The revelation, discussion and subsequent follow-up of a diagnosed cancer amongst paediatric patients come across as a challenge to most clinicians. It is a challenge not just in terms of discussing the reality of the disease to the family of the paediatric patient, but also handling the aftermath of potential psychological, emotional and behavioural issues that can develop amongst the family members.
In lieu of coping with the entire course of cancer of the child, the family members face a lot of emotional and psychological trauma. Development of emotional, behavioural as well as social issues has been observed to be particularly high amongst siblings of paediatric patients.
AdvertisementWhile development of these psychological mental health issues is a predictable event by most clinicians, there is not much research and data to correctly measure and evaluate the experiences and severity of these problems amongst the siblings of first time diagnosed cancer patients. As a result, a lot still remains to be done in terms of development and execution of specific interventional programs to help the siblings of the paediatric cancer patients to cope with the situation with minimum harm to their psychological and physical health.
In one of the few trials focusing on this issue, a team of researchers from Switzerland conducted a cohort study on 30 siblings of paediatric cancer patients from 21 families.
The study group was randomly divided into two equal sub-groups. The first sub-group received psychological and behaviour intervention in the form of two sessions. The first session was conducted at the beginning of the study after the baseline data was collected from both the groups. The second intervention was conducted two-weeks later.
Results were collected from both the groups at regular intervals in the form of questionnaires answered by the individuals. The parameters taken into consideration included: medical knowledge amongst the siblings, social support, health-related quality of life, post-traumatic stress symptoms, socio-economic status and severity of condition of the cancer patient as reported by the sibling.
Separate information was also collected from the parents of these siblings in both the groups.
The intervention as designed by the team of researchers focused on individualized counselling. This kind of individual intervention within two months of cancer diagnosis is a practical and result oriented intervention as each sibling of the paediatric cancer patient requires a different type of intervention depending on the stage and severity of the cancer of their sibling.
The intervention was provided in three basic forms. This consisted of the medical information provided to the siblings of the paediatric cancer patients, mechanisms to cope with the cancer of their siblings and finally in the form of psycho-educational booklets handed out to the parents of the siblings of paediatric cancer patients. These booklets had information on the psycho-social issues that can potentially develop in their children and their siblings and advice to deal with it.
Families in the control group were offered standard psychosocial care in the form of meeting with the psycho-oncologist assigned to the cancer patient.
A positive outcome of these interventions was observed in the study group in terms of their medical knowledge, psycho-social well-being and social support. However both study and control groups exhibited similar results in terms of post-traumatic stress symptoms, health related quality of life and anxiety.
The researchers of this pilot study suggest that the results should be evaluated with the help of larger group specific studies.
With the growing focus of researches on this issue, a better interventional program needs to be inculcated at all cancer centres for improving the physical as well psycho-social health of the siblings of paediatric patients.
Timely and correct interventions in this direction in form of individual counselling, interventional camps and booklet handouts can significantly improve the overall well-being of these children.
Reference: A two-session psychological intervention for siblings of pediatric cancer patients: a randomized controlled pilot trial; Alice Prchal et al; Child and Adolescent Psychiatry and Mental Health 2012
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