Factor Structure of the Experiences in Close Relationships-Relationship Structures Scale (ECR-RS) in Siblings of Children with Chronic Disorders.

Our objective was to examine the factor structure of the Experiences in Close Relationships-Relationships Structures (ECR-RS), an attachment-theory based relationship measure, in at-risk sample comprising siblings of children with chronic disorders. Psychometric studies with general populations have demonstrated that the ECR-RS comprises two factors, representing anxiety and avoidance in close relationships. The sample comprised 103 siblings (M age = 11.5 years, SD = 2.2, range 8 to 16 years) of children with chronic disorders and their parents. The siblings completed a 9-item version of the Experiences in Close Relationships-Relationships Structures (ECR-RS) about their relations with mothers and fathers that was analyzed with confirmatory factor analysis. We examined construct validity using correlations between sibling social functioning, measured with the Strengths and Difficulties Questionnaire, and parent mental health, measured with the Hopkins Symptom Checklist-90-Revised. The ECR-RS comprised two factors, anxiety and avoidance, in line with previous studies. Both factors demonstrated significant overlap with sibling social functioning, but not with parental mental health. We conclude that the ECR-RS comprises two factors, anxiety and avoidance, that are related to siblings' social functioning. The ECR-RS can be used as a psychometrically sound measure of relationship anxiety and avoidance in families of children with chronic disorders.

The development of SIBS-ONLINE, a group-based video conference intervention for siblings of children with chronic disorders and their parents.

Objective: During the last decade a knowledge-based group intervention called SIBS, aiming to prevent psychological difficulties in siblings of children with chronic disorders, has been developed and empirically evaluated. The results are promising, but SIBS has been difficult to implement in areas with low population density. To address the needs of low-density health regions a video conference-based version of SIBS, "SIBS-ONLINE", was developed. Method: SIBS-ONLINE was developed in three phases: 1) Gaining experience by delivering five support groups for siblings during the Covid-19 pandemic over video conference; 2) Developing the SIBS-ONLINE intervention based on the experiences of Phase 1; 3) Pilot testing the SIBS-ONLINE intervention with four groups (14 families). Results: The end-product was SIBS-ONLINE, an intervention for siblings aged 10-16 years and their parents. SIBS-ONLINE consists of three separate sibling and parent groups and three joint sessions delivered over video conference. Intervention materials to enable delivery were developed, such as a manual comprising specification of communication techniques in video conference groups, technical advice, and a detailed description of sessions. Conclusion: The developmental process resulted in a feasible group-based video conference intervention for families of children with chronic health disorders. Innovation: A unique group-based video conference intervention is described and general advice for developers and deliverers of future interventions provided.

A systematic review of social support for siblings of children with neurodevelopmental disorders.

BACKGROUND: Social support is a protective factor for siblings of children with neurodevelopmental disorders. AIMS: We reviewed studies on social support received by siblings of children with neurodevelopmental disorders. METHODS AND PROCEDURES: We conducted a pre-registered systematic review (CRD42020207686), searching PsycINFO, MEDLINE, Web of Science, and Scopus. OUTCOMES AND RESULTS: Fifteen articles were eligible for the review, 13 of which used cross-sectional designs. Two studies investigated sibling social support after an intervention. Multiple variables were negatively related to social support (e.g., sibling depression, loneliness, stress). Variables that were positively related to social support included prosocial behavior, competence (academic, social, and activity-related), problem-focused coping, and family quality of life. Potential moderators of the relationship between social support and psychosocial adjustment included the type of disorder of the affected sibling and the type of social support provider. We conclude with an overview of the reliability and validity of the seven social support measurements used across the studies. CONCLUSIONS AND IMPLICATIONS: Lower levels of social support are associated with more negative psychosocial adjustment among siblings of children with neurodevelopmental disorders. We encourage future researchers to further investigate ways to increase social support for siblings to improve outcomes.

Measuring family communication in pediatric nursing: Psychometric properties of the Parent-Child Communication Scale - Child Report (PCCS-CR).

