This project investigated siblings' perceptions of family disruption when a brother or sister had cystic fibrosis (CF) or asthma. Data were gathered by phone interviews and questionnaires. Phone interviews were conducted with siblings of chronically ill children and employed open-ended questions focusing on the impact of the illness on the sibling and the family unit. Along with the interview, siblings also completed a separate self-esteem measure. Assessments of family functioning and demographic variables were obtained through parental questionnaires. Only the sibling interview data are addressed in this article. Fifteen families from the two illness groups participated. There were 6 male and 9 female respondents, with a mean age of 10.1 years. The average age of the well sibling was slightly older than the average age of the chronically ill child. For siblings of both disease groups, positive outcomes included strengthening some family relationships, achieving more personal independence, and experiencing satisfaction in seeing improvement in the ill child. Negative outcomes included worrying about the brother's or sister's illness, being jealous of the attention paid to the ill child, and the restriction of family events. Appropriate family interventions are suggested, as well as feedback as to the efficacy of phone interviews with school-age children.

Nurses and other healthcare professionals should allow adolescents in the healthcare setting every opportunity to maintain their social networks of friends and family by encouraging visitation, providing social opportunities in the hospital, and emphasizing the importance of attending school when medically able.

There are 2.3-million children infected with HIV worldwide. Medical advances and therapies have increased the life expectancy of HIV-infected children and improved their quality of life. This article reviews the HIV literature over the past 15 years related to children's development including: (1) the effects of HIV on the neurocognitive development of children; (2) the relationship between disease status and developmental functioning in HIV-infected children; and (3) the influence of the environmental context on HIV-infected children's development. As children with HIV continue to live longer, they will become a population of children with special needs. This paper reflects the current evidence of these needs and explores the interventions available to HIV-infected children.

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