Division of Nursing, University of North Carolina Hospitals, Chapel Hill, North Carolina.
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Res Nurs Health. 2019 Oct;42(5):334-348. doi: 10.1002/nur.21978. Epub 2019 Aug 16.
Well siblings of chronically ill children experience family disruptions that profoundly affect them. Previous research focusing on well siblings' experiences has often produced inconsistent findings, likely the result of varying study designs and samples. The purposes of this synthesis research study were twofold: (a) to assess the applicability of existing grounded theory of sibling response to a child's cancer to a wider range of childhood conditions; and (b) to refine the existing theory to reflect the experiences of the broader sample. Data for the synthesis came from a National Institute of Nursing Research-funded mixed-methods synthesis examining the intersection of childhood chronic illness and family life. The current analysis was based on well sibling results extracted from 78 research reports published between 2000 and 2014. An existing grounded theory, Creating a Tenuous Balance (CTB), was discovered at the outset of analysis and used as the primary framework for coding and synthesizing results. The focus of most studies was siblings' responses to 14 chronic conditions, with cancer being the most often studied. Results reflected siblings' perspectives of their experiences as well as perspectives of parents and the ill child. The analysis substantiated all four patterns of sibling behavior included in CTB, with the patterns of adapting to changes in personal and family life, and handling strong emotions being especially challenging aspects of the sibling experience. Moreover, the results expanded several aspects of CTB. The analysis provided evidence of the applicability of the theory to a varied group of chronic conditions and enabled us to identify important areas for developing interventions to support siblings.
患有慢性疾病的儿童的兄弟姐妹会经历深刻影响他们的家庭破裂。之前关注兄弟姐妹经历的研究往往产生不一致的结果，这可能是由于不同的研究设计和样本造成的。这项综合研究的目的有两个：（a）评估现有的儿童癌症兄弟姐妹反应的扎根理论在更广泛的儿童疾病中的适用性；（b）完善现有理论，以反映更广泛样本的经验。综合研究的数据来自于一项由美国国立护理研究院资助的混合方法综合研究，该研究考察了儿童慢性疾病和家庭生活的交叉点。目前的分析基于从 2000 年至 2014 年发表的 78 份研究报告中提取的健康兄弟姐妹结果。在分析开始时发现了一个现有的扎根理论，即创建脆弱的平衡（CTB），并将其用作编码和综合结果的主要框架。大多数研究的重点是兄弟姐妹对 14 种慢性疾病的反应，其中癌症是最常研究的疾病。研究结果反映了兄弟姐妹对自己经历的看法，以及父母和患病儿童的看法。分析证实了 CTB 中包含的所有四种兄弟姐妹行为模式，其中适应个人和家庭生活变化以及处理强烈情绪的模式是兄弟姐妹经历的特别具有挑战性的方面。此外，该分析还扩展了 CTB 的几个方面。分析提供了证据表明该理论适用于各种慢性疾病群体，并使我们能够确定支持兄弟姐妹的干预措施的重要领域。
