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Multi-stakeholder perspectives into the experiences of siblings when a child is critically ill: A qualitative
Jessica Appleyard1, Beverley Copnell2, Alyssia Haling3
1La Trobe University, School of Nursing and Midwifery, Judith Lumley Centre, Bundoora, Australia; The Royal Children's Hospital, Paediatric Intensive Care Unit, Parkville, Australia; Murdoch Children's Research Institute, Paediatric Intensive Care Unit, Parkville, Australia.
Insights
Siblings of critically ill children face significant impacts, including separation and changing roles. Understanding their experiences is crucial for developing better family-centered care in pediatric intensive care units.
Area of Science:
- Pediatric critical care research
- Child psychology
- Family-centered care
Background:
- Critical illness in a child profoundly impacts families, yet sibling experiences are under-researched.
- Previous studies have focused on parents and the critically ill child, leaving a gap in understanding sibling perspectives.
Purpose of the Study:
- To systematically review and synthesize qualitative research on the experiences of siblings whose child is critically ill.
- To explore these experiences from the viewpoints of siblings and key stakeholders.
Main Methods:
- A comprehensive systematic search of six databases and three grey literature sources was conducted.
- Qualitative studies focusing on sibling experiences during a child's critical illness were included and synthesized using thematic analysis.
- Data extraction and quality assessment were performed rigorously by two independent reviewers.
Main Results:
- Twenty-four studies met inclusion criteria, revealing eight key themes of sibling experiences.
- Themes included visiting the intensive care unit (ICU), separation from family, altered family roles, future outlook, and support systems.
- Sibling experiences were influenced by parents, healthcare professionals, and hospital policies.
Conclusions:
- This review highlights the significant, multifaceted impacts on siblings of critically ill children.
- There is a critical need for more research into siblings' perspectives to inform supportive interventions.
- Enhancing holistic, family-centered care requires developing inclusive policies and guidelines for siblings in critical care settings.
Objectives:
A child's critical illness and admission to intensive care can have significant short- and long-term impacts for the parents and hospitalized child. While experiences of parents have been explored, the impact on siblings remains unclear. The aim was to systematically review and synthesize qualitative research exploring the experiences of siblings when a child is critically ill, from the perspectives of siblings and relevant key stakeholders.
Methods:
Comprehensive searches were performed across six databases and three sources of grey literature on October 30, 2023 and September 23, 2024. Original qualitative research focusing on sibling experiences during a child's critical illness were included. Two independent reviewers screened studies, with conflicts resolved by a third reviewer. Data extraction and quality assessment were carried out by one reviewer and verified by a second reviewer using Covidence. Thematic synthesis was used to synthesize extracted data, ensuring the rigor of the findings.
Findings:
Of 1,552 studies screened, 24 met inclusion criteria. Seven mixed methods and 17 qualitative studies were included. Experiences of siblings were categorized into eight themes and included elements such as visiting the ICU, being separated, changing roles, looking to the future, and getting support. Sibling experiences could be positively or negatively influenced by parents, healthcare professionals, hospital policies and environment.
Conclusions:
This study provides a novel insight into the underrepresented sibling experience in critical care research. Siblings experience significant multi-faceted impacts when a child is critically ill. This review underscores the necessity for further research on siblings' perspectives in critical care, to aid development of appropriate supports and interventions for siblings and families during a child's critical illness.
Implications For Clinical Practice:
Understanding siblings' experiences can enhance holistic family-centered care. Findings from this review demonstrate the need for more supportive practices for siblings in intensive care, through development of inclusive, family-centered care policies and guidelines.
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