Predominant sibling stressors included pre-illness stressors, the PICU environment, the appearance of the ill child, uncertainty, and parental stress. Siblings coped mainly via distractions, social support, and spirituality and by reflecting on the sibling relationship. Support from friends, family members, and the community was reported to be helpful. CONCLUSIONS Siblings visiting the PICU may experience a broad range of physical, emotional, and social responses. PRACTICE IMPLICATIONS Future research should fully incorporate the sibling perspective when designing interventions to mitigate the potentially distressing effects of PICU visitation on the family.
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Affiliation(s)
- Karla M Abela
- The University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave., Houston, Texas 77030, United States of America.
| | - Rebecca L Casarez
- The University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave., Houston, Texas 77030, United States of America
| | - Julie Kaplow
- The Trauma and Grief Center, Hackett Center for Mental Health, 6901 Bertner Ave., Houston, TX 77030, United States of America
| | - Geri LoBiondo-Wood
- The University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave., Houston, Texas 77030, United States of America
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4
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Shen J, Shi J, Cooper J, Chen C, Taylor HG, Xiang H. A Population-Based Study of the Incidence, Medical Care, and Medical Expenditures for Pediatric Traumatic Brain Injury. J Surg Res 2021; 268:87-96. [PMID: 34298211 DOI: 10.1016/j.jss.2021.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/25/2021] [Accepted: 06/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is one of the leading causes of pediatric trauma morbidity and mortality around the world. However, limited research exists regarding disparities in the incidence of TBI and medical care seeking behaviors and medical expenditures for TBI, particularly using population-based and nationally-representative data. MATERIALS AND METHODS The present study used the Medical Expenditure Panel Survey (MEPS) Panels 9-19 (2004-2015) to provide nationally-representative estimates for the civilian, non-institutionalized U.S. POPULATION We examined differences in TBI incidence and associated medical care seeking behaviors and expenditures in relation to individual and family sociodemographic characteristics. RESULTS From a total of 50,563 children in the MEPS Panels 9-19, we identified 449 children with TBI. For 82% of these children, medical treatment was sought. The estimated annual total expenditure associated with pediatric TBIs nationally was approximately $667 million, with mean expenditures per TBI being $1,532 and family out of pocket expenditures accounting for 8.3% of total expenditures. Race/ethnicity was the only significant factor associated with both medical care seeking behavior and total expenditures. CONCLUSIONS The present study is among the first to compare pediatric TBI-related medical expenditures among different sociodemographic groups in the U.S. Our findings can inform future intervention research and policy-making from the perspectives of both epidemiological and behavioral sciences.
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Affiliation(s)
- Jiabin Shen
- Department of Psychology, University of Massachusetts Lowell, Lowell, MA.
| | - Junxin Shi
- Center for Injury Research and Prevention, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH
| | - Jennifer Cooper
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
| | - Cheng Chen
- Center for Injury Research and Prevention, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH
| | - H Gerry Taylor
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
| | - Henry Xiang
- Center for Injury Research and Prevention, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
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Analytis P, Warren N, Ponsford J. The sibling relationship after acquired brain injury (ABI): perspectives of siblings with ABI and uninjured siblings. Brain Inj 2020; 34:1504-1512. [PMID: 32866049 DOI: 10.1080/02699052.2020.1809708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Primary Objective This study explored the sibling relationship across the lifespan after acquired brain injury (ABI). Research Design A qualitative approach was used to explore the perspectives of siblings with ABI and uninjured siblings. Methods and Procedures Semi-structured interviews with 19 siblings with ABI and 20 uninjured siblings (aged 6-61 years) were analyzed using reflexive thematic analysis. Main Outcomes and Results Four themes were identified: Living with ABI; Being normal siblings; Being part of a family; Experiencing social stigma of ABI. ABI was a traumatic event which differentiated siblings but increased understanding helped accommodate its impact. This impact was experienced within perceptions of typical sibling relationships as involving closeness and conflict. The family context shaped relationships, with parents mediating across the lifespan, while siblings' partners and children contributed to adult sibling relationships. Finally, social stigma led to distance but also protectiveness between siblings. Conclusions The sibling relationship was experienced as a continually evolving source of closeness and conflict within the family context. ABI enhanced preexisting dynamics and created new dynamics, shaped by social attitudes toward ABI. Increased understanding of ABI supported closer relationships, highlighting a need for psychoeducational interventions across the lifespan.
