Siblings of Children With Cancer and Their Challenges Across Everyday Life Contexts: A Two-Phase Qualitative Study in Denmark.

Aim: To explore the familial, emotional, social and school-related challenges experienced by school-aged siblings of children with cancer, focusing on how these challenges intersect across hospital, home and school in their everyday lives.

Design: Qualitative, two-phase, multi-site study.

Methods: Fieldwork was conducted at two distinct paediatric oncology wards, followed by semi-structured interviews with 11 siblings (aged 7-19 years) and 20 parents, recruited through criterion-based sampling. The data were analysed using reflexive thematic analysis.

Results: Analysis showed that siblings were often marginalised in hospital life due to (1) family logistics; (2) hospital-induced restrictions, rules and physical spaces and (3) perceptions of their presence as 'problematic', ultimately limiting their access. In family life, siblings experienced peripheral roles because (1) they were cared for by others, (2) had their needs subordinated and (3) faced shifting expectations. At school, siblings encountered (1) limited understanding from classmates and teachers and (2) insufficient support resources.

Conclusions: Siblings of children with cancer face significant, interconnected challenges, often amplified by the structural frameworks of healthcare, family and school contexts.

Impact: Siblings of children with cancer are often marginalised in their own lives. In healthcare, a family-centred approach to care should formally and actively include siblings. Nurses are well-positioned to promote this, ensuring whole-family support. Siblings would benefit from coordinated support bridging hospital, home and school.

Reporting method: This study adheres to the SRQR Checklist.

Patient or public contribution: Parents helped shape the study focus by discussing preliminary observations and potential support needs.