@article{InhesternBultmannBeierleinetal.2017, author = {Inhestern, Laura and Bultmann, Johanna Christine and Beierlein, Volker and M{\"o}ller, Birgit and Romer, Georg and Koch, Uwe and Bergelt, Corinna}, title = {Elterliche Sorgen und psychische Belastung bei krebskranken Eltern mit minderj{\"a}hrigen und jungerwachsenen Kindern}, series = {Psychotherapie, Psychosomatik, medizinische Psychologie}, volume = {67}, journal = {Psychotherapie, Psychosomatik, medizinische Psychologie}, doi = {10.1055/s-0043-110139}, pages = {279 -- 287}, year = {2017}, abstract = {Background Aim of the study was to analyze parenting concerns in cancer survivors and to identify covariats for parenting concerns. Method In a cross-sectional epidemiological sample of cancer survivors with minor children (n=1416) demographic and disease-related variables and psychological distress (HADS) were assessed. Parenting concerns were assessed using the Parenting Concerns Questionnaire (PCQ). The instrument covers the 3 subscales concerns about the 'practical impact' of the disease on the children, about the 'emotional impact' and concerns about the 'co-parent'. Results 73\% of survivors were female; mean age was 47.5 years (SD 5.9). 24\% to 71\% of patients reporting parenting concerns showed normal levels of anxiety and depression. We identified living alone, younger age of the youngest child, higher tumor stage and suffering from a comorbidity as significantly associated with parenting concerns in all subscales of the PCQ. Low socio-economic status was found to be significantly associated with parenting concerns regarding the emotional and practical impact of the disease. Being a mother was associated with concerns in the subscale co-parent. Discussion Parents with cancer not only suffer from psychological distress but also from parenting concerns about the impact of their disease on their children. Psychological support services should broach the issue of parenting concerns. Families at risk should be identified to allocate tailored support. Hintergrund Ziel der dargestellten Untersuchung ist es, elterliche Sorgen von Krebs{\"u}berlebenden zu untersuchen und Kovariaten dieser spezifischen Belastungen zu identifizieren. Material \& Methoden In einer epidemiologischen Stichprobe von n=1416 an Krebs erkrankten Eltern wurden soziodemografische und medizinische Merkmale sowie die psychische Belastung der Eltern (HADS) erhoben. Elterliche Sorgen wurden mit dem Parenting Concerns Questionnaire (PCQ) erhoben, der die Subskalen Sorgen um die ‚praktischen Auswirkungen' der Erkrankung auf die Kinder, ‚emotionale Auswirkungen' auf die Kinder und Sorgen in Bezug auf den ‚Co-Elternteil' umfasst. Ergebnisse 73\% der Krebs{\"u}berlebenden sind Frauen, das durchschnittliche Alter liegt bei 47,5 Jahren (SD 5,9). Zwischen 24\% und 71\% der Patienten mit elterlichen Sorgen zeigen in den Skalen der HADS unauff{\"a}llige Werte. Alleinleben, j{\"u}ngeres Alter des j{\"u}ngsten Kindes, ein h{\"o}heres Tumorstadium und das Vorhandensein einer weiteren k{\"o}rperlichen Erkrankung sind mit Sorgen in allen 3 Subskalen des PCQ positiv assoziiert. Ein niedriger Sozialstatus konnte als Kovariate f{\"u}r elterliche Sorgen auf emotionaler Ebene und auf praktischer Ebene identifiziert werden. Weibliches Geschlecht ist assoziiert mit Sorgen auf der Subskala Co-Elternteil. Diskussion Betroffene Eltern sind neben der allgemeinen psychischen Belastung durch die Erkrankung auch durch Sorgen um ihre Kinder belastet. Psychologische Unterst{\"u}tzungsangebote f{\"u}r krebskranke Eltern sollten auch spezifische elterliche Sorgen thematisieren. Eltern mit Risikokonstellationen f{\"u}r eine erh{\"o}hte Belastung sollten besonders ber{\"u}cksichtigt werden, um bedarfsgerecht Unterst{\"u}tzung anbieten zu k{\"o}nnen.}, subject = {Adolescent}, language = {de} } @article{KrattenmacherKuehneErnstetal.2012, author = {Krattenmacher, Thomas and K{\"u}hne, Franziska and Ernst, Johanna and Bergelt, Corinna and Romer, Georg and M{\"o}ller, Birgit}, title = {Parental cancer: factors associated with children's psychosocial adjustment - a systematic review}, series = {Journal of psychosomatic research}, volume = {72}, journal = {Journal of psychosomatic research}, doi = {10.1016/j.jpsychores.2012.01.011}, pages = {344 -- 356}, year = {2012}, abstract = {OBJECTIVE Children of cancer patients have an increased risk of developing psychosocial problems. But not all children are alike vulnerable to this stressful event. Thus, knowledge of risk and protective factors is required to design specific diagnostic tools and interventions for this vulnerable population. This study aims to provide a review and methodological evaluation of current studies examining factors associated with children's psychosocial adjustment when a parent has cancer. METHODS Four databases were systematically