The siblings of childhood cancer patients need early support: a follow up study over the first year

Abstract

Background and methods:In a 1 year follow up study, we assessed the life situation of 33 siblings of childhood cancer patients and 357 healthy controls. The hypothesis was that siblings have more behavioural and health related problems just after the cancer diagnosis. Validated assessment methods were used. Results: Siblings below school age tended to have conduct problems, psychosomatic problems, and a mixed group of other behavioural problems, when assessed 3 months after the cancer diagnosis. These symptoms became less evident during follow up. Among the school aged siblings, however, conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive symptoms, and other behavioural symptoms remained unchanged during follow up. In their self assessments, the school aged siblings showed both state and trait anxiety more often than controls at the first assessment, but later these symptoms settled to the same level as the controls. The overall Children's Depression Inventory (CDI) depression scores did not show differences between the study groups. Conclusions: The ratings of the parents were in keeping with the self assessment of the school aged siblings only in a few aspects; the emphasis of findings can be changed when proxies are used. The siblings have symptoms and adverse feelings which probably could be relieved by targeted, early information about the illness, and possibly by group discussions or activities, soon after the cancer diagnosis. In order to obtain necessary support for the siblings with educational problems, school personnel need to be informed about the sibling distress.

The effects of chronic renal failure on siblings

“…Rehabilitation and support courses run for families with a child with cancer have reported a beneficial effect on parental adaptation and family cohesion with better adaptation of siblings [24,25]. A recent study in siblings of cancer patients has again emphasised the value of targeted, early information about the chronic illness and the value of educational support with school personnel being informed [26]. Our own strategy has been to involve schoolteachers within the renal unit to actively liase with the patient's school and with families in the clinic [27,28].…”

Life balance in adult healthy siblings of individuals with childhood cancer.

“…Houtzager et al (2003Houtzager et al ( , 2004 found age-specific reactions to cancer, which suggests age of the sibling also influences healthy sibling outcomes. The time since diagnosis also influences healthy sibling outcomes (Alderfer et al, 2003;Hamama et al, 2000;Houtzager et al, 2003;Houtzager et al, 2004;Lähteenmäki et al, 2004). In addition to the healthy sibling's age and gender, Van Dongen-Melman et al (1995) found that the sibling's age at diagnosis also influenced healthy sibling outcomes.…”

“…French et al (2013) found that healthy siblings between 4 and 17 years from initial diagnosis missed significantly more days of school than their peers. Lähteenmäki et al (2004) found that 3 months and 1 year after diagnosis, school-aged healthy siblings exhibited more learning problems than their peers.…”

“…Labay and Walco (2004) found no relationship between time since diagnosis and behavioral problems. The studies above suggest that psychological difficulties are more likely to be found within the first 2 years after the initial cancer diagnosis, but more research is needed (Alderfer et al, 2003;Houtzager et al, 2003;Houtzager et al, 2004;Lähteenmäki, Sjöblom, Korhonen, & Salmi, 2004).…”

“…Several researchers have found that the time since the cancer diagnosis influences healthy sibling outcomes (Alderfer et al, 2003;Hamama et al, 2000;Houtzager et al, 2003Houtzager et al, , 2004Lähteenmäki et al, 2004). In particular, the more time that has passed since the sibling's diagnosis, the better the outcomes for the healthy sibling tend to be.…”