Rachel Crowther

SPAR PROJECT:  SIBLINGS OF CMC IN HOSPITAL 

What are the Health Outcomes of Siblings of Medically Complex Children During Hospitalization? A Scoping Review

Program: Master of Science in Nursing, University of British Columbia

Background 

Children with medical complexity (CMC) encompass a broad range of conditions and make up a small, yet increasing, proportion of the pediatric population (Harvey et al., 2024). While the immediate impact of complex chronic illness and increased healthcare needs is on CMC, the ripple effect of their care needs often extends to the entire family (Dinleyici et al., 2019). Specifically, siblings of CMC are often overlooked family members, where their needs may go unaddressed as a result of CMC requiring more visible need for support (Hanvey et al., 2022; Jaaniste et al., 2022). Although there is evidence on the long-term outcomes of siblings of CMC, literature investigating the impacts on mental and emotional health outcomes in siblings of CMC during the hospitalization period remains minimal. The aim of the proposed Scholarly Practice Advancement Research (SPAR) project is to conduct a scoping review of the literature to identify the mental, emotional and psychosocial health outcomes of siblings of hospitalized CMC. As the hospitalization period results in increased stress and uncertainty, parental absence, and exacerbation of feelings of being over-looked (Nabors et al., 2018), exploring this particularly sensitive window of time is crucial. As the concept of health outcomes of siblings during hospitalization has not been widely explored, a scoping review is appropriate. This scoping review will be guided by Arksey and O’Malley’s (2005) and Levac et al.’s (2010) methodological frameworks. The following questions were developed for the purpose of this SPAR: 1) What are the mental and emotional health outcomes in siblings of children with medical complexity during hospitalization? 2) What are the psychosocial outcomes and impacts on well-being in siblings of children with medical complexity during hospitalization? Four databases: Cumulative Index to Nursing and Allied Health Literature, Scopus, MEDLINE (via EBSCOhost), and PsycInfo, will be utilized. Grey literature will be searched through Google Scholar. The main focus of this search will be mental, emotional and psychosocial health outcomes of siblings with complex medical needs or conditions, and where these outcomes are being measured (i.e. at home, in the community, in hospital), to identify gaps in siblings mental, emotional, and psychosocial health outcomes during the hospitalization period. By exploring this literature, I aim to inform family-centered care practices, and programs, that consider the needs of the entire family unit during hospitalization, ultimately promoting better mental, emotional and psychosocial health outcomes for siblings of medically complex children.  

TimelineThe proposed SPAR timeline began in November 2024 with submitting a draft of the SPAR proposal, followed by revisions and feedback from SPAR Supervisor, Dr. Scott Ramsay, and committee member, Dr. Manon Ranger. A comprehensive literature search will be conducted throughout January 2025. Data extraction and organization will be completed using the Garrard Matrix Method in February 2025. Collating, summarizing, and reporting the results using thematic analysis will also be completed throughout February and March 2025. Ideally, a draft of the final SPAR will be submitted by March 2025, with a final submission to the University of British Columbia in April 2025.

References

Arksey, H., & O'Malley, L. (2005). Scoping studies: towards a methodological framework. International journal of social research methodology, 8(1), 19-32

Dinleyici, M., Sahin Dagli, F., & Gazi Universitesi Tip Fakultesi, Cocuk Sagligi ve Hastaliklari Anabilim Dali, Sosyal Pediatri Bilim Dali, Ankara, Turkiye. (2019). Evaluation of quality of life of healthy siblings of children with chronic disease. Türk Pediatri Arşivi, 53(4), 205–213. https://doi.org/10.5152/TurkPediatriArs.2018.6778

Hanvey, I., Malovic, A., & Ntontis, E. (2022). Glass children: The lived experiences of siblings of people with a disability or chronic illness. Journal of Community & Applied Social Psychology, 32(5), 936–948. https://doi.org/10.1002/casp.2602

Harvey, A. R., Meehan, E., Merrick, N., D’Aprano, A. L., Cox, G. R., Williams, K., Gibb, S. M., Mountford, N. J., Connell, T. G., & Cohen, E. (2024). Comprehensive care programmes for children with medical complexity. Cochrane Database of Systematic Reviews, 2024(5). https://doi.org/10.1002/14651858.CD013329.pub2

Jaaniste, T., Cuganesan, A., Chin, W. L. ( A., Tan, S. C., Coombs, S., Heaton, M., Cowan, S., Aouad, P., Potter, D., Smith, P. L., & Trethewie, S. (2022). Living with a child who has a life‐limiting condition: The functioning of well‐siblings and parents. Child: Care, Health and Development, 48(2), 269–276. https://doi.org/10.1111/cch.12927

Levac, D., Colquhoun, H., & O'brien, K. K. (2010). Scoping studies: advancing the methodology. Implementation science, 5, 1-9.

Nabors, L., Cunningham, J. F., Lang, M., Wood, K., Southwick, S., & Stough, C. O. (2018). Family Coping During Hospitalization of Children with Chronic Illnesses. Journal of Child and Family Studies, 27(5), 1482–1491. https://doi.org/10.1007/s10826-017-0986