No votes yet
Online Exclusive Article
Open Access Article

An Interruption in Family Life: Siblings' Lived Experience as They Transition Through the Pediatric Bone Marrow Transplant Trajectory

Krista L. Wilkins
Roberta L. Woodgate
ONF 2007, 34(2), E28-E35 DOI: 10.1188/07.ONF.E28-E35

Purpose/Objectives: To arrive at an understanding of the lived experience of healthy donor and nondonor siblings as they transition through the bone marrow transplantation (BMT) trajectory.

Research Approach: Qualitative study guided by the philosophy of hermeneutic phenomenology.

Setting: Participants' homes or the investigator's university or hospital office.

Participants: Eight siblings of pediatric BMT recipients were recruited based on their knowledge of the experience of transitioning through the BMT trajectory.

Methodologic Approach: Data were collected by semistructured, open-ended interviews; demographic forms; and field notes during a period of six months. Data analysis occurred concurrently with data collection. Thematic statements were isolated using Van Manen's selective highlighting approach. Interviews were reviewed repeatedly for significant statements.

Main Research Variable: Siblings' lived experience of the BMT trajectory.

Findings: Interruption in family life emerged as the essence of siblings' lived experience. Four themes supported this essence: life goes on, feeling more or less a part of a family, faith in God that things will be okay, and feelings around families.

Conclusions: Hermeneutic phenomenologic research increases understanding of what being a sibling of a pediatric BMT recipient means. This study is one of the few that have afforded siblings the opportunity to speak about what is important to them.

Interpretation: Findings from this study provide insight into how siblings live and cope throughout the BMT trajectory and will guide nurses as they seek to provide more sensitive and comprehensive care.


Andrykowski, M.A. (1994). Psychiatric and psychosocial aspects of bone marrow transplantation. <i>Psychosomatics, 35</i>, 13-24.

Bendor, S.J. (1990). Anxiety and isolation in siblings of pediatric cancer patients: The need for prevention. <i>Social Work in Health Care, 14</i>(3), 17-35.

Brown, H.N., & Kelly, M.J. (1976). Stages of bone marrow transplantation: A psychiatric perspective. <i>Psychosomatic Medicine, 38</i>, 439-446.

Carr-Gregg, M., & White, L. (1987). Siblings of paediatric cancer patients: A population at risk. <i>Medical and Pediatric Oncology, 15</i>, 62-68.

Carmaz, K. (1991). <i>Good days, bad days: The self in chronic illness and time</i>. New Brunswick, NJ: Rutgers University Press.

Chesler, M.A., Allesewede, J., & Barbarin, O.O. (1991). Voice from the margin of the family: Siblings of children with cancer. <i>Journal of Psychosocial Oncology, 9</i>(4), 19-42.

Clarke-Steffen, L. (1993). A model of the family transition to living with childhood cancer. <i>Cancer Practice</i>, 1, 285-292.

Ebmeier, C., Lough, M.A., Huth, M.M., & Autio, L. (1991). Hospitalized school-age children express ideas, feelings, and behaviors toward God. <i>Journal of Pediatric Nursing, 6</i>, 337-349.

Forinder, U. (2004). Bone marrow transplantation from a parental perspective. <i>Journal of Child Health Care, 8</i>, 134-148.

Freund, B.L., & Siegel, L. (1986). Problems in transition following bone marrow transplantation: Psychosocial aspects. <i>American Journal of Orthopsychiatry, 56</i>, 244-252.

Gardner, G.G., August, C.S., & Githens, J. (1977). Psychological issues in bone marrow transplantation. <i>Pediatrics, 60</i>, 625-631.

Heiney, S.P., Byrant, L.H., Godder, K., & Michaels, J. (2002). Preparing children to be bone marrow donors. <i>Oncology Nursing Forum, 29</i>, 1485-1489.

Heiney, S.P., Neuber, R.W., Myers, D., & Bergman, L.H. (1994). The aftermath of bone marrow transplant for parents of pediatric patients: A posttraumatic stress disorder. <i>Oncology Nursing Forum, 21</i>, 843-847.

Kinrade, L.C. (1987). Preparation of sibling donor for bone marrow transplant harvest procedure. <i>Cancer Nursing, 10</i>, 77-81.

MacLeod, K.D., Whitsett, S.F., Mash, E.J., & Pelletier, W. (2003). Pediatric sibling donors of successful and unsuccessful hematopoietic stem cell transplants: A qualitative study of their psychosocial experience. <i>Journal of Pediatric Psychology, 28</i>, 223-231.

Murray, J.S. (1999). Siblings of children with cancer: A review of the literature. <i>Journal of Pediatric Oncology Nursing, 16</i>(1), 25-34.

Packman, W.L. (1999). Psychosocial impact of pediatric BMT on siblings. <i>Bone Marrow Transplantation, 24</i>, 701-706.

