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Nguyen L, Jack SM, Davis H, Bellefeuille S, Arafeh D, Di Rezze B, Ketelaar M, Gorter JW. "Filling in the gap": A qualitative case study about identity construction of siblings of youth with a neurodisability. J Adolesc 2024. [PMID: 38797961 DOI: 10.1002/jad.12353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION In families of children with a neurodisability, siblings have unique experiences that can shape their identity. There is limited information about the developmental process of how siblings form their identity. This study aims to understand the identity construction of young siblings who have a sibling with a neurodisability. METHODS As part of a patient-oriented research program, we engaged with our Sibling Youth Advisory Council in Canada. In this qualitative case study, data from semi-structured interviews augmented by photo elicitation and graphic elicitation of relational maps were analyzed using reflexive thematic analysis. RESULTS Nineteen sibling participants (median age = 19 years, range = 14-33 years) reflected on the uniqueness of their role during childhood. During adolescence and emerging adulthood, they became closer with their sibling with a neurodisability and increased communication with their parents about how to care for their sibling with a neurodisability. These experiences influenced how they explored and began to reconcile their sibling identity with their professional and social identities. CONCLUSION Siblings of youth with a neurodisability discover their unique identity and require support in this developmental process. Future interventions could evaluate how supports for siblings can have an impact on the positive development of their identity.
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Affiliation(s)
- Linda Nguyen
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Susan M Jack
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Hanae Davis
- Sibling Youth Advisory Council, Hamilton, Ontario, Canada
| | | | - Dana Arafeh
- Sibling Youth Advisory Council, Hamilton, Ontario, Canada
| | - Briano Di Rezze
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Marjolijn Ketelaar
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Jan Willem Gorter
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
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Nguyen L, Jack SM, Davis H, Bellefeuille S, Arafeh D, Di Rezze B, Ketelaar M, Gorter JW. Being a sibling of a youth with a neurodisability: A qualitative study about the roles and responsibilities during the transition to adulthood. Child Care Health Dev 2024; 50:e13241. [PMID: 38445673 DOI: 10.1111/cch.13241] [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: 04/17/2023] [Revised: 12/18/2023] [Accepted: 02/05/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND During the transition to adulthood, a common challenge that youth with a neurodisability may experience is learning how to navigate services in the adult care system. During this transition youth may rely on their families, including siblings, for support. However, delineation of sibling roles and responsibilities during this transition period are unclear. This study aims to identify the roles and responsibilities that siblings perceive to have with their sibling with a neurodisability during the transition to adulthood, and describe the decision-making process of how siblings chose these roles. METHODS In this descriptive qualitative case study, siblings were eligible to participate if they were between 14 to 40 years old, had a sibling between 14 to 21 years with a childhood-onset neurodisability and spoke English. Semi-structured interviews augmented by techniques of photo elicitation and relational maps were conducted. Reflexive thematic analysis was applied to identify sibling roles, as well as the emotional and decision-making process associated with these roles. Our team partnered with siblings with lived experience in all study phases. RESULTS Nineteen participants (median age = 19 years, range = 14 to 33 years) from 16 unique families were interviewed. Six unique roles were described: friend, role model/mentor, protector, advocate, supporter, or caregiver. The emotions that siblings experienced with each role, also known as emotional responsibility, were categorized into levels of low, medium or high. Siblings also described a four-phase decision-making process for their roles: (1) acquiring knowledge; (2) preparing plans; (3) making adjustments; and (4) seeking support. Intrapersonal characteristics, including personal identity, values and experiences, influenced roles assumed by siblings. CONCLUSIONS Siblings identified needing support as they process their decisions and emotional responsibility in their roles when their sibling with a neurodisability is transitioning to adulthood. Resources should be developed or further enhanced to support siblings.
