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 ...