A qualitative analysis of the impact of childhood cancer on the lives of siblings at school, in extracurricular activities, and with friends

The purpose of this study was to examine the ways in which siblings of children with cancer perceive childhood cancer to have influenced their lives at school, in extracurricular activities, and with friends-the various social contexts in which child development occurs external to the family system. The qualitative interviews of 33 purposively sampled siblings of children with cancer were analyzed using modified grounded theory. Siblings were 8-15 years old (M = 11.6, SD = 1.9), and the child with cancer was on treatment or within 2 years of diagnosis. Most siblings reported that cancer led to changes at school (81%), in extracurricular activities (79%), and with friends (94%). Generally, siblings reported less time within each of these social domains and also changes in the content, character, or quality of their experiences. Positive changes (e.g., increased support at school, strengthened friendships) and negative changes (e.g., trouble concentrating, disrupted routines, insensitivity and awkwardness within interpersonal relationships) were both uncovered. Documenting the possibly subtle but important changes that cancer diagnosis and treatment cause within the lives of siblings of children with cancer provides valuable information upon which to inform clinical care efforts to meet the psychosocial needs of siblings. Psychosocial providers in pediatric oncology should join with parents, community providers, and schools in collaborative efforts to screen, monitor, and address the needs of siblings of children with cancer.