番茄社区

ORLANDO – Siblings of children with juvenile idiopathic arthritis (JIA) had higher levels of anxiety than children from JIA-free homes, researchers reported here.

On the Spence Children's Anxiety Scale, significant increases in score were found among girl siblings and among children under 10 years of age, said Maria Cusano-Sanzo, RN, DNP-RN, from research she performed as a doctoral student at Sacred Heart University, Trumbull, Conn. She is now a rheumatology clinic coordinator at Genentech.

In her poster presentation at the annual meeting of the , Cusano-Sanzo said that the siblings of children with arthritis "scored approximately 10.6 points higher than children without arthritis in the family which is highly [clinically] significant." The Spence scale is a screening tool, and a 10-point difference could trigger specialist referral for treating anxiety.

"This suggests that, as a group, siblings of children with juvenile idiopathic arthritis may be at higher risk of experiencing anxiety than non-clinical children," Cusano-Sanzo said. "Pediatric chronic illness can have a tremendous impact on children and their parents. Education and support is typically focused on the child and parents of those newly diagnosed with diabetes, cancer, renal failure, asthma, arthritis and other illnesses of childhood, often leaving siblings out of this important aspect."

She recruited 27 children for the project, 12 girls and 15 boys, all 8-15 years old. The children completed the 44-item Spence questionnaire. Their parents completed a demographic survey. Ten of the children were ages 8-10; 6 were ages 11-12; 11 were ages 13-15.

Cusano-Sanzo said that her study implies that "practice policy changes should be made to incorporate siblings in the education of disease states not only for juvenile idiopathic arthritis but other chronic diseases as well."

By addressing anxiety, clinicians might avoid negative outcomes, improve patient and family outcomes and improve family satisfaction, she suggested.

"The nurse should share the findings of this study to encourage parents to make sure that the unaffected child does not feel left out or uninformed and should provide the family with educational material for the sibling without arthritis. The implications for nursing education as a result of this study echo the importance of teaching family-centered care," Cusano-Sanzo said.

Commenting on the study, Annelle Reed, CRNP, a pediatric rheumatology nurse at Children's of Alabama in Birmingham, told 番茄社区, "I think that to reduce anxiety in the sibling, you have to reduce anxiety in the parent and in the patient. We definitely need to inform parents that the siblings may become anxious also."

"We see that in families where there is a person with chronic illness, there is a higher levels of anxiety; there are higher levels of divorce; there are higher levels of everything," said Reed.

"This study is significant because we don't think enough about the siblings. This should remind us that: 'Hello. This is the whole family.'"

In her poster, Cusano-Sanzo reflected on the relationship of siblings in families and why there would be anxiety in the healthy child. "Siblings share a unique bond; they can be each other's best friend and advocate or become each other's adversary. Be it a success, an illness, or playground bullying, what affects one sibling can have an effect on the entire family," she said.