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When a child is diagnosed with a chronic, life-threatening illness, there is a significant impact on the healthy siblings. Few studies have addressed the adaptation of well siblings in diagnoses other than cancer. The purpose of this descriptive correlational study was to examine the relationships between the risk and protective factors that affect the psychological adaptation of healthy siblings of a child with cystic fibrosis. Findings from this study suggest family environment, especially parental stress and perceived social support, may affect the adaptation of the well sibling. Adolescent well siblings were more at risk for environmental influences than their younger counterparts., When a child is diagnosed with a chronic, life-threatening illness, there is a significant impact on the entire family. Well siblings are at risk for psychological adaptation problems because of [...]

The overall mortality rate for infants in the U.S. is 9 in 1000 live births, two thirds of which die within the first 28 days of life (neonatal mortality). Factors influencing mortality rates need to be assessed to effectively lower total infant mortality. Birth weights influence fetal outcome the most and are the greatest single contributor to infant death rates. Low birth weight infants, weighing less than 2,500 grams (5.5 pounds), are generally cared for in hospital intensive care units, which has been found to improve survival. Hospital levels of care are rated one through three, where level three facilities treat highest risk patients. If overall infant mortality rates are to be lowered, an evaluation of level of care for normal birth weight infants has to be made to determine if care level contributes to their death. Birth and death records over a three year period between Jan 1979 and Dec 1982 were examined in Georgia. The level of care was determined by fetal, mother, and infant risk before delivery. Low birth weight infants treated in level three facilities had lower mortality rates. Normal birth weight infants with high maternal pre-delivery risk had decreased chance of death as the level of care improved. Labor complications which developed in pregnant women, regardless of pre-delivery risk, were associated with increased neonatal mortality rates at level one hospitals. The study suggests pregnant women should be evaluated for risk status and referred to level two or three hospitals for delivery if appropriate.