title: Changes in siblings after the death of a child from cancer.
abstract: BACKGROUND
  Few studies have examined changes in siblings after the death of a brother or sister, particularly from mother, father, and sibling perspectives within the first year after death.
  
  
  OBJECTIVE
  This descriptive study identified and assessed the frequency of changes in siblings after a child's death from cancer.
  
  
  METHODS
  Participants were recruited from cancer registries at 3 hospitals in the United States and Canada 3 to 12 months after the child's death. Thirty-six mothers, 24 fathers, and 39 siblings from 40 families were included. Semistructured interviews using open-ended questions were conducted with each parent and sibling separately in the home. Content analysis identified emerging themes, and the McNemar tests compared frequencies between each paired set of reports (sibling vs mother, sibling vs father, mother vs father).
  
  
  RESULTS
  Sixty-nine percent of participants reported personal changes in siblings (eg, changes in personality, school work, goals/life perspective, activities/interests). Forty-seven percent noted changes in siblings' relationships with family members and peers. Only 21% of participants reported no changes attributed to the death. Comparisons of frequencies across informants were not significant.
  
  
  CONCLUSIONS
  Most siblings experienced changes in multiple areas of their lives after the death of a brother or sister to cancer. Some changes reflected siblings that were positively adapting to the death, whereas other changes reflected difficulties.
  
  
  CONCLUSIONS
  Our findings offer guidance to improve aftercare for bereaved siblings and their families. Additional research is needed to further delineate the needs of bereaved siblings and to develop strategies to promote adaptation to loss.
authors: School of Nursing, Vanderbilt University, Nashville, Tennessee 37240, USA. terrah.l.foster@vanderbilt.edu
authors: Terrah L
authors: TL
authors: Foster
authors: Mary Jo
authors: MJ
authors: Gilmer
authors: Kathryn
authors: K
authors: Vannatta
authors: Maru
authors: M
authors: Barrera
authors: Betty
authors: B
authors: Davies
authors: Mary S
authors: MS
authors: Dietrich
authors: Diane L
authors: DL
authors: Fairclough
authors: Cynthia A
authors: CA
authors: Gerhardt
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001601:Bereavement; D002648:Child; D003430:Cross-Sectional Studies; D003643:Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D015404:Nursing Methodology Research; D010290:Parents / Q000523:psychology; D036301:Qualitative Research; D035781:Siblings / Q000523:psychology*; D013997:Time Factors