How to Write Critical Appraisal for Qualitative Study?

Author: Sana Rehman

This qualitative research is about the attitudes and approaches towards the vaginal atrophy when there is menopause in females and they have to face vaginal atrophy. The results were collected from the focus groups discussion of multicultural settings. These focus groups were composed of females who were experiencing vaginal atrophy after menopause and the results were collected based on personality types and the psychological factors. The study findings depicted that the responses and treatment concern for vaginal atrophy among females depends upon personality types (Utian & Maamari, 2014). The Following steps would highlight ''How to write critical appraisal for qualitative study''.

Steps of the Research Process

The purpose of the research was to collect the responses from females towards the vaginal atrophy after menopause. The focus groups discussion comprised on three-four hours and maximum 3-5 women have been a part of this focus groups. Hence, the research method for this study was the preference of focus groups to obtained the in-depth information. After FGD's, the results were presented considering the personality types of females. It was found out that those females who had individualism and stongth decision making power had taken the treatment for vaginal atrophy. In contrast those women who were submissive and had instincts of belongingness were not provided with any treatments. Their health care physicians satisfied them that vaginal atrophy is a part of aging and requires no treatment. However, it was concluded at the end of the research that the responses and approach for treatment to vaginal atrophy was based on the personality types. The findings of the study will help thefthe to understand how their personality types are interlinked with their perception towards health. 

Strengths and Weaknesses of the Qualitative Research

Congruency between the research questions and the research methodologies is the strength of good research (Lockwood, Munn & Porritt, 2015). This research has a good congruency because the research question is well explained with the help of the results collected during the focus group studies. The other strengths of this study are to make the females aware that vaginal atrophy is a medical condition and they need to take it seriously. They must see a doctor and if they are facing any severe or mild difficulty, they need to tell the doctor or their health care provider. Another strength of this research is the selection of focus groups at international level which shows that this problem prevails all around the world and females face and combat this issue according to the personality types. The research can make them stimulated to have awareness about this topic and to address this issue with the wise approach. This is so because they have all the rights to talk about their physical issues and must not hide or ignore such issues. The study is also important because all the females in the world have to pass through a phase of menopause and then they develop certain changes in their bodies and vaginal atrophy is one of them. Another positive goal of the study is the use of personality-based approaches to treat the females and to create awareness among them. This research highlights the issues and concerns about the health of females. The weakness of this research is realized when only a small fraction of respondents are included in the focus groups. Another weakness is felt that doctors or care providers have not been included in this research. So, the opinions of only females regarding the issue were recorded.

Credibility and Reliability of the Results

Good research also has unbiased goals and presentation of the results irrespective of the cultural perspectives. This shows that quality research is based on theories and facts and is not biased with the cultural backgrounds of the researcher (Lockwood, Munn & Porritt, 2015). Hence, this research is shown at an international level without considering the cultural perspectives. Only one thing was taken into account during the research and it was the medical reason of the females. The research is both credible and reliable, because it was based on a careful focus group discussion and the problems were observed and recorded all around the world that females are facing vaginal atrophy after the menopause. So, the international issue of females has come under observation and the research has put enough contribution to highlight the revolving factors. A lot of females in the world are facing this issue and there is a need to create awareness to deal with this issue and counseling of the females is needed to be done to promote awareness among them. Couselling services will help them get better health status and strenght to deal with their genuine medical issues.

Questions for Peer Follow-up

1-      The results of this research show that vaginal atrophy treatment is dependent on the personality types of the females and according to me there might be some other reasons behind this. What is your input in this regard?

2-       In the research methodology, only women were selected from four counties and the research is given the name of the international study. Is not it a partial study in which other countries needed to be added at a broad level? What is your stance on this insight?