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Affiliation(s)
- Penelope Analytis
- Monash-Epworth Rehabilitation Research Centre, Monash University , Melbourne, Australia.,Turner Institute for Brain and Mental Health, Brain Injury and Rehabilitation Program, School of Psychological Sciences, Monash University , Melbourne, Australia
| | - Narelle Warren
- School of Social Sciences, Faculty of Arts, Monash University , Melbourne, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Monash University , Melbourne, Australia.,Turner Institute for Brain and Mental Health, Brain Injury and Rehabilitation Program, School of Psychological Sciences, Monash University , Melbourne, Australia
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Ownsworth T, Karlsson L. A systematic review of siblings' psychosocial outcomes following traumatic brain injury. Disabil Rehabil 2020; 44:496-508. [PMID: 32478586 DOI: 10.1080/09638288.2020.1769206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To investigate the psychosocial impact of TBI on siblings and to identify the factors associated with their psychosocial functioning.Methods: A systematic search of six databases (CINAHL, Medline, Scopus, PsychINFO, Web of Science and Embase) was conducted from 1980 to May 1st, 2020. Studies involving siblings of a child or adult with TBI that employed validated self-report measures of psychosocial functioning were included. Quality of methodology was appraised by two reviewers.Results: Thirteen articles were identified, reporting on 11 cross-sectional studies. Although there were mixed findings overall, siblings typically reported greater mood symptoms and distress related to family functioning as compared to the norms and control samples. Siblings' psychosocial functioning was comparable to other family members, although they were less likely to be primary caregivers. Having a brother or sister with behavioural problems and low levels of social support were the factors most consistently related to poor psychosocial functioning in siblings.Conclusions: Siblings of individuals with TBI may experience negative changes in psychosocial functioning. They are at greater risk of poor psychosocial functioning when their brother or sister with TBI has behavioural problems and when they perceive low social support. Longitudinal studies on siblings' adjustment trajectory over time and research on support interventions for siblings are recommended.Implications for RehabilitationTraumatic brain injury can have a negative impact on siblings' psychosocial functioning with respect to mood and distress related to family functioning.As siblings experience similar impacts on their psychosocial functioning to other family members, specific focus on their adjustment to role changes may be needed.Siblings with a brother or sister with behavioural problems and those perceiving lower social support may particularly benefit from monitoring and support.
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Affiliation(s)
- Tamara Ownsworth
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, Australia
| | - Lina Karlsson
- School of Applied Psychology, Menzies Health Institute Queensland, Griffith University, Mt Gravatt, Australia
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Necessary Adaptations to CBT with Pediatric Patients. HANDBOOK OF COGNITIVE BEHAVIORAL THERAPY FOR PEDIATRIC MEDICAL CONDITIONS 2019. [DOI: 10.1007/978-3-030-21683-2_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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8
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Tyerman E, Eccles FJR, Gray V, Murray CD. Siblings' experiences of their relationship with a brother or sister with a pediatric acquired brain injury. Disabil Rehabil 2018; 41:2940-2948. [PMID: 29987955 DOI: 10.1080/09638288.2018.1482506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Primary purpose: Child acquired brain injury has significant impact on the family, including siblings. This study aimed to explore siblings' experiences of their relationship with their brother or sister with acquired brain injury in order to make recommendations for health professionals working with this population.Research design: Semi-structured interviews were conducted with five siblings of children with acquired brain injury aged between 9 and 12 years and analyzed using interpretative phenomenological analysis.Results: The analysis resulted in four themes: (i) Coping with "a nightmare that you live"; (ii) Disconnection from family relationships; (iii) My sibling is different but "still the same underneath all this thing"; and (iv) Changing togetherness.Conclusions: The siblings in this study experienced a high level of distress with the near loss of their brother or sister. This was followed by difficulty in adjusting to the physical and psychological changes in their injured sibling and the impact on their sibling role and relationship. The changes were experienced alongside disruption to family relationships. Important clinical implications include the inclusion of siblings in their injured sibling's care and the provision of information and support for this group.Implications for RehabilitationSiblings of children with an acquired brain injury experience significant challenges while trying to adapt to their changing sibling relationship and feelings of disconnection with their family.This study highlights a need to work systemically with families of childhood brain injury and recognize siblings' important role in their family unit and therefore involve them in their brother/sister's care and rehabilitation.This study also highlights a need to support siblings to cope with the trauma and provide information to validate and understand their experience.
