Carer Reported Perceptions of Child Vulnerability and Self-Reported Health Self-Efficacy in Siblings of Children with Chronic Physical Illness.

Objective - This study aimed to explore whether parental perceptions of child vulnerability were elevated in siblings of children with chronic illness, and to examine the effect of such beliefs on children’s own health self-efficacy and psychological adjustment. Design - Cross sectional questionnaire methodology. Setting - Two major hospitals in the United Kingdom with specialist paediatric services. Participants - 35 parent/child pairs from families with children who experienced difficulties relating to cancer or cardiological problems. Main Outcome Measures -Parents were asked to complete the child vulnerability scale (Forsyth, Horwitz, Leventhal, Burger & Leaf, 1996), and the Strengths and Difficulties Questionnaire (Parent Form - Goodman, 1997). Siblings were asked to complete items from the School Health Self-Efficacy Scale (Froman & Owen, 1991). Results - Siblings were not more likely to be perceived as ‘vulnerable’ to a statistically significant level. No substantial relationship existed between parental vulnerability perceptions and children’s health self-efficacy beliefs. Self-efficacy was found to be significantly higher than the community sample. Both constructs were correlated with psychological outcomes. Sibling adjustment was found to be significantly different from that expected from community samples for emotional symptoms. Use of exploratory correlation suggested that self-efficacy beliefs might to some extent moderate the relationship between vulnerability and emotional symptoms. Conclusions - While siblings of children with physical illness do experience difficulties, health self-efficacy is a valuable potential source of resilience for young people in the context of family illness