title: Gender affects self-evaluation in children with cystic fibrosis and their healthy siblings.
abstract: OBJECTIVE
  To determine whether self-esteem among children with cystic fibrosis (CF) and their healthy siblings differs from that of a healthy reference group and whether there are differences within and between sibling pairs.
  
  
  METHODS
  All Swedish CF children 6-14 y old with a healthy sibling in the same age range (n=65) were invited to participate, 55 sibling pairs and their parents taking part in the study. Five aspects of the children's self-concept-physical characteristics, skills and talents, mental well-being, relations to parents and family, and relations to others-were assessed by the "I think I am" self-evaluation questionnaire. Severity of illness was assessed by means of the Shwachman Clinical Evaluation System.
  
  
  RESULTS
  Whereas self-evaluation did not differ between groups at a general level, healthy girls as well as those with CF scored lower than girls in the reference group on the "mental well-being" and "relations to parents and family" subscales. Comparison of gender combinations (sick girl/healthy boy, sick girl/healthy girl, sick boy/healthy boy, sick boy/healthy girl) suggested that girls pay a cost of a lesser sense of psychological well-being and feelings of inadequacy in relation to their parents and family. The Shwachman score of the sick child was not related to the level of self-esteem.
  
  
  CONCLUSIONS
  When CF is present among siblings, girls seem to carry more of the family pain than boys, a finding that calls for an increased awareness of the girls' situation by members of care teams.
authors.affiliation: Department of Psychology, Lund University and Department of Paediatrics, Lund University Hospital, Lund, Sweden. lill.wennstrom@home.se
authors.forename: Inga-Lill
authors.initials: IL
authors.lastname: Wennström
authors.forename: Ulla
authors.initials: U
authors.lastname: Berg
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Kornfält
authors.forename: Olof
authors.initials: O
authors.lastname: Rydén
mesh_terms: D000293:Adolescent; D002648:Child; D003550:Cystic Fibrosis / Q000523:psychology*; D005190:Family; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D012129:Respiratory Function Tests; D012649:Self Concept; D012737:Sex Factors; D035781:Siblings; D011795:Surveys and Questionnaires; D013548:Sweden