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Affiliation(s)
- Emma Tyerman
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Fiona J R Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Victoria Gray
- Psychological Services (Paediatrics), Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Craig D Murray
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Hallion M, Taylor A, Roberts R. Complete mental health in adult siblings of those with a chronic illness or disability. Disabil Rehabil 2016; 40:296-301. [PMID: 27846732 DOI: 10.1080/09638288.2016.1251500] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Sibling relationships have lifelong significance and childhood chronic illness and disability can have considerable impacts on healthy siblings, influencing development into adulthood. Research has not yet assessed well-being in this population using measures of both mental health and mental illness. Thus, this study assessed well-being in a comprehensive manner using the complete mental health (CMH) model. METHOD Participants (N = 144) included both adult siblings of those with chronic illness or disability and adults with healthy siblings. Measures of positive social, psychological and emotional well-being were used to assess mental health and a measure of depression, anxiety, and stress was used to assess mental illness. RESULTS A high proportion of participants, both with and without siblings with a chronic illness or disability, were experiencing symptoms of mental illness, accompanied by high wellbeing. This indicates that many participants fit into the struggling category of the CMH model. DISCUSSION The present research highlights the need for early intervention services to ensure that siblings of those with a chronic illness or disability are well supported in developing strengths, as well as managing difficulties. Results also indicate that targeting students in mental health promotion is important to encourage participation in services. Implications for rehabilitation Siblings of those with a chronic illness or disability need to be included in assessments in order to understand the experience of the family unit. It is important for families and clinicians to be aware of the needs of healthy siblings and encourage them to interact with support services in order to maximise and maintain well-being. Skills-based support could be beneficial, particularly for providing caregivers with strategies to meet the needs of both their child with a chronic illness or disability and their healthy children.
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Affiliation(s)
- Madeleine Hallion
- a School of Psychology , The University of Adelaide , Adelaide , Australia
| | - Amanda Taylor
- a School of Psychology , The University of Adelaide , Adelaide , Australia
| | - Rachel Roberts
- a School of Psychology , The University of Adelaide , Adelaide , Australia
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10
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Gan C, Ballantyne M. Brain injury family intervention for adolescents: A solution-focused approach. NeuroRehabilitation 2016; 38:231-41. [PMID: 27030900 DOI: 10.3233/nre-1601315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Strengths-based approaches are increasingly utilized in health care, but little is known about their practical application in rehabilitation with families after pediatric acquired brain injury (ABI). OBJECTIVE To describe a strengths-based model, Solution-Focused Brief Therapy (SFBT) and its clinical application to family intervention for adolescents with ABI. METHODS A literature review highlights a growing movement towards resilience and strengths-based approaches to family intervention after pediatric ABI. The authors introduce the assumptions, tenets, and clinical application of SFBT, which is a competency-based and resource-based model that focuses on family strengths and successes. A direct comparison is made between the traditional medical model and the solution-focused paradigm. RESULTS Key elements of SFBT are described, including specific strategies, techniques, and its clinical application in the Brain Injury Family Intervention for Adolescents (BIFI-A). The BIFI-A, designed for adolescents with ABI and their families, is a 12-session manualized intervention that encompasses education about ABI, skill building, and emotional support. CONCLUSIONS Given the increased interest for research regarding strengths-based approaches in pediatric rehabilitation, the utilization of SFBT with families of adolescents with ABI warrants further attention and investigation. The BIFI-A, with its underpinnings of SFBT, is a promising new family system intervention that also merits further research.
