Clinical outcomes of psychosocial interventions for healthy siblings of children with cancer: A systematic review and meta-analysis.
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PURPOSE: To identify the psychosocial interventions delivered to healthy siblings of children with cancer, characterize their targeted outcomes, and determine their clinical effectiveness through meta-analysis. METHODS: This systematic review and meta-analysis followed PRISMA guidelines. Six databases were searched through December 2, 2025. Randomized controlled, non-randomized controlled, quasi-experimental, and single-group pre-post intervention studies were eligible. Risk of bias was assessed using Cochrane RoB 2 and ROBINS-I. Random-effects meta-analyses were performed, with sensitivity analyses stratified by study design and overall risk of bias. RESULTS: Twenty-two studies involving 1194 healthy siblings from 11 countries were included; 16 contributed to at least one meta-analysis (anxiety, n = 10; depressive symptoms, n = 9; quality of life, n = 6; trauma-related symptoms, n = 3). Interventions were mainly group-based and incorporated psychoeducation and cognitive-behavioral components across hospital, home, rehabilitation, and camp settings. Interventions were associated with reduced anxiety (Hedges' g = -0.442, p < .001), depressive symptoms (g = -0.231, p < .001), and trauma-related symptoms (g = -0.433, p < .001), and improved child self-reported quality of life (g = 0.350, p < .001). Parent-proxy quality of life also improved (g = 0.212, p = .003). Effect estimates were generally consistent across study-design and risk-of-bias strata. CONCLUSIONS: Psychosocial interventions were associated with improved psychological outcomes and quality of life, with the most consistent effect observed for anxiety. Because many included studies used single-group pre-post designs, findings primarily quantify observed change rather than establish causal efficacy. IMPLICATIONS FOR NURSING PRACTICE: Structured, evidence-based psychosocial programs involving nursing and mental health professionals may strengthen supportive care for healthy siblings of children with cancer.