Experiences and support needs of siblings of children with cancer.

The diagnosis and treatment of childhood cancer places considerable demands on family life. Siblings have been shown to be at risk for development of emotional and behavioural problems. However, most studies have relied on parents' reports, and less is known about siblings' own views of their experiences. This paper presents findings from interviews with 94 siblings of children with cancer, at 6 and 18 months after diagnosis of the illness. Results show that, six months after diagnosis, siblings reported a number of problems: loss of attention and status; loss of their own and their families' usual activities and routines; loss of certainty and security; and loss of companionship of the ill child. For many, problems had resolved 18 months after diagnosis, but problems remained or had arisen for some. These were not confined to those whose brothers or sisters had relapsed or continued to have treatment. Supportive relationships were reported to be important resources, providing an opportunity for siblings to express their own feelings and needs, and information about the illness and treatment helped them to understand why family life was disrupted. Positive effects were also apparent: gains in maturity, understanding and compassion, and closer family relationships. The findings point to the need for support for siblings to provide information to help them make sense of the situation; opportunities to express their own feelings and reassurance to avoid fear and guilt; attention to feel valued and maintain self-esteem; and help to keep up their own interests and activities. Attention of parents and professionals in contact with the families was generally paid to the ill child. There is a need for health professionals, particularly those in the family's home community, to take a holistic approach to family support, to ensure that information and support is available to siblings.