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Graff C, Mandleco B, Dyches TT, Coverston CR, Roper SO, Freeborn D. Perspectives of adolescent siblings of children with Down syndrome who have multiple health problems. JOURNAL OF FAMILY NURSING 2012; 18:175-199. [PMID: 22415205 DOI: 10.1177/1074840712439797] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Authors of this qualitative descriptive study interviewed 21 adolescent siblings of children with Down syndrome (DS) who also had additional health problems rated as requiring extensive care by parents. Analysis revealed positive/negative aspects of the experience; however, participants emphasized the positive rather than negative experiences and focused more on the fact that the child had DS rather than health problems requiring additional care. Most said they would not change anything about their experience and did not believe the child with DS would ever live independently. They did, however, acknowledge their family was affected by the caregiving needs of the child which often required extra vigilance or specific care depending on the health problem. Information gained can help improve understanding of adolescent sibling perceptions about living with a child with DS who also requires additional care because of ongoing health problems so more appropriate and individualized nursing interventions can be provided.
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Affiliation(s)
- Carol Graff
- Tricity Medical and Urgent Care, Pleasant Grove, UT, USA
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Mealings M, Douglas J. ‘School's a big part of your life …’: Adolescent Perspectives of Their School Participation Following Traumatic Brain Injury. BRAIN IMPAIR 2012. [DOI: 10.1375/brim.11.1.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractSustaining a traumatic brain injury (TBI) as an adolescent has a significant impact on life roles and most notably on that of school participation. In the literature there is a wide range of studies that provide clinicians with information regarding recommendations for assisting students in their return to school. However this information has predominantly been provided from the perspectives of educators and rehabilitation staff. The aim of this preliminary project was to hear the stories of three male adolescent students as they reflected on their own experiences of what it was like to go back to school after sustaining a severe TBI. Using a qualitative research design and in-depth interviews, the students' stories were transcribed and coded using grounded theory principles. Despite persisting communication difficulties, the students were able to provide rich stories indicative of their personal experiences. Three key themes emerged from the interviews: theadolescent student's sense of self, changesthe students noted; andsupportsthe students identified. A tentative model illustrating the relationship between these areas was developed. It is anticipated that this model will assist clinicians and educators to develop a holistic picture of a student's school participation from transition to ongoing school life.
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13
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Fay T, Barker-Collo S. Sibling Behaviours and Relationships Following Mild to Moderate Childhood Traumatic Brain Injury: Preliminary Findings. BRAIN IMPAIR 2012. [DOI: 10.1375/brim.4.2.91.27029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractRecent attention has begun to focus on the impact of childhood traumatic brain injury (TBI) on the family. This study examined the impact of mild to moderate childhood TBI on parental ratings of well and injured siblings' behaviours in relation to well siblings' ratings of the impact of injury and the sibling relationship. Parents of 10 children with TBI and 10 children with orthopaedic injury rated both injured and well siblings' behaviours using the Child Behaviour Checklist (CBCL). Well siblings completed the Sibling Impact Questionnaire (SIQ) and Sibling Relationship Questionnaire (SRQ). Results indicated that children with TBI exhibited significantly more externalising and total behaviours than children with orthopaedic injury, while well siblings of children with TBI exhibited more internalising behaviours than siblings of children with orthopaedic injury. Well siblings' ratings of the impact of the injury and sibling relationship did not differ significantly across groups. The behaviours of well siblings and their ratings of injury impact and sibling relationship are examined in relation to the behaviours of the injured siblings for the two groups. The implications of the findings are examined in terms of the need to involve siblings in the rehabilitation process.
