• Terrah L Foster, Mary Jo Gilmer, Kathryn Vannatta, Maru Barrera, Betty Davies, Mary S Dietrich, Diane L Fairclough, and Cynthia A Gerhardt.
• School of Nursing, Vanderbilt University, Nashville, Tennessee 37240, USA. terrah.l.foster@vanderbilt.edu
• Cancer Nurs. 2012 Sep 1;35(5):347-54.

BackgroundFew 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.ObjectiveThis descriptive study identified and assessed the frequency of changes in siblings after a child's death from cancer.MethodsParticipants 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).ResultsSixty-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.ConclusionsMost 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.Implications For PracticeOur 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.

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