(862) Psychosocial Effect of Critical Illness or Injury on Siblings: A Caregiver Perspective

Introduction: Critical illness and injury are associated with psychosocial stressors, changes in caregiver responsibilities, financial strain, and emotional tolls. While work has been done to decrease psychological sequelae for parents, work evaluating and addressing the needs of siblings is lacking. We aimed to explore the psychosocial effects of PICU admissions on siblings.

Methods: We conducted semi-structured interviews with caregivers of children admitted to the PICU at a free-standing children’s hospital for at least 72 hours with school-aged siblings. We excluded patients with scheduled admissions, at the end of life, with severe traumatic brain injury, or with complex chronic conditions. Interviews asked about sibling PICU experience, mental health, behaviors, and extracurricular activities. Interviews were inductively coded to identify emerging themes.

Results: We interviewed 15 caregivers who chose to discuss the sibling with a confirmed or presumed pre-existing psychiatric diagnosis for the study. Caregivers described multiple factors that contributed to sibling emotional distress including the loss of close relationships with the patient and caregiver, physical displacement from their home with alternative caregivers, and changes in routine. These emotional changes were associated with changes in the sibling including a focus on the patient’s discharge date and an increase in negative behaviors. Parents reported different levels of transparency about the medical condition, with caregivers often choosing to explain at a level they presumed the sibling would understand. This resulted in parental concern about whether siblings fully grasped the severity of the illness or injury.

Conclusions: This study explores how patient admission to the PICU impacts school-aged siblings. We found that emotional distress is common in siblings and screening for sibling medical history may be beneficial to guide appropriate resources and interventions. Further investigation is needed into the long-term impact of the hospitalization on siblings.