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Gill, M.A. (2020). Making space for siblings in family-centered care. Pediatric Nursing, 46(1), 48-51.
Key Words: Family-centered care, siblings, behavior.
Until recently, healthy siblings, like other family members, were largely absent from pediatric health care settings. Since then, however, research has shown that healthy children benefit when allowed to visit their siblings with illnesses or injuries in the hospital. For example, Oehler and Vileisis (1990) found that young children allowed to visit their newborn siblings in the hospital displayed less negative behavior in the weeks after birth. Children who visited were better able to recall even basic information, such as their sibling's name, as well as talk about their diagnosis. Nevertheless, being present during a hospitalization or other medical event can also be difficult for siblings. In the words of a child who lost a sibling to cancer, "One must not forget the siblings and just because they are older doesn't mean that they can manage by themselves. We need as much support [as the patient]" (Lövgren, Bylund-Grenklo et al., 2016, p. 299).
Siblings of children facing illness and injury are at risk of adverse developmental and psychological outcomes when their unique needs are not addressed fully and in a timely manner. It is also possible for children to experience psychological growth in the face of illness and hospitalization (Picoraro et al., 2014); however, this type of growth is not predominantly characteristic of sibling experiences. For example, parents of children with cystic fibrosis and cancer report far more negative than positive sibling outcomes, including emotional challenges, such as jealousy, anger, and depression, as well as behavioral and academic problems (Williams et al., 2009). Other difficulties facing healthy siblings include anxiety, sadness, activity restrictions, problems with peer relationships, a lack of information, and changes in family roles that contribute to increased family conflict (Nabors et al., 2018; Velleman et al., 2016; Wakefield et al., 2013).
These challenges have important implications for siblings' long-term physical and mental health. Children experience more frequent acute illnesses, hospitalizations, and medication changes in the first year after a sibling's death, suggesting that bereaved siblings' emotional distress has a physiological impact and creates a large health care cost burden (Brooten et al., 2018). Furthermore, it is well documented that pediatric patients...