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Intervention/
Outcome
Measures
Results
Study
Limitations
Implications for
OT
Summer camp interventions should begin with a discussion facilitated by the occupational therapist where children
share tips on how they cope with their situation so as to promote the development of peer support networks at the
very beginning of the camp. Occupational therapists can both, serve as mentors and train other staff mentors on
reinforcement of positive behaviors, effective ways of providing positive feedback, and ensuring that each child has
at least one experience of success during the week. Traditional camp activities such as archery, swimming, boating,
sports, arts and crafts can also serve to boost self-confidence when the just right challenge is provided
Societal Needs:
PTSD rates of 38% are much higher in this population compared to typical children (5.4% -11%) and although it
dropped to 18% post-camp, this rate is still very high, suggesting the need for interventions with added focus on
addressing trauma
Healthcare delivery and policy:
Health care policies should cover occupational therapy services in therapeutic summer camp settings as a valid
psychosocial intervention.
Education and training of OT students:
Students should have coursework that prepares them to develop, organize, and implement psychosocial therapeutic
camping interventions
Refinement, revision, and advancement of factual knowledge or theory:
Siblings of pediatric cancer patients experience anxiety due to the uncertainty of the situation. Anxiety interferes with
sleep, and can produce physical pain and illness.
Author/ Year
Study
Objectives
Level/Design/
Subjects
Siblings assume greater responsibility while receiving less attention and rewards, which results in anger and jealousy
towards the cancer patient and guilt over having these feelings, which in turn leads to lowered self-esteem.
Intervention/
Outcome
Measures
Results
Study
Limitations
Implications for
OT
Author/ Year
Study
Objectives
Level/Design/
Subjects
Intervention/
Outcome
Measures
Results
Study
Limitations
Implications for
OT
Intervention/
Outcome
Measures
Results
Study
Limitations
Implications for
OT
Intervention/
Outcome
Measures
Results
Study
Limitations
Implications for
OT
Adolescent girls had higher rates of depression than boys. Younger boys had the highest decrease in depression after
the intervention.
No control group
Transportation problems for the parents
Small sample size
The clinical and community-based practice of OT:
Group programs with an emphasis in enhancing cancer knowledge and confidence can be useful in reducing anxiety
and depression.
Program development:
Developing a manual to facilitate consistency in delivery of this program will increase access and consistent
provision of support group interventions for this population.
Societal Needs:
Siblings experience behavioral problems, sleeping problems, and premature emotional maturity due to their
experience.
Healthcare delivery and policy:
Policies should offer coverage of support groups for this population.
Education and training of OT students:
Occupational therapy students should receive coursework that prepares them to develop and facilitate group
protocols.
Refinement, revision, and advancement of factual knowledge or theory:
Knowledge and education about cancer, its treatment, and side effects reduces uncertainty and thus relieves anxiety,
sleep problems, physical complaints, and psychological distress.
Author/ Year
Study
Objectives
Level/Design/
Subjects
Intervention/
Outcome
Measures
Results
Study
Limitations
Implications for
OT
Medical Variables
Siblings in the intervention group experienced better psychological well-being, medical knowledge, and social
support
The intervention had no effects on anxiety or PTSS
Small sample
Measures for social support and medical knowledge were developed by the researchers and had poor internal
consistency
Other psychometric properties were not evaluated.
Only participants fluent in German were included
The clinical and community-based practice of OT:
Even a brief individual two-session psychological intervention provided at the hospital can have benefits.
Program development:
Individualized intervention programs should be tailored to the developmental cognitive level of children and include:
medical information of body function, illness mechanism, location, and chemotherapy. The intervention should also
include discussion of the participants greatest stressors since the cancer diagnosis, implementing cognitive
behavioral therapy (CBT) to talk about coping strategies. Parents should be provided with a psychoeducational
booklet with information about how to support siblings.
Societal Needs:
Individual therapy might be more appropriate and effective for mental health issues experienced by siblings of
pediatric cancer patients, such as PTSD. Providing early preventative therapy within 2 months of the ill sibling
diagnosis might be more effective to avoid worsening symptoms of PTSD
Healthcare delivery and policy:
Expanding the definition of mental health providers to include occupational therapists will make individual
psychosocial treatments more widely available.
Education and training of OT students:
Occupational therapy students should receive coursework that prepares them to identify and treat mental health
diagnoses such as PTSD as well as utilize effective interventions such as cognitive behavioral therapy (CBT).
Refinement, revision, and advancement of factual knowledge or theory:
Siblings can develop PTSD and experience declines in health, school performance, and social functioning, as well as
increased risk for emotional, behavioral, and social problems.