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Vermaes IPR, van Susante AMJ, van Bakel HJA. Psychological functioning of siblings in families of children with chronic health conditions: a meta-analysis. J Pediatr Psychol 2011; 37:166-84. [PMID: 21994420 DOI: 10.1093/jpepsy/jsr081] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this meta-analysis was to provide an up-to-date review of the literature to enhance our understanding of how chronic health conditions (CHCs) affect siblings, both positively and negatively. METHODS PsycINFO and Medline were systematically searched. Inclusion criteria were as follows: (a) peer-reviewed, empirical research report; (b) sample n ≥ 10; and (c) reports statistics on siblings' internalizing problems, externalizing problems, and/or positive self-attributes. RESULTS Overall, there was a significant small negative effect of CHCs on siblings (d(+) = -.10). Siblings of children with CHCs had more internalizing problems (d(+) = .17), more externalizing problems (d(+) = .08), and less positive self-attributes (d(+) = -.09) than comparisons. Older siblings and siblings of children with life-threatening and/or highly intrusive CHCs were more at risk for psychological problems. CONCLUSIONS This study identified several mechanisms through which CHCs affect siblings. Future research should focus on parent-child dynamics and the longitudinal development of positive self-attributes and internalizing problems as well as on identifying what works in services for siblings of children with CHCs.
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Affiliation(s)
- Ignace P R Vermaes
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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15
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Predictors of long-term sibling behavioral outcome and self-esteem following pediatric traumatic brain injury. J Head Trauma Rehabil 2011; 27:413-23. [PMID: 21912276 DOI: 10.1097/htr.0b013e3182274162] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine predictors of self-esteem and behavioral outcome among siblings of children with traumatic brain injury (TBI). DESIGN Cross-sectional. PARTICIPANTS Thirty-nine siblings closest in age to a child who sustained moderate to severe TBI. MEASURES OUTCOME VARIABLES sibling behavior (Child Behavior Checklist-Revised) and self-esteem (The Self-Perception Profile for Children-Global Self-Worth). PREDICTOR VARIABLES social support (The Social Support Scale for Children), knowledge (The Child TBI Knowledge Questionnaire), injured child behavior (Child Behavior Checklist-Revised), injured child adaptive skills (Adaptive Behavior Assessment System II-Practical Component), severity of injury (Glasgow Coma Scale), injured child age at injury, time since injury, family functioning (The Family Adaptability and Cohesion Evaluation Scales II - Cohesion Subscale), and socio economic status. RESULTS Significantly reduced self-esteem, but no evidence of behavioral difficulties, were found in siblings of children who had sustained TBI. Sibling self-esteem did not correlate with any other study variables. Behavioral outcome correlated with: sense of social support, knowledge about TBI and injured child behavior. Nevertheless, simultaneous regression analyses revealed that only knowledge about TBI and sense of social support made significant independent contributions to behavioral outcome. CONCLUSIONS Educating uninjured siblings about TBI and raising awareness of their needs in members of their social support network may be important in facilitating sibling behavioral outcome.
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Sambuco M, Brookes N, Lah S. Paediatric traumatic brain injury: A review of siblings’ outcome. Brain Inj 2009; 22:7-17. [DOI: 10.1080/02699050701822022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Chapter 8 Siblings of Children with Intellectual Disabilities. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s0074-7750(09)37008-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Degeneffe CE, Olney MF. Future Concerns of Adult Siblings of Persons With Traumatic Brain Injury. REHABILITATION COUNSELING BULLETIN 2008. [DOI: 10.1177/0034355207311319] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined future concerns conveyed by adult siblings who provided regular caregiving support to their brothers and sisters with traumatic brain injury (TBI). The authors surveyed a national sample of 280 adult siblings of persons with TBI. Using a constant comparative approach to text analysis, the authors analyzed responses to the question “What are your concerns regarding the future for your sibling with TBI?” Common themes of such concerns were related to the caregiving siblings' roles as future caregivers and their perceptions of the quality of professional care provided to their injured family members. Also, participants endorsed concerns for their injured siblings' independence, recovery, and relationships with family and friends. Clinical, advocacy, and research implications of these findings are discussed.