 

 

 

 

 

 

 

 

Psychiatry of Pandemic: A Mental Health Response To Crises Management

 

Author: Sana Rehman

The book depicts the interesting but alarming picture of multiple historical infection outbreaks. It signifies how the previous infection outbreak occurred and impacted the mental, physical & psychological wellbeing of humans. Also, unlike other disaster management book, it stressed upon the formulation of mental health response to combat against unique elements of a pandemic outbreak. The has book been divided into 13 sections including, introduction, history of the pandemic, psychology of pandemic, social, public & epidemiological aspects of the pandemic, the importance of culture in managing pandemic, preparing for an outbreak, Neuropsychiatric complication of pandemic, social distancing, the mental health of isolation or quarantine, mental health care for survivors, mental health assistance to family and vaccination. 

The book is significant as it provided the historical evidenced based strategies, which would help in dealing with the contemporary COVID-19 pandemic. According to the introductory chapter, the most prevalent infection outbreaks were ZIKA Virus, MERS, SARS, HIV Pandemic, Ebola, Haemorrhage Fever, The Antoine Plague, The Justinian Plague, The Black Death, The Athenian Plague (430 B.C), SARS, Spanish Flue Pandemic (1918-1920), Swine Flue or H1N1/09 pandemic, Ebola Outbreak (2014-2016), Zika (2015-2016), and Smallpox in Yogoslavai (1972). The effects of these outbreaks developed the uneasiness & anxiety in previous centuries across the globe were described. 

According to the book, the advances in therapies, health care, technologies, and international surveillance efforts could not faint the epidemic potential of an infection outbreak. The impact of infection outbreak on socio-economic life was also observed in the form of expansion, international travel, misuse of antimicrobial agent and attitude towards immunization. Hence the international public health intends to identify the infectious disease to reduce/ overcome the public health risk.

Mental health experts devoted their contribution, but unfortunately, the psychiatric care in the infectious outbreak could not get recognition as a discipline. The subspecialty psychiatry (a) consultation-liaison psychiatry (b) and disaster psychiatry were introduced and applied to control the mental health responses of the people.

The book highlights the several pandemic responses such as time-lapse and disease modelling, mental health burden on health workers, quarantine neuropsychiatry, behavioural contagions and emotional epidemiology and the precarious status of health care facilities. The book advocates the mental health responses to these outbreaks following the insanity and plague concept. 

The book describes the number of cultural, religious and burial approaches to mitigate the devastating impact of a pandemic. Also, it, suggest that the preparation for an outbreak considering medication, psychotherapies an intervention plan helps to reduce the devastating consequences of the pandemic (Wolf, 2016).

The book acclaimed the strong relation between infection outbreak and neuropsychiatric complications. The biological and psychological impact of infection has been elaborated in the light of literature. The representation of biological anatomy due to infectious disease has been depicted very interestingly. Furthermore, it has also been elaborated that the treatment and medication of infection diseases cause neuropsychiatric complications such as delirium, dementia, schizophrenia, anxiety and depression (Munjal, 2017). The book also recommended the two effective ways to break the chain the pandemic, i.e. isolation and quarantine.

 The history and emergence of quarantine and isolation have been elaborated in details. Furthermore, it highlighted the mental health of the patients and population who are exposed to isolation and pandemic. The most commonly reported psychological issues were depression, anxiety, delirium, hopelessness, despair, psychological trauma and cognitive impairment. The mental health issues of people affected by quarantine have also been discussed. The book demonstrates the psychiatric square of surviving the pandemic its complications, and its treatment complications. In the acute phase of suffering, minor symptoms can cause psychiatric symptoms from mood changes to cognitive impairment.

The role of the health care worker in the crucial time of pandemic has been elaborated cornering their mental health. It was reported that health care workers experience psychological and emotional burnt during the isolation or quarantine. In the light of literature, multiple innervations and facilities were suggested to support them. The book provides a clear picture for providing the psychological first aid with the interventions and medications furthermore, as health care professionals provide self-less health care support.

The health care staff persistent exposure to stressful situation, increased the risk for death, separation from a loved one, traumatization and hopelessness. The findings highlight the physical, emotional, psychological and spiritual need for health care professionals such as communication, leadership, support, health assessment, prophylactic medication, relaxation, mindfulness, self-help skill workforce resilience, teamwork, self-appreciation, and psychosocial programs for families. Lastly, the employee assistance program should be introduced to access the psychiatric and pharmacological intervention, antidepressants, psychotic interventions. 