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Affiliation(s)
- Linda Nguyen
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Susan M Jack
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Hanae Davis
- Sibling Youth Advisory Council, Hamilton, Ontario, Canada
| | | | - Dana Arafeh
- Sibling Youth Advisory Council, Hamilton, Ontario, Canada
| | - Briano Di Rezze
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Marjolijn Ketelaar
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Jan Willem Gorter
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Pediatrics, McMaster University and McMaster Children's Hospital, Hamilton, Ontario, Canada
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Killackey T, Soltani S, Noel M, Birnie KA, Choinière M, Pagé MG, Dassieu L, Lacasse A, Lalloo C, Poulin P, Ali S, Baerg K, Battaglia M, Campbell F, Mohabir V, Nishat F, Kelly R, Lund T, Isaac-Bertrand A, Benayon M, Jordan I, Stinson J. "We survived the pandemic together": The impact of the COVID-19 pandemic on Canadian families living with chronic pain. Can J Pain 2023; 7:2157251. [PMID: 36760709 PMCID: PMC9904303 DOI: 10.1080/24740527.2022.2157251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction Pediatric chronic pain is a significant problem in Canada, affecting one in five youth. This study describes the impact of the pandemic on the experiences of Canadian families living with chronic pain through interviews with youth living with chronic pain, parents, and siblings. Methods Employing a qualitative descriptive design, in-depth semistructured interviews were completed with Canadian youth living with pain, as well as parents and siblings. Participants were not required to be related. Interviews were analyzed using a reflexive thematic analysis approach. Results Forty-four interviews were completed with 14 parents, 19 youth with chronic pain, and 11 siblings from across the country. Three key themes were developed: (1) absorbing and shifting: the toll of the pandemic on the family system (e.g., loss of coping mechanisms, shifting roles to respond to the pandemic), (2) social ambiguity and abandonment (e.g., social sacrifice and abandonment by the health care system), and (3) building community resilience: familial adaptation to the pandemic (e.g., family cohesion, confidence, and self-management). Discussion/Conclusions Youth, parents, and siblings reported that the pandemic impacted coping strategies across the family system. These results outline the challenges youth experienced managing their pain and overall health throughout the pandemic and the resilience built within families during this time. Going forward, it would be relevant to examine how racialized and structurally marginalized youth with chronic pain and their families experienced the pandemic. Future research should examine how unexpected benefits of the pandemic (e.g., increased confidence and self-management) may be sustained into the future.
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Affiliation(s)
- Tieghan Killackey
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,CONTACT Tieghan Killackey Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ONM5G 0A4, Canada
| | - Sabine Soltani
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Department of Psychology, Alberta Children’s Hospital, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Kathryn A. Birnie
- Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Manon Choinière
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada,Research Center of the Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - M. Gabrielle Pagé
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada,Research Center of the Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada,Department of Psychology, Université de Montréa, Montreal, Quebec, Canada
| | - Lise Dassieu
- Research Center of the Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada,Department of Biomedical Sciences, Université de Montréal, Montreal, Quebec, Canada
| | - Anaïs Lacasse
- Department of Health Sciences, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Chitra Lalloo
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Patricia Poulin
- Department of Anesthesiology & Pain Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada,Department of Psychology, The Ottawa Hospital, Ottawa, Ontario, Canada,Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Samina Ali
- Departments of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada,Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada,Women and Children’s Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Krista Baerg
- Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada,Department of Pediatrics, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
| | - Marco Battaglia
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Centre for Addiction and Mental Health CYEA programme, Toronto, Ontario, Canada
| | - Fiona Campbell
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada,Department of Anesthesia and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vina Mohabir
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Fareha Nishat
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rachel Kelly
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tatiana Lund
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Ariane Isaac-Bertrand
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,Summer Research Student, Child Health Evaluative Sciences, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Myles Benayon
- Internal Medicine Residency Program, McMaster University, Hamilton, Ontario, Canada
| | | | - Jennifer Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada,Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Programs to Prepare Siblings for Future Roles to Support Their Brother or Sister with a Neurodevelopmental Disability: a Scoping Review. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2023; 10:47-79. [PMID: 36845576 PMCID: PMC9942034 DOI: 10.1007/s40474-023-00272-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2023] [Indexed: 02/23/2023]
Abstract
Purpose of Review To identify and map the characteristics and outcomes of programs designed to prepare siblings for their future roles with their sibling with a neurodevelopmental disability. Recent Findings Existing programs to support siblings of individuals with a neurodevelopmental disability often focus on providing information about neurodevelopmental disabilities, creating a community for siblings to connect with each other, and connecting siblings to resources and services to support them in their roles. Some programs are offered to the whole family with specific sessions for siblings. While these program descriptions are provided in the literature, there is limited understanding about the impacts and outcomes of these programs on siblings of an individual with a neurodevelopmental disability. Summary Fifty-eight articles (published between 1975 and 2020, with > 50% published since 2010) met the inclusion criteria, representing 54 sibling programs from 11 countries. Extracted data represented 1033 (553 females) sibling participants, between 4 and 67 years old. Twenty-seven programs focused on the outcome of knowledge acquisition for the siblings and thirty-one programs focused on the outcome of empowerment for the siblings to teach skills to their sibling with a neurodevelopmental disability. While there is an increasing number of programs for siblings of individuals with a neurodevelopmental disability in the past decade, there is a lack of siblings as co-developers or facilitators. Future research should consider the various roles that siblings can have in programs to address their needs. Supplementary Information The online version contains supplementary material available at 10.1007/s40474-023-00272-w.
