Siblings' Perceptions of the Bone Marrow Transplantation Process

Abstract

Although bone marrow transplantation (BMT) has become a widely practiced therapy for many childhood disorders, little research has been conducted on the psychosocial impact of BMT on family members. Parents have expressed particular concern about the psychosocial effects of BMT on the ill child's siblings. In a cohort of donor and nondonor siblings, the authors found that donors had significantly more anxiety, lower self-esteem, and more adaptive skills in school than did nondonors, whereas nondonors exhibited significantly more school problems. The authors report detailed findings derived from interviews with 44 siblings aged 6 to 18 years and 44 parents of surviving pediatric BMT patients. Among the siblings, minimal explanation of the transplant procedure, loneliness and lack of attention, donors' lack of choice, and need for support groups emerged as major themes. The authors emphasize the importance of attending to siblings' needs throughout the transplantation process and offer suggestions for professionals and parents.

Additional information

Notes on contributors

Morton J. Cowan

Dr. Packman is a Postdoctoral Fellow in Clinical Psychology and Dr. Criiten-den is Clinical Professor of Pediatrics, Division of Behavioral & Developmental Pediatrics, Department of Pediatrics; Ms. Rieger Fischer is a Clinical Social Worker, Bone Marrow Transplant (BMT) Program, Department of Social Work, University of California at San Francisco (UCSF). Dr. Schaeffer is Assistant Professor of Clinical Psychology and Dr. Bongar is Professor of Clinical Psychology, Pacific Graduate School of Psychology, Palo Alto, California. Dr. Cowan is Professor of Pediatrics, BMT Program, Department of Pediatrics, UCSF. (Address correspondence to Dr. Packman, c/o Mary R. Crittenden, PhD, Box 0374, Room A203, Division of Behavioral & Developmental Pediatrics, Department of Pediatrics, University of California-San Francisco, San Francisco, CA 94143-0374.) The article is based on Dr. Packman's doctoral dissertation under the direction of Dr. Crittenden. The authors wish to thank Kenneih Dc Sanies, MD, Linda Abra-movitz, MSN, and the staff of the BMT Unit; art therapists Carol Gruencrt, MA, and Janet Long, MFCC, who scored the drawings; child life workers Adrianne Burton, RN, MS, and Joan Kazerounian, MEd, Department of Pediatrics, UCSF; and, above all, the siblings and parents who invited the authors into their lives and their homes and who wanted so much lo help other families going through the BMT process.