PURPOSE: Communication quality is an essential indicator of family functioning and represents an important outcome after pediatric nursing interventions. However, few well-documented child-report questionnaires for family communication exist. We aimed to document the psychometric properties of a previously developed child-rated family communication scale for use in pediatric nursing. DESIGN AND METHODS: We examined the Parent-Child Communication Scale - Child Report (PCCS-CR) in terms of factor structure, convergent validity against the Experiences in Close Relationships-Relationship Structures scale (ECR-RS), and known-groups validity between a sample of siblings of children with pediatric health conditions and controls. The sample comprised 101 siblings of children with a pediatric health condition and 44 controls (M age = 11.5 years, SD = 2.2). RESULTS: We confirmed a two-factor structure of the PCCS-CR. One factor is communication from the child to the parent, labelled child communication (e.g., "I discuss problems with my parents") and the other is communication from the parent to the child, labelled parent communication (e.g., "My parent is a good listener"). Convergent validity of the PCCS-CR was demonstrated through correlations with ECR-RS (r = -0.73 to -0.22, p ≤ .05). Further, construct validity through differences between families with and without a child with a pediatric health condition was demonstrated (g = 0.36-0.83, p ≤ .052). CONCLUSION: The PCCS-CR appears to be a psychometrically sound measure of parent-child communication from the child's point of view. PRACTICAL IMPLICATIONS: The PCCS-CR can be administered in pediatric nursing care and can be used to target and measure the outcomes of interventions aimed at enhancing family functioning.

Psychosocial Functioning in Siblings of Children With Rare Disorders Compared to Controls.

Siblings of children with chronic disorders are at increased risk of psychosocial problems. The risk may be exacerbated when the chronic disorder is rare and limited medical knowledge is available, due to more uncertainty and feelings of isolation. We examined mental health, parent-child communication, child-parent relationship quality, and social support among 100 children aged 8 to 16 years (M age 11.5 years, SD = 2.2; 50.0% boys, 50.0% girls). Fifty-six were siblings of children with rare disorders, and 44 were controls. The siblings of children with rare disorders (herein, siblings) were recruited from a resource centre for rare disorders and comprised siblings of children with a range of rare disorders including neuromuscular disorders and rare chromosomal disorders with intellectual disability. Controls were recruited from schools. Self-reported child mental health was significantly poorer for siblings compared to controls (effect size difference d = 0.75). Parent-reported child mental health was not significantly different between the groups (d = -0.06 to 0.16). Most child-parent relationships (anxiety/avoidance; mothers/fathers) were significantly poorer for siblings compared to controls (d = 0.47 to 0.91). There was no difference between groups in anxious relation with mother. Parent-child communication was significantly poorer for siblings compared to controls (d = -0.87 to -0.75). Social support was significantly poorer for siblings compared to controls (d = 0.61). We conclude that siblings of children with rare disorders display more psychosocial problems than controls. Interventions are indicated to prevent further maladjustment for siblings.

The validity of a measure of adjustment in siblings of children with developmental and physical disabilities: a brief report.

Background: Few questionnaires are tailored for siblings of children with disabilities. The Negative Adjustment Scale (NAS) was developed to measure siblings' adjustment, but has not yet been validated.Objective: To investigate the factor structure and convergent validity of the NAS.Method: We examined the validity of the NAS in terms of factor structure and convergent validity against a general mental health measure. The sample comprised 107 siblings (M age = 11.5 years, SD = 2.1, 53.8% boys) of children with disabilities.Results: We confirmed a one-factor structure for the NAS. Convergent validity was demonstrated through significant correlations (r=.29-.44) with sibling externalizing and internalizing mental health difficulties.Conclusion: The NAS holds promise as a measure tailored for the assessment of sibling's adjustment.

Emotional Experiences Among Siblings of Children With Rare Disorders.

OBJECTIVE: This research aimed to provide new knowledge about the emotional experiences of siblings of children with rare disorders. METHODS: Qualitative thematic analysis was conducted based on videotapes of 11 support groups for 58 siblings aged 7-17 years (Mage = 11.4 years, SD = 2.4) of children with rare disorders. RESULTS: Participants described contradictory emotions in three main contexts: (1) implications of the disorder (knowledge, medical issues, prognosis); (2) consequences for family life (practical implications, limitations of the child with disorder, perspectives on the sibling relationship); and (3) consequences for social life (reflections about (ab)normality, reactions from others). Passive coping strategies were frequently described relative to active coping strategies. An emerging dilemma for participants was hiding versus sharing emotional experiences. CONCLUSIONS: Siblings' emotional experiences are characterized by diverse and contradictory feelings. Interventions to promote emotional health in siblings of children with rare disorder should address this complexity.