Although the provision of mental health support is hard to provide but a crucial part. The book highlight the importance and need of mental health facilities to a family member, survivors and health care staff through grief and loss counselling, medication and psychological interventions.

Finally, the role of vaccination in controlling the pandemic has been elaborated. Initially, the book illustrates the discoveries of the vaccine started from 1706s for the management of smallpox. In 1881 Loius pasture discovered the management for chicken cholera and anthrax. The twenty centuries several successful vaccinations have been introduced against Diphtheria, Mumps, Measles and Rebbula. The polio vaccine has been one of the major development for Herps, Simplex, HIV, Gonorrhoea and Malaria. Then the dependency and effectiveness of the vaccine have been elaborated. The economic changes in the development and preservation of vaccine have been elaborated.

Vaccination policy reported is being a critical element in attaining the immunity against infectious disease. Role of national authorities and agencies such as WHO, European Commission and CDC in immunization agenda has also been highlighted. Vaccination in the context of the pandemic outbreak has also been elaborated. According to the book, the vaccine was working effectively; but due to new strains, the advancement in vaccination was needed. 

The adverse effect of the vaccine on the mental health of patients has also been addressed in details. Overall, the book provided the historical background of infection diseases along with treatment modalities. The book has contemporary significance as like other historical infection diseases; the COVID-19 can also be controlled using pharmacological, psychological and vaccination (Goldberg, 2020: Li et al., 2020).

 

 

 

 

 

Childhood Obesity among Aboriginal and Torres Strait Islander children living in Rural Queensland

Author: Sana Rehman

Part A: Impact of Childhood Obesity at the Level of Individual, Community and Population 

Childhood obesity has become the most concerning issue of the current time. The action plan is needed to prevent childhood obesity in rural Queensland. For developing the action plan, the adverse impact of childhood obesity is crucial to identify. The impact of childhood obesity, key areas to make changes, and action plan are mentioned below.

 

According to the 2016 census, the ratio of Aboriginal and Torres Islander children in the rural island is 4.0% (Queensland Government Statistician’s Office, 2016). In the recent five years, the Aboriginal and Torres Strait Islander residents of Queensland rural area ratio has been increased to 19.7% (30,658) (Sherriff et al., 2019). The growing proportion of aboriginal and Torres Strait islander is adversely impacting the health conditions of the general population and the children’s as well. The ever increasing ratio is developing economic issue to meet the necessities of the population, and the most prevalent issue which has been observed is childhood obesity.

Childhood obesity is very prevalent among Aboriginal and Terror Strait Australian Children living in rural Queensland (Thurber, Dobbins, Neeman, Banwell, & Banks, 2017). In particular, the burden of disproportionate morbidity and mortality are very common among obsess children’s of rural Queen land (Phillips, Morrell, Taylor, Daniels, 2014). In 2012 to 2013 the one-third of Aboriginal and Strait Islander child (age range 12-14) estimated to be overweight (Phillips, Morrell, Taylor, & Daniels, 2014: Australian Bureau of Statistics, 2013). The impact of childhood obesity is alarming for physical, emotional, psychological and social life (Schwarzman et al., 2019). 

The physical impact of childhood obesity liked to develop type 2 diabetes. It adversely affects the life expectancy of the child for up to 27 years. Childhood obesity adversely affects the emotional well-being of the child, and they start to display inappropriate emotion in a diverse situation. The recent researches have demonstrated the positive correlation between childhood obesity and emotional problems (Phillips, Morrell, Taylor, & Daniels, 2014). 

The psychological impact of physical obesity includes low self-esteem, negative self-concept, and anxiety and body dysmorphic symptoms. The literature suggested that childhood obesity is positivity associated with the psychological disturbance, which may deteriorate the personal, social and occupational life of the children (Schwarzman et al., 2019). 

