Blog PedPalASCNET

This blog features expert commentaries on recent publications of interest in pediatric palliative care research. Our bloggers provide their personal take on an article chosen from our monthly citation list and discuss how it relates to trends within the field. To view our search strategy, click here.

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Trends in Pediatric Palliative Care 2016; Issue #10

November 4, 2016

Gail Andrews

Feature Article: Stephenson, E., DeLongis, A., Steele, R., Cadell, S., Andrews, G. S., & Siden, H. (2016). Siblings of Children With a Complex Chronic Health Condition: Maternal Posttraumatic Growth as a Predictor of Changes in Child Behavior Problems. Journal of Pediatric Psychology

Health in siblings of seriously ill children has been a long term interest of our group of researchers and clinicians. Our work with dying children focuses mostly on the sick child and their parents. We know that healthy siblings of chronically sick children struggle to maintain normal psychological functioning like their peers. It is important to understand what siblings experience when their brother or sister has a life-threatening illness.

This article was written using data from our Charting the Territory study with 258 families of children with life-threatening conditions in Canada and the US. Early data analysis showed that when reporting problem behaviours for their healthy children (siblings to sick children), parents reported more internalizing issues (e.g. anxiety and withdrawing) than normal for these children at baseline. These problem behaviours normalized for the most part over time. There were no significant differences between boys and girls on behaviour problem scores demonstrated in our early data analysis.

What our lead author Ellen Stephenson adds in this article is a fascinating look at how mothers can influence the behaviour of healthy siblings. In her analysis, Ellen and our psychosocial research team explore whether mothers who report post-traumatic growth have children with less behaviour problems.

Post-traumatic growth is experienced as an adjustment or change in the face of adversity. Through our research we have learned that growth is not due to an absence of trauma or difficulty, but rather to the new growth and resilience that comes from surviving hard times. It is the nature of caregiving that having a chronically sick child is difficult. Interestingly, however, mothers who experience post-traumatic growth while caring for a sick child are able to pass some of the benefits on to their sick child’s healthy siblings.

What is super interesting about our findings is that the siblings themselves report a decrease in problem behaviours when their mothers report higher scores in the ‘relationships with others’ domain of post-traumatic growth. This confirms that on at least some level, the healthy siblings noticed a change in themselves that could be predicted by their mother’s post-traumatic growth scores. It is possible that when one member of the family experiences relationship-focused coping from post-traumatic growth, it may impact other members of the sick child’s family in a positive way.

It would be interesting in our next study to look at whether healthy siblings themselves experience post-traumatic growth and what impact that has on their quality of life and behaviour over time.