Author/ Year
Study
Objectives
Level/Design/
Subjects
Intervention/
Outcome
Measures
Results
Study
Limitations
Implications for
OT
very beginning of camp. Occupational therapists can both, serve as mentors and train other staff mentors on
reinforcement of positive behaviors, effective ways of providing positive feedback, and ensuring that each child has
at least one experience of success during the week. Traditional camp activities such as archery, swimming, boating,
sports, and arts and crafts can also serve to boost self-confidence when the just right challenge is provided.
Societal Needs:
Families of children diagnosed with cancer may overlook the needs of the healthy siblings. Since 63% of siblings
experience at least transient psychological problems, prompt psychological interventions may reduce distress,
prevent more severe difficulties, and reduce the familys burden.
Healthcare delivery and policy:
Health care policies should cover occupational therapy services in therapeutic summer camp settings as a valid
psychosocial intervention.
Education and training of OT students:
Occupational therapy students should complete coursework that prepares them to develop, organize, and implement
psychosocial therapeutic camping interventions.
Refinement, revision, and advancement of factual knowledge or theory:
Siblings assume greater responsibility while receiving less attention and rewards, which results in anger and jealousy
towards the cancer patient and guilt over having these feelings, which in turn leads to lowered self-esteem.
Author/ Year
Study
Objectives
Level/Design/
Subjects
Intervention/
Outcome
Measures
Results
Study
Limitations
Implications for
OT
Negative Mood
Interpersonal Problems
Ineffectiveness
Anhedonia
Negative Self-Esteem
Outcome Measures: 1) Childrens Depression inventory, 2) Things you did at camp, 3) Youth self-report
Significant improvements on negative mood & interpersonal problems when comparing baseline to follow up.
Statistically significant improvements on anhedonia
No control group
Small sample size
Long period of time between the culmination of the camp experience and the surveys.
The clinical and community-based practice of OT:
Summer camps can be an effective means of normalizing the life experience of siblings of pediatric cancer patients.
Program development:
Summer camp interventions should begin with a discussion facilitated by the occupational therapist where children
share tips on how they cope with their situation so as to promote the development of peer support networks at the
very beginning of the camp. Occupational therapists can both, serve as mentors and train other staff mentors on
reinforcement of positive behaviors, effective ways of providing positive feedback, and ensuring that each child has
at least one experience of success during the week. Traditional camp activities such as archery, swimming, boating,
sports, and arts and crafts can also serve to boost self-confidence when the just right challenge is provided
Societal Needs:
Siblings of pediatric cancer patients are at risk for mental health problems, including depression, anxiety and PTSD.
Healthcare delivery and policy:
Health care policies should cover occupational therapy services in therapeutic summer camp settings as a valid
psychosocial intervention.
Education and training of OT students:
Occupational therapy students should be offered coursework that prepares them to develop, organize, and implement
psychosocial therapeutic camping interventions.
Intervention/
Outcome
Measures
Results
Study
Limitations
Implications for
OT
Being emotional
Waiting for a normal, good life despite the uncertain future.
Outcome Measures: Audio recorded semi-structured interviews conducted by one of the authors over the telephone
before and after the intervention.
Specific knowledge about cancer treatment and its side effects increased.
Sleep improved moderately for most siblings.
Bodily pain and emotional regulation problems decreased.
Siblings longed for the treatment to end, and for the sick child to return to their normal life. Some siblings avoided
thinking about the future and lived in the moment, and others struggled with thinking ahead due to uncertainty.
Siblings reported being grateful to have been contacted and not forgotten.
Convenience sample
Small sample
Several participants came from the same family
Only siblings who had computers could participate.
Three of the siblings had dyslexia but they reported that they were able to express everything they experienced in
their answers.
Some families could not afford to pay for transportation to the city in order for these siblings to participate. Other
families had no time to spare, or were afraid to participate due not having a residence permit.
The clinical and community-based practice of OT:
E-health is an effective modality to deliver therapeutic interventions that provide therapeutic education and emotional
support to siblings of pediatric cancer patients.
Program development:
Intervention programs for this population should provide specific medical information about cancer and its treatment
and implement practice of coping skills, as well as offer relevant education for parents.
Societal Needs:
The high cost and current shortages in health care practitioners could be minimized through the use of virtual
modalities by including interactive media such as Skype. E-Health is a cost effective treatment modality that can be
used in conjunction with therapeutic education, journal reflection, and regular virtual communication with supportive
practitioners.
Healthcare delivery and policy:
Policies that regulate the provision of occupational therapy through virtual modalities should be enacted to ensure
that virtual medical care is covered and it abides by the requirements of confidentiality and HIPPA guidelines.
Education and training of OT students:
Occupational therapy students should be offered courses that prepare then to address the psychosocial needs of other
family members, in particular siblings.
Refinement, revision, and advancement of factual knowledge or theory:
Knowledge and education about cancer, its treatment, and side effects reduces uncertainty and thus relieves anxiety,
sleep problems, physical complaints, and psychological distress.