School-based social and educational support for siblings of children with cancer- Siblings' and parents' feedback on an intervention proposal (SUPREME)

Purpose: Siblings of children with cancer experience the consequences of their brother or sister's disease and treatment firsthand, often causing social and school-related difficulties. This study aimed to gather parents' and siblings' feedback on a proposal for a school-based social and educational support intervention for siblings with the goal of tailoring the program to meet the needs of siblings. Method: Adopting a criterion sampling strategy, we conducted interviews with 20 parents and 11 siblings, aged 7-19 years, of children with cancer. During the interviews, we introduced a proposal for a school-based intervention as part of a co-creation design. Data were examined by content analysis. Results: The analysis showed that both parents and siblings recognized: 1) the need to inform the class about the family's situation, 2) the need for the timing and content of the support to align with the family's stage in the cancer journey. 3) Parents' concerns centered on potentially imposing experiences on siblings, losing school as a 'free space', and the risk of siblings standing out. 4) Siblings' concerns related to a fear of losing control over the cancer-related information at school and the reactions of peers. The final SUPREME intervention involved clarifying family meetings before two educational, nurse-led school visits addressing challenges relevant to siblings' academic and social lives. Conclusion: The participants' responses to the intervention proposal played a key role in shaping the final intervention, encompassing valuable insights into precautions necessary for implementing school-based support for siblings of children with cancer.