title: Regaining Equilibrium: Understanding the Process of Sibling Adjustment to Pediatric Acquired Brain Injury
Creators: name: Bursnall, Samantha
Publisher: name: Griffith University
Year: 2004
Subjects: subject: Public Health and Health Services
subject: FOS: Health sciences
subject: Social Work
subject: FOS: Sociology
subject: 1117
subject: 1607
subject: brain
subject: injury
subject: damage
subject: child
subject: children
subject: pediatric
subject: acquired
subject: adjustment
subject: equilibrium
subject: sibling
subject: siblings
subject: brother
subject: brothers
subject: sister
subject: sisters
subject: adolescent
subject: adolescents
subject: adolescence
subject: adult
subject: adults

description: This study developed a comprehensive framework for understanding the process of sibling adjustment to pediatric acquired brain injury (ABI). Grounded theory methodology was employed to inductively explore the issues siblings perceived to be their main concerns and how they managed these concerns. Fifty-three interviews were conducted recursively with twenty child and adolescent siblings of individuals with an ABI, four adult siblings of individuals with an ABI and four child and adolescent siblings of individuals with congenital disability. Observational and secondary data from hospital staff and parents were also analyzed. The framework was developed and verified through simultaneous data collection and analysis (Glaser, 1978; Strauss &amp; Corbin, 1990). The main issue of concern for siblings following their brother or sister's ABI was the loss of equilibrium in their lives. Losing equilibrium was defined by the concepts of vulnerability and emotional turmoil. Specifically, following ABI, siblings were confronted with the vulnerability of their assumptive world, which was influenced by their exposure to unforeseen circumstances, mortality, the enduring nature of their brother or sister’s injury, and the perceived vulnerability of their family unit. In response to these losses, siblings experienced emotional turmoil, including acute anxiety, chronic worry, ambivalent emotions and disenfranchised grief. Losing equilibrium was an ongoing concern for siblings that threatened their sense of security, safety, predictability and control for many years post injury. To manage these ongoing concerns, siblings employed a variety of interrelated strategies to regain equilibrium. These strategies were conceptualized by the concepts, navigating and sacrificing. The purpose of these strategies was to restore safety, predictability and control in the siblings' environment. Navigating required siblings to negotiate the enduring disequilibrium in their lives, by challenging new rules with old tools, withdrawal, trying and buying, merging the familiar and the unfamiliar and integrating. Sacrificing required siblings to relinquish their needs and desires to regain equilibrium and was illustrated through the concepts, surrogate parent, surrendering parental attention, emotional repression, and self-blame. These self-sacrificing strategies appeared to influence siblings' long-term personal development. For instance, siblings believed that they became more responsible, understanding, tolerant, and cautious in everyday activities. The data indicated that these personal changes subsequently maintained siblings sacrificing behaviors. Although sacrificing strategies were employed by some siblings from the time of the ABI, most siblings mastered their loss of equilibrium through the navigating process. Like the non-finite nature of losing equilibrium, regaining equilibrium was an ongoing cyclical process. Rather than focusing on adjustment outcomes only, the current study has extended previous research by providing a framework for understanding the process of sibling adjustment to ABI. This framework provides a set of integrated categories, concepts, hypotheses and propositions to inform future research and practice.