The Quiet Struggle: Parental Perspectives on Sibling Well-Being During PICU Admission

OBJECTIVE: To identify the impact of PICU admission on parental perceptions of the well-being of patients' child-aged siblings and understand how families use hospital resources to support siblings. DESIGN: Qualitative study using semi-structured interviews of parents of PICU patients with siblings to characterize sibling socioemotional changes during PICU admission and how the sibling interacted with hospital resources. Interviews were transcribed and thematically analyzed. SETTING: Quaternary-care PICU at a level 1 trauma center in St. Louis, MO. SUBJECTS: Parents of a child admitted to the PICU with at least one additional child living at home between the ages of 5 and 19 years. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Fourteen biological parents and one legal guardian representing 15 households and 17 siblings of PICU patients were interviewed. Four themes were identified describing parental perspective on sibling psychosocial well-being: 1) routine is important, 2) parents consider multiple factors when evaluating the impact of sibling visits on child well-being, 3) hospitalizations impacts sibling well-being in many ways, and 4) few siblings' physical well-being changed following hospitalization. Two themes were identified regarding parental perspective of hospital resources: 5) parents believed that hospital support was designed to cultivate a sense of normalcy, and 6) the provision and utilization of child life services was not uniform. CONCLUSIONS: It is critical to prioritize the emotional and social well-being of siblings of critically ill and injured children through the maintenance of routine, balancing the needs of both patient and sibling when considering visitation policies, and providing hospital supports tailored to sibling's age and cognitive level.