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Document Type

Thesis - University Access Only

Award Date


Degree Name

Master of Science (MS)

Department / School

Graduate Nursing

First Advisor

Diana Sorenson


family relationships with chronically ill children, brother and sister attitudes


Chronic illness incidence is escalating in our society. Chronic conditions and illnesses affect not only the individual but the entire family. Health care research has shown interest toward this topic. The familial response to a childhood chronic condition has been studied by a variety of researchers (Austin, 1990; Futcher, 1988; Lipman, 1989). However, few studies have directly researched the sibling response to childhood chronic illness (Brett, 1988). What impact do visible childhood chronic conditions have on well school-aged siblings in a family? Ten well school aged siblings of chronically ill children were interviewed to identify, describe and analyze the impact on their lives.
During analysis of the data obtained from the interviews four major categories of response were identified. The categories Atoning Behavior. Making Nice. Reacting to Injustice and Insulating were descriptive of the behavior portrayed and feelings expressed by the interviewees. Atoning Behavior is self-denial which produces the acceptance of heavy responsibilities and relinquishment of personal desires due to sorrow and rueful feelings. Reacting to Injustice can be defined as responding to the unfairness of the siblings condition and to inequality of treatment displayed toward the children. This reaction is often indignation but may be envy, jealousy or sorrow. Making Nice is giving a deceptively attractive or explanation for an uncomfortable or unappealing experience. These children "gloss over" the burdens or difficulties in their lives, dealing with the subject lightly or not at all. The final category Insulating is acting to shield, protect or buffer another from the "darts" of the outside, world. The well sibling takes on a protecting role, cushioning the child with the chronic condition from the outside world. One child's comment summarized the impact of childhood chronic condition on well siblings lives quiet well. "Well I'm older of course, not older in years, but you know, I act older. We all do."

Library of Congress Subject Headings

Chronically ill children -- Family relationships
Brothers and sisters -- Attitudes



Number of Pages



South Dakota State University


Copyright © 1992 Diane Murray. All rights reserved