Protective shield: a thematic analysis of the experience of having an adult sibling with insulin-dependent diabetes mellitus.

The purpose of this investigation was to describe the adult well sibling's experience of having grown up with a sibling who has insulin-dependent diabetes mellitus (IDDM). Using existential-phenomenological interview procedures, 14 participants were asked what it was like to have a chronically ill sibling. Analysis of participants' experiences was done using a hermeneutical approach. The thematic description of the experience of having lived with a chronically ill sibling with IDDM was divided into two interdependent and interrelated periods, the past and the present. The metaphor of a protective shield woven around the diabetic sibling by his or her family was taken from the words of a participant, and is seen by participants as occurring in the past and the present. The themes of the past provide the background for the themes of the present. Many of the themes of the past are moved forward to the present, but, because of the passage of time, are described differently by participants. Results of this study reinforce the fact that the stressors of chronic illness affect all family members, including the well siblings. It is imperative that nurses give care to the family, not just the designated patient. Nurses must be prepared to provide counseling, education, and anticipatory guidance to adults who have a sibling with a chronic illness.