title: A systematic review of interventions to support siblings of children with chronic illness or disability.
abstract: OBJECTIVE
  Chronic illness or disability in children can have a deleterious effect on the psychosocial health of well siblings. This systematic review synthesised evidence from studies evaluating sibling-oriented care aimed at improving behavioural and emotional outcomes in well siblings of children with chronic illness or disability.
  
  
  METHODS
  Twenty electronic databases were searched. Study selection, data extraction and assessment of methodological quality were performed by two independent reviewers.
  
  
  RESULTS
  Five controlled and nine uncontrolled studies were included. In higher-quality controlled trials, benefits of sibling-oriented care included reduced anxiety, improved mood and behavioural adjustment; however, these findings were not consistently demonstrated across studies. Study differences made it difficult to determine which sibling care features were most salient.
  
  
  CONCLUSIONS
  Study findings highlight the potential for enhancing emotional and behavioural outcomes in well siblings. Future evaluations need to clearly identify the intended purpose of the care (what improvements are intended) and which types of siblings are most likely to benefit. This approach may yield more consistent and clinically important results.
authors.affiliation: Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry and Departments of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Stollery Children's Hospital, Patients as Partners, Division of Quality & Service Improvement, Alberta Health Services and Women and Children's Health Research Institute, Edmonton, Alberta, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hartling
authors.forename: Andrea
authors.initials: A
authors.lastname: Milne
authors.forename: Lisa
authors.initials: L
authors.lastname: Tjosvold
authors.forename: Dawn
authors.initials: D
authors.lastname: Wrightson
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gallivan
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Newton
mesh_terms: D000293:Adolescent; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D002908:Chronic Disease / Q000523:psychology / Q000534:rehabilitation*; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D020380:Needs Assessment; D016032:Randomized Controlled Trials as Topic; D012657:Self-Help Groups / Q000458:organization & administration*; D012801:Sibling Relations; D035781:Siblings / Q000523:psychology; D014481:United States