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Chapter Seven Theoretical and Methodological Issues in Sibling Research. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s0074-7750(08)00007-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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Shudy M, de Almeida ML, Ly S, Landon C, Groft S, Jenkins TL, Nicholson CE. Impact of pediatric critical illness and injury on families: a systematic literature review. Pediatrics 2006; 118 Suppl 3:S203-18. [PMID: 17142557 DOI: 10.1542/peds.2006-0951b] [Citation(s) in RCA: 175] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We sought to inform decision-making for children and families by describing what is known and remains unknown about the impact of childhood critical illness and injury on families. This report also was designed as a tool for research planning and design so that meaningful studies are performed and duplication is avoided. DESIGN After a national scholarship competition and the identification of 3 medical student summer scholars, a literature search was conducted by using the National Library of Medicine and a PubMed keyword search system at the National Institutes of Health. RESULTS A total of 115 reports were reviewed and assigned to the 5 following categories characterizing the impact of pediatric critical illness/injury on families: stressors, needs, specific domains (psychological, physical, social), coping, and interventions. The reports reviewed indicate that pediatric critical illness and injury is stressful for the entire family. The effects on parents, siblings, and marital cohesion were variably described. Needs of family members (eg, rest, nutrition, communication) were identified as being unmet in many studies. Permanent impact on siblings and marital relationships has been considered detrimental, but these conclusions are not adequately quantified in presently available studies. Reviewed reports minimally investigated cultural diversity, effects on fathers versus mothers, siblings, socioeconomic status, and financial burden. Studies were often anecdotal and included small sample sizes. Methodologic limitations were numerous and varied and seriously narrowed the significance of the studies we reviewed. The reports that we evaluated were largely limited to those of English-speaking families, white people, and married mothers. CONCLUSIONS Future research should use more rigorous methods in the measurement of impact of childhood critical illness and injury on families. Families of critically ill and injured children would benefit from the practitioners of pediatric critical care acquiring enhanced knowledge and sensitivity about family communication and dynamics.
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Affiliation(s)
- Marysia Shudy
- University of Minnesota Medical School, Minneapolis, Minnesota, USA.
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Verhaeghe S, Defloor T, Grypdonck M. Stress and coping among families of patients with traumatic brain injury: a review of the literature. J Clin Nurs 2005; 14:1004-12. [PMID: 16102152 DOI: 10.1111/j.1365-2702.2005.01126.x] [Citation(s) in RCA: 184] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This literature review aims to structure the available information on the psychological reactions of family members confronted with traumatic brain injury. The stress-coping theory and the systems theory provide the theoretical framework for this review. METHOD Literature review. RESULTS The level of stress experienced by the family members of patients who have traumatic brain injury is such that professional intervention is appropriate, even after 10-15 years. Not the severity of the injury but the nature of the injuries determines the level of stress. Partners experience more stress than parents. Children have specific difficulties. Young families with little social support, financial, psychiatric and/or medical problems are the most vulnerable. Coping with traumatic brain injury can be described in phases. The better family members can cope with the situation, the better the patient's recovery. There are functional and non-functional coping mechanisms and coping is influenced by such factors as gender, social and professional support and the possibility to have reciprocal communication or an affective relation with the patient. RELEVANCE TO CLINICAL PRACTICE Support from professionals reduces the stress being experienced and encourages people to cope effectively. Conflicts with professional carers should be avoided. Every attempt should be made to develop models of long-term support and care that alleviate sources of burden on relatives. Further research is necessary to develop such models.
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