The social impact of childhood obesity adversely affect the occupational functioning of the child as further leads to isolation and leads to much antisocial behaviour (Chung et al., 2016). Therefore for the emotional, psychological, and behavioural well-being of the children, their physical fitness is crucial.

The socio-economic factors determine the prospect of any area. The lack of nutrients and medical facilities leads to poor health and low life expectancy (Sherriff et al., 2019). The environment of rural Queensland poses lack of health and nutrient facility. These deprivation are leading to childhood obesity and related issues. The Aboriginal and terror strait island child experience substantial hurdles if rural Queensland. Therefore there is dire need to devise a plan for changing the alarming current condition. 

B: Key areas where change can be made to reduce the impact of health issues

The risk factor for childhood obesity can be seen in three clusters such as biological, socio-economic and behavioural. Firstly, according to the biological perspective, obesity has some predisposed effect. According to researches, obsess parents are more at risk of having obese children’s compared to slim ones. Secondly, as mentioned earlier, Childhood obesity is interlinked with the poor socio-economic condition of children living in rural Queensland. 

The food and health care deprivation among children’s of rural areas are the primary determinants of childhood obesity. According to recent data, the proportion of childhood obesity is significantly correlated with disadvantages background (Schwarzman et al., 2019). The lack of adequate socio-economic facilities leads to childhood obesity.

 

As the rural areas posses with the least medical and nutrients facility and children with low socio-economic status bound to buy cheap and unhealthy foods (Kim et al., 2017). Furthermore, the lack of adequate medical facilities also contributes to developing health-related issues. The two main areas which have been identifying to make change are unhealthy food leads and lack of medical facilities in rural areas of Queensland. Thirdly, unhealthy behaviours are also very strong determents of childhood obesity (Australian Institute of Health and Welfare, 2018). The children often commit unhealthy behaviour due to inadequate rural environment. Therefore, the prevention of childhood obesity is essential by making changes in these areas. 

The change in reducing childhood obesity can be made by following a few steps. Initially, childhood obesity can be curbed among children of rural areas of queen land through policymaking, considering the social-economic context. The Government should take collaborative steps with the Aboriginal community for reducing nutrition deficiency and other related health issues. More actions should be taken to promote the Minjilang Health and Nutrition Project (Northern Territory; 1989-199029) in rural Queensland for the aboriginal and terror islander children (Australian Bureau of Statistics. (2016). The Government should facilitate the peoples of rural Queen land with basic health care measures.

 

There is dire need to hire more health care staff, funding aids, and workforce training in rural areas so that childhood obesity can be control. Furthermore, another is that needs attention to children behaviour. The children’s are indulged in the poor behavioural chain of food intake and routine habit. In order to break their food intake and unhealthy health habit chain, health equality policies should be promoted (Guzys, Brown, Halcomb, & Amp; Whitehead, 2017). 

The aboriginal and terror island children do not get equal, housing, medical, education and social facilities. Unequal rights lead to unhygienic or unhealthy behaviour. The implication of the Looma Healthy Lifestyle Project (Western Australia; initiated in 1993 and still ongoing) is needed for childhood obesity prevention (Schwarzman et al., 2019). The obesity itself is not that dangerous, but a risk factor for causing multiple deadly diseases. Therefore the prevention programs are essential to developing. 

C: Action plans to address the health issues

The best nursing practice is primarily associated with promoting health and fabric in the community as the current issue of childhood obesity in rural Queensland is very prevalent (Queensland Government Statistician’s Office, 2016). Here the role of a registered nurse is very crucial to develop health-related behaviour to prevalent the proportion of childhood obesity. The health promotion empowers the infected individual, family and community to develop insight by educating and developing skill to combat against disease (Edelman, Mandle, &Kudzma, 2014). 

