Predisposing, Precipitating, Perpetuating, and Protective Factors Associated With Distress in the Siblings of Children With Cancer: A Systematic Review.
This systematic review of 12 articles categorized 19 factors associated with increased or decreased psychological distress among siblings of children receiving active cancer treatment using a predisposing, precipitating, perpetuating, and protective framework.
Open original publication →What the AI sees
This systematic review of 12 articles categorized 19 factors associated with increased or decreased psychological distress among siblings of children receiving active cancer treatment using a predisposing, precipitating, perpetuating, and protective framework.
Research significance
The review provides associative evidence that factors such as perceived lifestyle threat and caregiving burden identify siblings at greater risk of distress, while protective factors correlate with less distress; it is reasonable—but not demonstrated here—to hypothesize that screening for these factors and targeting modifiable burdens could improve sibling psychosocial outcomes.
Source abstract
BackgroundSiblings in families caring for a child with cancer have unique childhood experiences, often resulting in high levels of anxiety, depression, and posttraumatic stress symptoms.ObjectiveThis systematic review aims to summarize and categorize factors related to increased and decreased experiences of emotional distress among siblings of children with cancer.MethodUsing the Cochrane method, searches were conducted in six academic databases. Eligible studies included those examining siblings of children with cancer aged 21 years old or younger and on active treatment and reported on factors associated with sibling experiences of distress. Identified factors were categorized in accordance with the 4Ps of case formulation (predisposing, precipitating, perpetuating, and protective factors). Results were reported using a narrative synthesis.ResultsOf 18,059 studies retrieved, we included 12 articles. In total, 19 factors were identified, including 7 predisposing factors (e.g., sibling age), 1 precipitating factor (sibling perception of threat to lifestyle), 8 perpetuating factors (e.g., increased caregiving burden), and 3 protective factors (e.g., greater time elapsed since diagnosis). Predisposing, precipitating, and perpetuating factors increased sibling distress, while protective factors reduced sibling distress.ConclusionWe identified factors associated with distress in siblings of children with cancer. The findings may enable clinicians to identify siblings at greater risk of experiencing distress and inform the creation of psychosocial interventions that decrease experiences of distress in siblings.