Siblings of children with cancer face stressors that increase their risk for emotional and behavioural difficulties. Identifying at-risk siblings and providing targeted interventions is key to their adjustment. In this study, we investigated the prevalence of psychosocial problems in siblings and their association with social support, cancer knowledge, and various demographic and health variables. 31 siblings (aged 10-18 years) and 37 parents completed online questionnaires. We also developed a preventive psychoeducational programme, which included two sessions with a ward tour, cancer information, discussions on emotions and coping strategies, and relaxation exercises. Four siblings of children in active treatment were included in the programme. Follow-up assessments were carried out immediately after the intervention and after one to two months. We found that siblings of children with cancer have more problems than the comparison group, but with a small effect size. Self-reports show greater distress than parent reports. Social support is a protective factor, while more knowledge about cancer was unexpectedly associated with more internalizing problems. Additional risk factors include older age and female sex of the sibling, lower parental education, as well as more health complications and active treatment status of the ill child. Most participants expressed a need for formalized professional support, especially closer to diagnosis. Although the intervention did not significantly improve psychosocial outcomes or knowledge about cancer, participants were satisfied with it and reported perceived benefits in coping and reducing loneliness. This confirms that the programme successfully addresses the needs of this overlooked population and contributes to the development of comprehensive family support in paediatric oncology.
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