The targeted area that needs change to overcome obesity in rural Queensland is health-related behaviour. The obsess children of rural areas found to be indulged in health risk behaviour such as cheap and malnutrient foods, improper daily routine, unhygienic habits and residential issues (Fleming & Parker, 2019). The issues should be resolve at border spectrum as Government and policymaker should invest their time and expenditures to improve the condition of the children’s. The Government and policymakers would indulge in this action plan and informed about the necessities of the medical staff, financial aid, funding and other related things. As far as the action plan for the nursing perspective is concerned, by taking multiple steps the childhood obesity can be control. 

The very first step of an action plan for the promotion of health and the prevention of childhood obesity is the regular assessment of the children. The assessment includes diet, sedentary behaviours and physical activity. The second step is the assessment of family environment such as parenting, acceptance, rejection, and quality time etc. The obtained information from this initial assessment would provide sufficient details to design an intervention plan for the children. On the basis of these assessments, it can be concluded that intervention should be universally applied or individually. 

What population should be targeted, such as children, parents, caregivers, teachers and neighbours?  

In the current issue of obesity, children will be asses on a regular basis for identifying their health habits, including nutrients, sedentary lifestyles, and physical activity. The cheap and unhealthy food and lack of physical activity will be reduced following behaviour modification technique. The children will be educated through stories, video clips and other interesting activities about how malnutirents food and lack of health activities leads to childhood obesity. The parents or caretaker of the children’s would also be psycho-educate about unhealthy health habits and would assist in developing health-related behaviour to prevent obesity among children’s. The effectivity of the action plan would be assessed through post-assessment. This action plan would help in controlling the obesity issues in rural Queensland. 

Conclusion 

The childhood obesity has arisen to an alarming extent in rural Queensland, but with appropriate aid and action plan, the issue can be controlled. Further longitudinal researchers, case studies and systematic reviews are crucial to conducting for the identification of the latest epidemiological issues so that more intervention plan can be designed. 

Case Study of Structural and Functional Changes in Crohn's Disease

Author: Sana Rehman

Crohn's disease is a type of inflammatory bowel disease which refers to the intermittent episodes of abdominal cramping and diarrhea. It causes inflammation in the digestive tract and often leads to weight loss fatigue and vomiting and nausea. In the current case, Jordan is a 25 years old male diagnosed with Crohn's Disease.

Structural and Functional Changes 

The structural and functional wellbeing of digestive tracts is crucial for the health of the individual. The structural abnormalities often leads to functional decline, as a result human experience unhealthy life. The structural changes in inflammatory bowel disease mainly occur due to issue in digestive tract. Hence the distal ileum is the most prevalent issue in IBD. Furthermore, the inflammation or thickness of the intestine wall is also one of the kind of inflammatory bowel disease. In the current case, Jordan was experiencing diarrhea, abdominal cramp, and weight loss and diagnosed with Crohn's disease. 

The complete medical assessment of the Jorden’s reports suggest multiple changes in the structure of digestive tracts, which further leads to the weight loss. The structure changes of inflammatory disease were large patches of inflamed mucosa and submosca throughout his small bowel and colon. He was also diagnosed with the bowel obstruction in his terminal ileum. The dry and pale skin were the other symptoms due to the structural issues. The structural abnormalities were inhibiting the organs to function well. The relationship between structural and functions are consistent. The structural wellbeing of the digestive system promotes better functioning. In contrast, the structural abnormalities disturb the functional system as well (Nair et al., 2016).  

The functional changes which have been observed in Jordan’s case were dysfunction of food consumption and water intake. The digestive system was not processing appropriately to absorb the food. As a result, Jordan was experiencing nausea and vomiting. The inflamed digestive tract was not properly performing its function. Diarrhea or lack of food consumption and vomiting were reducing the weight of the Jordan. Due to Crohn's disease, the sleep cycle was also disturbed. Furthermore, Jordan was not able to appropriately walk and perform daily activities. The work-life was also reported to be disturbed. Apart from these, Jordan was experiencing multiple pain.

