Kirchhofer Solveig M, Fredriksen Trude, Orm Stian, Botta Matteo, Zahl Erica, Cogo-Moreira Hugo, Prentice Caitlin M, Vatne Torun M, Haukeland Yngvild B, Silverman Wendy K, Fjermestad Krister W
Department of Psychology, University of Oslo, Oslo, Norway.
Child and Adolescent Mental Health Services, Nic Waals Institute, Lovisenberg Hospital, Oslo, Norway.
J Pediatr Psychol. 2025 Jun 1;50(6):443-453. doi: 10.1093/jpepsy/jsaf021.
We evaluated the effectiveness of SIBS, a preventive intervention for siblings and parents of children with chronic disorders (CDs).
This two-arm, unmasked cluster randomized controlled trial registered on ClinicalTrials.gov (NCT04056884), included 288 siblings (M age = 10.4 years, SD = 1.9) and parents of children with CDs (mainly neurodevelopmental disorders) randomly assigned to intervention (k = 34, n = 137) or waitlist control (k = 35, n = 151) groups. Eligible siblings were aged 8-16 years and had a sibling diagnosed with a CD. SIBS is manual-based and was delivered as five sessions over 2 weeks in primary care and hospital settings across Norway. Three sessions are separate for siblings and parents, and two are integrated sibling-parent dialogues. The primary outcome was sibling mental health, rated by siblings, parents, and teachers. The secondary outcome was parent-child communication, rated by siblings and parents. Analyses included intention-to-treat (ITT) and complier average causal effects (CACE).
Although not statistically significant, at 3-month follow-up, the intervention group showed fewer mental health problems (ITT: sibling-rated d = -0.16, 95% CI [-0.49, 0.17]; parent-rated d = -0.10, 95% CI [-0.48, 0.12]; teacher-rated d = -0.18, 95% CI [-0.50, 0.29]) and higher-quality parent-child communication (ITT: sibling-rated d = 0.21, 95% CI [-0.10, 0.52]; parent-rated d = 0.24, 95% CI [-0.07, 0.55]) compared to waitlist.
The SIBS intervention demonstrated small, consistent positive effects on sibling mental health and parent-child communication. This suggests SIBS is a promising preventive program for siblings of children with CDs.
我们评估了SIBS（一种针对患有慢性疾病（CD）儿童的兄弟姐妹及父母的预防性干预措施）的效果。
这项双臂、非盲法整群随机对照试验已在ClinicalTrials.gov（NCT04056884）上注册，纳入了288名患有慢性疾病儿童的兄弟姐妹（平均年龄M = 10.4岁，标准差SD = 1.9）及其父母，这些儿童主要患有神经发育障碍，他们被随机分配到干预组（k = 34，n = 137）或等待名单对照组（k = 35，n = 151）。符合条件的兄弟姐妹年龄在8至16岁之间，其兄弟姐妹被诊断患有慢性疾病。SIBS基于手册实施，在挪威各地的初级保健和医院环境中，于2周内分五个阶段进行。其中三个阶段分别针对兄弟姐妹和父母，另外两个阶段是兄弟姐妹与父母的联合对话。主要结局是由兄弟姐妹、父母和教师评定的兄弟姐妹心理健康状况。次要结局是由兄弟姐妹和父母评定的亲子沟通情况。分析包括意向性分析（ITT）和依从者平均因果效应（CACE）。
在3个月的随访中，尽管差异无统计学意义，但与等待名单对照组相比，干预组的心理健康问题较少（意向性分析：兄弟姐妹评定的d = -0.16，95%置信区间[-0.49, 0.17]；父母评定的d = -0.10，95%置信区间[-0.48, 0.12]；教师评定的d = -0.18，95%置信区间[-0.50, 0.29]），亲子沟通质量较高（意向性分析：兄弟姐妹评定的d = 0.21，95%置信区间[-0.10, 0.52]；父母评定的d = 0.24，95%置信区间[-0.07, 0.55]）。
SIBS干预措施对兄弟姐妹的心理健康和亲子沟通显示出微小但持续的积极影响。这表明SIBS对于患有慢性疾病儿童的兄弟姐妹来说是一个有前景的预防项目。
