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 While it's perfectly logical to assume healthy kids in this
situation might experience strong emotions, running the gamut from
anger to fear to stress, much of the research to date has focused on
parents' perceptions of how children feel. Parents in these studies
tended to think their healthy kids were coping well under the
circumstances, researchers note in Pediatrics.
But the current study tells a different story, based on the handful
of studies that examined this issue by asking kids - not their
parents - how they felt about living with a sick sibling.
"The novel finding was that in order for healthy siblings to get
their emotional needs met, they adapted their behavior and identity
over time to fit with the needs of the family, which focused on the
unwell sibling," said lead study author Antoinette Deavin of
Lancaster University in the UK.
"This meant that the healthy sibling often felt they had to suppress
their emotional needs," Deavin said by email. "This can cause them
to be seen by the adults in their lives as functioning well and
consequently be overlooked, whilst still experiencing distress."
Taken together, the 12 smaller studies in the current analysis paint
a picture of the potential for both resilience and unmet emotional
needs.
When siblings of sick kids described a cohesive family unit, with
everyone pitching in to help care for the chronically ill child,
they tended to describe bonding that brought the family closer
together.
Some healthy siblings felt that participating in activities -
whether helping with chores, preparing meals or supervising their
sibling and assisting with care - was a positive experience. This
made them feel like their circumstances helped them mature and
develop coping skills.
But when parents tried to shield siblings of sick kids from knowing
anything about the illness or contributing to care or support of the
unwell child, the healthy siblings tended to return parents' silence
by clamming up about their own emotional turmoil.
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Healthy siblings were also unlikely to voice any problems of their
own if they worried about burdening or angering their parents.
The study didn't examine findings from controlled experiments
designed to prove whether or how life with a chronically ill sibling
might impact mental health for their siblings.
Even so, the results underscore that how well siblings of sick
children fare emotionally may depend on the specific dynamics in
individual families, said Jerica Berge, a researcher at the
University of Minnesota Medical School in Minneapolis who wasn't
involved in the study.
In some cases, healthy siblings might experience depression or
anxiety or feel like parents are giving the sick child preferential
treatment, Berge said by email. Other times, however, the illness
might bring siblings closer together and healthy children might not
experience any psychological issues.
Ideally, treatment of the chronically ill child will take a
family-centered approach that considers support not just for
parents, but for other children, Berge said.
"Often, parental resources and resources for the child with the
chronic illness are readily available, however, tailored materials
for the siblings are not," Berge said. "It may be important to
rethink how child life specialists focus their efforts - they could
also take on the role of family navigator . . . so that all members
are taken into consideration when treating a child with a chronic
illness."
SOURCE: https://bit.ly/2OiJ6ep Pediatrics, online July 26, 2018.
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