Packman, W.L., Beck, V.L., VanZutphen, K.H., Long, J.K., & Spengler, G. (2003). The human figure drawing with donor and nondonor siblings of pediatric bone marrow transplant patients. <i>Art Therapy: Journal of the American Art Therapy Association, 20</i>, 83-91.

Packman, W.L., Crittenden, M.R., Fischer, J.B.R., Cowan, M.J., Long, J.K., Gruenert, C., et al. (1998). The kinetic family drawing with donor and nondonor siblings of pediatric bone marrow transplant patients. <i>Art Therapy: Journal of the American Art Therapy Association, 15</i>, 177-184.

Packman, W.L., Crittenden, M.R., Fischer, J.B.R., Schaeffer, E., Bongar, B., & Cowan, M.J. (1997). Siblings' perceptions of the bone marrow transplantation process. <i>Journal of Psychosocial Oncology, 15</i>(3/4), 81-105.

Packman, W.L., Crittenden, M.R., Schaeffer, E., Bongar, B., Fischer, J.B., & Cowan, M.J. (1997). Psychosocial consequences of bone marrow in donor and nondonor siblings. <i>Journal of Developmental and Behavioural Pediatrics, 18</i>, 244-253.

Parmar, G., Wu, J.W.Y., & Chan, K.W. (2003). Bone marrow donation in childhood: One donor's perspective. <i>Psycho-Oncology, 12</i>, 91-94.

Patenaude, A.F., Szymanski, L., & Rappeport, J. (1979). Psychological costs of bone marrow transplantation in children. <i>American Journal of Orthopsychiatry, 49</i>, 409-422.

Patton, M. (1990). <i>Qualitative evaluation and research methods</i> (2nd ed.). Newbury Park, CA: Sage.

Phipps, S., & Mulhern, R.K. (1995). Family cohesion and expressiveness promote resilience to the stress of pediatric bone marrow transplant: A preliminary report. <i>Journal of Developmental and Behavioural Pediatrics, 16</i>, 257-263.

Pot-Mees, C.C., & Zeitlin, H. (1987). Psychosocial consequences of bone marrow transplantation in children: Preliminary communication. <i>Journal of Psychosocial Oncology, 5</i>(2), 73-81.

Rodrigue, J.R., MacNaughton, K., Hoffman, R.G., III, Graham-Pole, J., Andres, J.M., Novak, D.A., et al. (1997). Transplantation in children: A longitudinal assessment of mothers' stress, coping, and perceptions of family functioning. <i>Psychosomatics, 38</i>, 478-486.

Shama, W.I. (1998). The experience and preparation of pediatric sibling bone marrow donors. <i>Social Work in Health Care, 27</i>(1), 89-99.

Sommer, D.R. (1989). The spiritual needs of dying children. <i>Issues in Comprehensive Pediatric Nursing, 12</i>, 225-233.

Sommer, D.R. (1994). Exploring the spirituality of children in the midst of illness and suffering. <i>ACCH Advocate, 1</i>, 7-12.

Speziale, H.J., & Carpenter, D.R. (2003). <i>Qualitative research in nursing: Advancing the humanistic imperative</i> (3rd ed.). Philadelphia: Lippincott Williams and Wilkins.

Spilka, B., Zwartjes, W.J., & Zwartjes, G.M. (1991). The role of religion in coping with childhood cancer. <i>Pastoral Psychology, 39</i>, 295-304.

Van Manen, M. (1990). <i>Researching lived experience: Human science for an action sensitive pedagogy</i>. Albany, NY: State University of New York Press.

Wiley, F.M., Lindamood, M.M., & Pfefferbaum-Levine, B. (1984). Donorpatient relationship in pediatric bone marrow transplantation. <i>Journal of the Association of Pediatric Oncology Nurses, 1</i>(3), 8-14.

Wilkins, K.L., & Woodgate, R.L. (2005). A review of qualitative research on the childhood cancer experience from the perspective of siblings: A need to give them a voice. <i>Journal of Pediatric Oncology Nursing, 22</i>, 305-319.

Woodgate, R.L. (2001). <i>Symptom experiences in the illness trajectory of children with cancer and their families</i>. Doctoral dissertation, University of Manitoba, Winnipeg, Canada.

Woodgate, R.L. (2006a). Life is never the same: Childhood cancer narratives. <i>European Journal of Cancer Care, 15</i>(1), 8-18.

Woodgate, R.L. (2006b). Siblings' experiences with childhood cancer: A different way of being in the family. <i>Cancer Nursing, 29</i>, 406-414.

Woodgate, R.L., & Degner, L.F. (2003). A substantive theory of keeping the spirit alive: The spirit within children with cancer and their families. <i>Journal of Pediatric Oncology Nursing, 20</i>, 103-119.