The functions of the entire body were disturbed due to structural issues. All these structural abnormalities were contributing to weight loss in Jordan’s case. Literature suggests that structural abnormalities in the digestive system not merely affect the function of that particular organ, but also disturbs the entire body functions (Nair et al., 2016).

Role of Morphine in determining the Pathways to alter the Conscious Perception of Pain

Morphine is a very effective painkiller for reducing pain in multiple body areas. In particular, it is effective in blocking the pain due to Crohn's disease. Morphine found to be more effective painkiller in contemporary medicines. The recent data suggested the effectivity of morphine in pain reduction and led to a better condition of the patients. It is effective because it directly effects on opioid receptors (GCPR), which regulates pain in the nervous system. Opioid receptors are widely distributed in the brain, spinal cord, digestive tract. These receptors respond to encephala, which control body pain.

Morphine mimics the compound to artificially block pain. Morphine binds the opioid receptors that generate the series of events, and GCPR activates g-protein. It also triggers more conduction through potassium channels and minimizes the conduction through calcium channels and adenylate cyclase. In this way, the nervous system controls the body’s signalling system that transmits pain. The robust evidence-based studies have been carried out on patients with Crohn's disease (Morrone et al., 2017). 

The results of the studies recommended the morphine three most effective medicine for blocking pain. A few contradictory studies also reported that morphine as a least effective painkiller due to its side effect (Long, Barnes, Herfarth, &Drossman, 2012), but the ratio of such studies were very limited. Therefore, it can be concluded that morphine is an effective medicine for relieving abdominal pain.

The Clinical Manifestation indicates the deterioration of Jordan’s Condition

The clinical manifestation that deteriorates the Jordan Crohns or inflammatory bowel is comprised of a cluster of symptoms. Such as diarrhea, abdominal pain, weight loss, nausea or billing vomiting, fatigue, mails, tenderness, abdominal gurgling & rumbling, and dark colour urine. The medical examination showed right lower abdominal quadrant and audible bowl sound, pale and dry skin, cool extremities, capillary and flat neck veins. Medical Officer reported bowel obstruction in terminal inflamed mucosa & submucosa throughout his small bowel and colon. The above symptoms have a history of gradual development.

 This early sign and symptoms of the Crohn's disease were observed in the age of 17. Currently, Jordan is 25 years old and still suffering from acute pain and Crohn's disease. Unfortunately, the lack of proper treatment by medical officers and surgeon lead to deteriorating the condition of Jordan. The issues needed medical attention but tried to manage by consulting doctors and nutrients. No improvement in Jordan's condition has been observed despite having invasive treatments. According to recent studies, the timely treatment for an early sign and symptoms for Crohn's disease must be taken (Ha, & Khalil, 2015). In some other studies, the delayed treatment and inappropriate treatments worsen the condition of the patients.

Characteristics of Intravenous Fluid and Rational for Administration

The intravenous fluid is a liquid substance used to fulfil the water, sugar and salt (Barkas, Liberopoulos, Kei &Elisaf, 2013). The intravenous fluid injected through a vein to those patients who cannot consume oral food. Intravenous food is available in many types and forms. In Jordan’s case, the 100 ml Hartman compound sodium was used to fulfil diet deficiency. The Hartman solution is a mixture of sodium lactate, sodium chloride, potassium, calcium and chloride. It is used for multiple purposes such as relapsing electrolytes & fluids among patients with low blood pressure, low blood volume and metabolic acidosis (Kammermeier, 2016). The fluid is injected through veins.

In the current case as Jorden was suffering from weight loss. He was not consuming many diets due to diarrhea and vomiting, as his intestine and bowel tract was not functioning correctly. To fulfil the diet deficiency, 100 ml Hartman compound solution was injected in his body. The literature is enriched with the evidence-based studies reflects the effectivities of intravenous fluid for the management of Crohn's disease affects (Barkas, Liberopoulos, Kei &Elisaf, 2013). The robust studies also indicate the effectiveness of intravenous fluid in weight gain among the patients of Crohn's disease (Kammermeier, 2016).

 

Envy among Siblings

 

Author: Sana Rehman

What is Envy among Siblings?

