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
While 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
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
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