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    Changes in Children's Sibling Relationships After Pediatric Bone Marrow Transplantation and Children's Adaptation: A Grounded Theory Approach

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    Author
    Modry-Mandell, Kerri
    Issue Date
    2007
    Keywords
    children's sibling relationships
    child adaptation
    pediatric bone marrow transplantation
    childhood cancer
    grounded theory
    well siblings
    Advisor
    Gamble, Wendy C.
    Committee Chair
    Gamble, Wendy C.
    
    Metadata
    Show full item record
    Publisher
    The University of Arizona.
    Rights
    Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
    Abstract
    In the present study, a grounded theory approach was employed with the purpose of developing a substantive theoretical model to identify and illustrate changes in sibling relationships after pediatric bone marrow transplantation (BMT). Further investigation of the impact of sibling relationship quality on children's adaptation following this life-threatening medical procedure was examined. Two families, each consisting of a sibling dyad that included a child who received a BMT and a well sibling that ranged in age from 10-14 and a parent, participated in the study. Siblings were interviewed individually, and in the dyad, to capture an insider's view of the sibling relationship after BMT and factors that impact child adaptation to pediatric BMT. Child observational and parent survey data provided a multiple-informant and multiple-method approach which helped to foster a more complete picture of the broader family context. Findings suggest that children's sibling relationships improved after BMT, as evidenced by their building a close relationship, establishing intimacy and gaining trust, and learning to get along and settle differences better. Positive coping strategies included identifying and utilizing supports and resources, praying/prayer, making life easier for the sibling, and redefining what is important in life. Children's individual adaptation outcomes included accepting the illness, recognizing the longevity of the relationship, reducing worry/stress, and moving beyond the illness. Analyses that were grounded in the data from the present study suggest four theoretical propositions. First,children's sibling relationships have the potential for positive change after BMT. Second, close sibling relationships can serve as a buffer, or protective factor, to the adverse conditions and extremely stressful situations encountered after BMT. Third, positive changes in children's sibling relationships after BMT can positively influence children's coping strategies which may have a direct influence on children's adaptation to BMT. The fourth, and primary hypothesis, suggests that positive changes in children's sibling relationships after BMT potentiate new coping strategies in the dyad that are more facilitative to child adaptation than managing stress on one's own. Findings add to the general knowledge on sibling relationships and shed light on the complexities of children's sibling relationships when one child is severely ill.
    Type
    text
    Electronic Dissertation
    Degree Name
    PhD
    Degree Level
    doctoral
    Degree Program
    Family & Consumer Sciences
    Graduate College
    Degree Grantor
    University of Arizona
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