Fiziksel ve/veya Zihinsel Engelli Çocukların Kardeşlerinin Psikososyal Durumu

Demet Yılmaz; Dilek Toprak; Gülşen Köse

doi:10.4274/BMB.galenos.2025.87597

Öz

Amaç

Bu çalışmada, çoğu kez göz ardı edilebilen fiziksel ve/veya zihinsel engelli çocukların kardeşlerinin psikososyal durumlarını ve sosyo-demografik özellikleriyle ilişkisini değerlendirmeyi, çocukların psikososyal gelişimlerinin desteklenmesini; elde ettiğimiz bulgular ışığında aileye ve çocuklarına destek olacak yeni projeler oluşturulmasını amaçladık.

Yöntem

Çalışma katılımcıların prospektif olarak alındığı kesitsel, tek merkezli, tanımlayıcı ve analitik nitelikte bir çalışma olarak planlandı. Sağlık Bilimleri Üniversitesi, Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Aile Hekimliği Polikliniği ve Çocuk Nörolojisi Polikliniği'ne başvuran, fiziksel ve/veya mental retarde çocukları olan ailelerin 6-17 yaş arası sağlıklı çocukları dahil edildi. Çocukların psikososyal durumu ve depresyon düzeyleri çocuk-ergen depresyon ölçeği (ÇDÖ) uygulanarak, yüzyüze görüşmeyle değerlendirildi. Analizlerde frekans, ki-kare, t-testi kullanıldı; p<0,05 anlamlı kabul edildi.

Bulgular

Çalışmaya katılan 51 çocuğun çoğu kız (%60,8) ve yaş ortalaması 11,25±3,14 idi. Sağlıklı kardeşlerin ortalama ÇDÖ puanı 11,76±6,56 idi. %15,7’sinin depresyonda olduğu; depresyonda olanların %75’inin kız çocuk olduğu belirlendi. Depresyonda olan çocukların ortalama ÇDÖ puanı 22,87±3,90 olarak bulundu. Kız çocukların ortalama ÇDÖ puanının (12,03±6,32), erkek çocuklara göre (11,35±7,06) daha yüksek olduğu ancak aralarında anlamlı bir ilişki olmadığı saptandı. Gruplar arasında anlamlı bir ilişki saptanmasa da, kardeşi eğitim almayan çocukların ortalama ÇDÖ puanı (13,5±7,21), kardeşi eğitim alanlara göre (11,23±6,35) daha yüksekti. Bununla birlikte kardeşi eğitim alanların %12,8’inin, kardeşi eğitim almayanların ise %25,0’ının depresyonda olduğu saptandı (p>0,05).

Sonuç

Bu çalışma, engelli çocukların kardeşlerinin psikososyal gelişimleriyle ilgili problemler yaşayabileceklerini, depresyona meyilli ya da depresyonda olabileceklerini göstermiştir. Engelli çocukların sağlıklı kardeşlerinin gelişim süreci göz ardı edilemeyecek kadar büyük önem taşımaktadır.

Anahtar Kelimeler:

Anahtar kelimeler: Çocuklar, depresyon, engelli, kardeş, psikososyal gelişim

Kaynaklar

Kittelsen TB, Castor C, Lee A, Kvarme LG, Winger A. "What about me?": lived experiences of siblings living with a brother or sister with a life-threatening or life-limiting condition. Int J Qual Stud Health Well-being. 2024;19(1):2321645.

CrossRef PubMed Google Scholar

Dinkelbach L, Köhler M, Galushko M, Pieper L, Kuhlen M, Danneberg M, et al. Psychosocial well-being of siblings of pediatric patients in palliative home care. J Pain Symptom Manage. 2023;66(6):630-637.e1.

CrossRef

Fullerton JM, Totsika V, Hain R, Hastings RP. Siblings of children with life-limiting conditions: psychological adjustment and sibling relationships. Child Care Health Dev. 2017;43(3):393-400.

CrossRef PubMed Google Scholar

Alderfer MA, Long KA, Lown EA, Marsland AL, Ostrowski NL, Hock JM, et al. Psychosocial adjustment of siblings of children with cancer: a systematic review. Psychooncology. 2010;19(8):789-805.

Long KA, Lehmann V, Gerhardt CA, Carpenter AL, Marsland AL, Alderfer MA. Psychosocial functioning and risk factors among siblings of children with cancer: an updated systematic review. Psychooncology. 2018;27(6):1467-1479.

CrossRef PubMed Google Scholar

Arslan E. (Advisor: Arı R.). Investigation of Erikson’s psychosocial development periods and ego identity processes in adolescents in terms of attachment styles. Doctoral Thesis, Institute of Social Sciences, Selcuk University. Department of child development and home management; child development and education department, Konya:2008.

Erik H. Erikson. Identity, youth and crisis. New York: W. W. Norton Company, 1968.

Erik H. Erikson. Identity and life cycle. New York: W. W. Norton Company, 1980.

Dereboy IF. Identity confusion, understanding, recognizing, handle. 1st ed., Malatya: Ozmert Ofset, 1993.

Erikson EH. The eight period of huma. Ankara: Individual and Community Publishing, 1984.

Kaplan BJ, Sadock VA, Ruiz P. Synopsis of psychiatry behavioral sciences/clinical psychiatry. 11st ed., Lippincot Williams & Wilkins. [Psikiyatri: davranış bilimleri/klinik psikiyatri. (Ali Bozkurt, Çev. Ed.). Ankara: Güneş Tıp Kitabevleri]; 2016.

Long C. (Advisor: Deniz ME.). Evaluation of depression and social skills in children with and without divorced parents. Master's Thesis, Istanbul Arel University Institute of Social Sciences, Department of Psychology, Istanbul:2013.