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Nguyen L, Jack SM, Di Rezze B, Ketelaar M, Gorter JW. Protocol of the BEST SIBS study: a qualitative case study to investigate the roles and responsibilities of siblings of youth with a neurodisability during health care transition. JOURNAL OF TRANSITION MEDICINE 2021. [DOI: 10.1515/jtm-2021-0004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Children and youth with neurodisabilities may experience different challenges during their transition to adulthood, such as pursuing postsecondary education, finding employment, and navigating a new adult health care system. Families, including siblings, have an important role in the process for when youth with neurodisabilities are transitioning to adulthood. Siblings are in a unique position, where they can have different roles such as a friend, mentor, or caregiver. Siblings can offer various supports to their brother or sister with a neurodisability, but they require knowledge and skills for these different supporting roles. Currently, there are limited programs available for siblings to learn how to support their brother or sister with a neurodisability during transition. A first step to develop these sibling support programs is to understand the experiences of siblings of youth with a neurodisability. The purpose of this report is to describe a protocol of a qualitative case study aimed at examining the experiences of siblings including their roles and responsibilities to their brother or sister with a neurodisability during health care transition.
Methods
An exploratory single case study design will be used. An integrated knowledge translation approach to conducting this study will be used by partnering with the Sibling Youth Advisory Council comprised of siblings who have a brother or sister with a disability throughout all study phases. Participants will include siblings (ages 14–40 years old) with a brother or sister (ages 14–21 years old) with a neurodisability in Ontario, Canada. Semi-structured interviews will be conducted, that will be augmented by photo elicitation and drawings of family tree diagrams. Data will be analyzed using reflexive thematic analysis.
Discussion
Findings from this study will be shared with siblings, families, researchers, and the broader community. It is important to understand the roles and responsibilities that siblings are choosing to have to support their brother or sister with a neurodisability, and how these roles may change over time as their sibling is growing up and transitions to adulthood. Siblings may require knowledge and skills in these roles, and an understanding about siblings’ experiences in certain roles can help to inform the development of a resource to support siblings during health care transition.
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Affiliation(s)
- Linda Nguyen
- School of Rehabilitation Science , Faculty of Health Sciences, McMaster University , Hamilton , Ontario , Canada
- CanChild Centre for Childhood Disability Research , McMaster University , Hamilton , Ontario , Canada
| | - Susan M. Jack
- School of Nursing , Faculty of Health Sciences, McMaster University , Hamilton , Ontario , Canada
- Department of Health Research Methods, Evidence, and Impact , Faculty of Health Sciences, McMaster University , Hamilton , Ontario , Canada
- Offord Centre for Child Studies , Hamilton , Ontario , Canada
| | - Briano Di Rezze
- School of Rehabilitation Science , Faculty of Health Sciences, McMaster University , Hamilton , Ontario , Canada
- CanChild Centre for Childhood Disability Research , McMaster University , Hamilton , Ontario , Canada
| | - Marjolijn Ketelaar
- CanChild Centre for Childhood Disability Research , McMaster University , Hamilton , Ontario , Canada
- Centre of Excellence for Rehabilitation Medicine , University Medical Center Utrecht and De Hoogstraat Rehabilitation , Utrecht , Netherlands
| | - Jan Willem Gorter
- School of Rehabilitation Science , Faculty of Health Sciences, McMaster University , Hamilton , Ontario , Canada
- CanChild Centre for Childhood Disability Research , McMaster University , Hamilton , Ontario , Canada
- Department of Pediatrics , McMaster University and McMaster Children’s Hospital , Hamilton , Ontario , Canada
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