Envy is a feeling of discontented aroused by siblings' luck, possession, or quality. The envy among siblings has become a very alarming issue in the current time. Many awful, terrible, and nasty incidents have been seen regarding envy towards siblings on media. However, it is very important to identify the causes and ways to reduce envy among siblings. The common causes and ways to overcome envy are listed below.

What are the Causes of Envy 

The causes of Envy are important to address so that recommendations can be identified. The following points are the fundamental causes of Envy. 

Birth order. The birth order among sibling influences the personality patterns. It has been observed through literature those firstborn children are more confident and dominating compared to the other siblings. While the younger one found to be more stubborn, outspoken, and aggressive compare to the middle child. Besides, the middle child often manifests a shy, even-tempered, and spoiled baby. The feeling of envy developed when they do not get the environment according to their needs and personality demand.

Unfair Comparisons. Sometimes sibling starts hating each other due to making unfair comparisons. They do not understand their individual difference and want to get all the qualities and advantage the other sibling gets. For example, my sibling is more capable or beautiful than me. He gets more love from parents compared to me. These kinds of unfair comparisons lead to envy and hate among siblings.

Work pressure. Domestic work or work for financial support is also a reason for developing envy among siblings. It has been observed that if a sibling fulfills his work-oriented responsibilities properly, but the other sibling doesn’t. This kind of conflict also leads to a feeling of envy among siblings.  

Family Influence. Sometimes family develops a feeling of hate or envy among their children. The provision of more academic and career opportunities to one child develops the hate of that particular child. Sometimes a child or person gets more respect from family due to his personality traits, as a result, the other sibling starts feeling insecure. These insecurities further retransform in envy and other negative emotions.

Parental Influence. Parental affection towards one child is considered another important factor in developing envy among other siblings. In a western culture like Pakistan, people either love their talented or successful child or the most incapable child. The preference and love for children vary from family to family. If parents love the incapable child the hardworking child experiences disappointment and as a result manifests negative feelings towards siblings. On the other hand, if a parent loves only a capable child, then a less hardworking child manifests more envy or feeling of hate towards other siblings. 

Hitting Millstones. Sometimes one child of the family achieves high milestones such as high academic grades, a good job, or better carrier options. Such a milestone provides high attention from relatives, family, and people. High achievement of one child often develops low self-esteem among people and they start manifesting feelings of hatred.

How to Reduce Envy among Siblings?

The feeling of envy among siblings is very crucial to reduce for establishing healthy relationships. There are certain ways to control envy towards siblings, which are listed below.

Stop making Comparison. As mentioned above unfair comparison among siblings by parents, relatives or self is a very common cause. Therefore there is a need to avoid making a comparison in front of siblings. On the parental level, the parents should understand that each child is born with some special and unique characteristics. On a personal level, children, adults, or adolescents need to understand that they have different qualities and use their talent wisely to achieve their academic, career, or personal goal. They also need to understand that envy is a very negative feeling and blood relations are meant to be loved.

Divide work or responsibility equally. Every sibling needs to understand their role and responsibilities and perform their tasks persistently. The division of responsibilities and work is very effective in establishing healthy or stable relationships. 

Remind positive traits. Usually, people start hating their siblings because they do not know their positive traits. Familiarity with personal traits or capabilities gives a sense of self-confidence. As a result, one doesn’t feel insecure about the success of other siblings. Not only familiarity but one should frequently remind their positive traits to avoid the feeling of envy.  

Love Yourself. Always accept and love yourself, this s the only way to keep your mind positive. The people who do not love themselves often shoe unkind behavior towards others. Love towards self often develops the feeling of respect and affection for the other one. Hence in this way envy can hate can be reduced.

 Find the special and alone time. Try to spend quality time with each of your siblings. Quality time will help you to establish mutual understanding. Mutual understanding would further help you to accept your siblings regardless of all flaws or virtues. All these factors would help to build a healthy relationship with siblings and overcome the feeling of envy.