Taner YI. Depressive and bipolar disorders in children, adolescents, adults and the elderly. Department of Child and Adolescent. Ankara, 2013.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. [Internet]. Available from:https://www.psychiatry.org/psychiatrists/practice/dsm.

Kovacs M. The children's depression, inventory (CDI). Psychopharmacol Bull. 1985;21(4):995-998.

PubMed

Öy B. A validity and reliability study of the depression scale for children. Turkish Journal of Psychiatry. 1991;2(2):132-136.

Levante A, Martis C, Del Prete CM, Martino P, Primiceri P, Lecciso F. Siblings of persons with disabilities: a systematic integrative review of the empirical literature. Clin Child Fam Psychol Rev. 2025;28(1):209-253. Erratum in: Clin Child Fam Psychol Rev. 2025;28(1):254.

CrossRef PubMed Google Scholar

Martinez B, Pechlivanoglou P, Meng D, Traubici B, Mahood Q, Korczak D, et al. Clinical health outcomes of siblings of children with chronic conditions: a systematic review and meta-analysis. J Pediatr. 2022;250:83-92.e8.

Pinquart M. Behavior problems, self-esteem, and prosocial behavior in siblings of children with chronic physical health conditions: an updated meta-analysis. J Pediatr Psychol. 2023;48(1):77-90.

CrossRef PubMed Google Scholar

Wolff B, Magiati I, Roberts R, Pellicano E, Glasson EJ. Risk and resilience factors impacting the mental health and wellbeing of siblings of individuals with neurodevelopmental conditions: a mixed methods systematic review. Clin Psychol Rev. 2022;98:102217.

CrossRef PubMed Google Scholar

Powell TH, Ogle PA. Brothers and sisters: a special part of exceptional families. 3rd ed., Baltimore: Paul H. Brooks; 1985.

Valdivieso C, Ribley S, Ambler L. NICHCY New Digest; Children With Disabilities: Understanding sibling issues. Washington, Washington DS: Interstate Research Associates; 1988;11.

Bayhan P, Yükselen A. Sibling relationships of children who have disabled siblings. Journal of Selcuk University Faculty of Education. 2001;11:190-205.

Senel GH. Comparison of attitudes about insufficiency and their anxiety levels who have siblings with disability and those who do not. Journal of Special Education. 1995;2(1):33-39.

Ertürk B. (Advisor: Ahmetoğlu E.) Evaluation of the sibling relations of children with disabilities who participate in integrated education and those who do not, according to their mother and sibling perceptions Master's Thesis, Institute of Social Sciences, Trakya University. Department of Primary Education; Classroom Teaching. Edirne:2009.

Sloper P. Experiences and support needs of siblings of children with cancer. Health Soc Care Community. 2000;8(5):298-306.

CrossRef PubMed Google Scholar

Hanvey I, Malovic A, Ntontis E. Glass children: the lived experiences of siblings of people with a disability or chronic illness. J Community Appl Soc Psychol. 2022;32(5):936-948.

CrossRef

Bhattashali A, Ostrosky MM, Monda-Amaya L. Perceptions of typically developing children in India about their siblings with disabilities. International Journal of Inclusive Education. 2018;22(12):1257-1271.

CrossRef

Wawrzynski SE, Alderfer MA, Kvistad W, Linder L, Reblin M, Guo JW, et al. The social networks and social support of siblings of children with cancer. Children (Basel). 2022;9(1):113.

CrossRef

Le Boudec A, Akre C, Barrense-Dias Y, Berchtold A, Suris JC. Siblings of youths with chronic conditions: a school-based survey. Int J Adolesc Med Health. 2020;33(3):173-180.

CrossRef PubMed Google Scholar

Orm S, Haukeland Y, Vatne T, Silverman WK, Fjermestad K. Prosocial behavior is a relative strength in siblings of children with physical disabilities or autism spectrum disorder. Journal of Developmental and Physical Disabilities. 2022;34(4):591-608.

CrossRef PubMed Google Scholar

Shivers CM, Kozimor LM. Adolescent siblings of individuals with intellectual disabilities with and without comorbid mental health problems: a preliminary comparison of sibling perceptions. Journal of Mental Health Research in Intellectual Disabilities. 2017;10(1):1-16.

CrossRef

Shojaee S, Hemati Alamdarloo G, Nikoobin Borujeni F. Adjustment difficulties of siblings of children with disabilities and typically developing children. International Journal of Inclusive Education. 2020;24(4):414-426.

CrossRef

Tomeny TS, Baker LK, Barry TD, Eldred SW, Rankin JA. Emotional and behavioral functioning of typically-developing sisters of children with autism spectrum disorder: the roles of ASD severity, parental stress, and marital status. Research in Autism Spectrum Disorders. 2016;32:130-142.

CrossRef

Tomeny TS, Barry TD, Fair EC. Parentification of adult siblings of individuals with autism spectrum disorder: distress, sibling relationship attitudes, and the role of social support. Journal of Intellectual & Developmental Disability. 2016;42(4):320-331.

Tsai HJ, Cebula K, Liang SH, Fletcher-Watson S. Siblings' experiences of growing up with children with autism in Taiwan and the United Kingdom. Res Dev Disabil. 2018;83:206-216.

CrossRef PubMed Google Scholar

Shivers CM. Self-reported guilt among adult siblings of people with intellectual and developmental disabilities. Am J Intellect Dev Disabil. 2019;124(5):470-477.

CrossRef PubMed Google Scholar

Sommantico M, Parrello S, De Rosa B. Adult siblings of people with and without intellectual and developmental disabilities: sibling relationship attitudes and psychosocial outcomes. Res Dev Disabil. 2020;99:103594.

CrossRef PubMed Google Scholar