Williams PD1, Williams AR2, Graff JC1, Hanson S1, Stanton A1, Liebergen A1, Setter RK1, Ridder L1
(1) University of Kansas Medical Center (KUMC), Kansas City, Kansas
(2) Division of Health Care Policy & Research, Mayo Clinic, Rochester, MN
Background: 26% of siblings of children with chronic illness develop mental health or behavior problems. 29% of U.S. children suffer from some moderate to severe chronic illness. Perhaps as many as 4-6% of all American children suffer from such problems.
Objective: To investigate the effects of an intervention for siblings of children with chronic illness (diabetes, developmental disability, spina bifida, cystic fibrosis, cancer).
Methodology: Randomized, three-group, repeated measures design; the full intervention comprised of three aspects: structured teaching about the brother/sister’s illness, psychosocial sessions, and respite. One group of siblings (TG1) received the full intervention at a residential camp, followed by two "booster" sessions. Treatment group 2 (partial, TG2) only attended camp (respite). Control group (CG) attended camp after completion of all measurement time points. Baseline and post-intervention phases documented six outcomes: siblings' levels of knowledge about illness, attitude toward the illness, social support, self-esteem, mood, and behavior problems. Covariates were factors in the family and the caregiving environment (well sibling age, family SES, cohesion, maternal mood). Variables were measured at four time points post-intervention: Immediately after, 4, 9, and 12 months after.
Findings: With a 14% attrition rate, 252 siblings and parents completed the study at 12 months—79, 71, and102 in TG1, TG2, and CG, respectively. Panel analysis examined the six outcomes (1260 observations), adjusted for covariates, using 6 estimating equations, one for each outcome. Results showed that, compared to baseline: (a) The full treatment group (TG1) showed statistically significant improvements in all 6 outcome measures at almost all 4 periods of post-intervention observation. (b) The partial treatment group (camp only, TG2) showed significant, consistent improvements over time in 3 outcomes (social support, self-esteem, and attitude). (c) The control group (CG) showed improvement over time in 2 outcomes (social support and attitude).
Conclusions: Outcome improvement pattern was: TG1 > TG2 > CG. Email: pwilliam@kumc.edu
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