searched for quantitative research articles examining associative factors of children's adjustment. Study characteristics were analyzed and methodological quality was assessed by two independent reviewers. RESULTS 28 studies examining associative factors in 2896 families were identified. The included studies used a broad range of instruments assessing children's adjustment. Most patients were female breast cancer patients with middle to high socio-economic status. The majority of included studies used correlational approaches and cross-sectional designs. None of the studies examined toddlers or assessed children's quality of life. Across studies with low to high quality, we found no evidence of illness-related factors, except worse disease status that was related to lower adjustment. Evidence from moderate to high quality studies suggest that better family functioning indicates better adjustment, whereas parent's depressive mood indicates worse adjustment of the children. Child-related factors were inconsistent. CONCLUSION Health professionals should pay attention to cancer patients' dependent children. In order to identify this at-risk population, parent's depressive mood and poor family functioning should be considered. Future studies should also assess children's quality of life and child-related factors.}, subject = {Adaptation}, language = {en} } @article{KrattenmacherKuehneFuehreretal.2013, author = {Krattenmacher, Thomas and K{\"u}hne, Franziska and F{\"u}hrer, Daniel and Beierlein, Volker and Br{\"a}hler, Elmar and Resch, Franz and Klitzing, Kai V. and Flechtner, Hans-Henning and Bergelt, Corinna and Romer, Georg and M{\"o}ller, Birgit}, title = {Coping skills and mental health status in adolescents when a parent has cancer: a multicenter and multi-perspective study}, series = {Journal of psychosomatic research}, volume = {74}, journal = {Journal of psychosomatic research}, doi = {10.1016/j.jpsychores.2012.10.003}, pages = {252 -- 259}, year = {2013}, abstract = {OBJECTIVE Parental cancer increases the risk of psychosocial problems in adolescents. We investigated the frequency and efficacy of adolescents' coping strategies and relationships between those strategies and mental health status. Age and gender differences regarding coping and mental health were also investigated. METHODS In total, 214 adolescents from 167 families participated in a cross-sectional, multicenter study. All participants were recruited from standard oncological care. Among the participants, 52\% utilized a child-centered intervention program. Adolescents' coping skills were measured using KIDCOPE. Mental health status was rated by adolescents and parents by the SDQ for symptomatology and the KIDSCREEN for well-being. RESULTS We found that 29\% of the adolescents showed emotional and behavioral problems. We found gender differences in mental health status but not in coping. Adolescents used a broad spectrum of coping strategies. Active problem-solving, distraction, acceptance, wishful thinking and seeking social support were the most frequently used coping strategies. The utilization of certain coping skills was mediated by their perceived efficacy. Problem-focused or approach-oriented coping strategies generally are associated with better mental health, while avoidance-oriented coping are associated with worse mental health. Emotion-focused coping was associated with both lower and higher mental health. CONCLUSION The strategies used by adolescents to cope with parental cancer are associated with their mental health. Problem-solving and approach-oriented coping strategies should be facilitated by psychological interventions regardless of age and gender. Age and gender differences in adolescents' mental health should be further investigated because these differences are not explained by differences in coping strategies.}, subject = {Adaptation}, language = {en} } @article{KrattenmacherKuehneFuehreretal.2012, author = {Krattenmacher, Thomas and K{\"u}hne, Franziska and F{\"u}hrer, Daniel and Ernst, Johanna and Br{\"a}hler, Elmar and Herzog, Wolfgang and Klitzing, Kai and Flechtner, Hans-Henning and Bergelt, Corinna and Romer, Georg and M{\"o}ller, Birgit}, title = {Kinder krebskranker Eltern - elterliches Coping, famili{\"a}res Funktionsniveau und psychosoziale Anpassung der Kinder}, series = {Praxis der Kinderpsychologie und Kinderpsychiatrie}, volume = {61}, journal = {Praxis der Kinderpsychologie und Kinderpsychiatrie}, issn = {0032-7034}, doi = {10.13109/prkk.2012.61.6.447}, pages = {447 -- 462}, year = {2012}, abstract = {Children exposed to parental cancer have an increased risk of mental health problems. However, the parental illness itself and its features do not predict children's psychological adjustment. Parent- and family-related factors are more predictive for children's well-being and the incidence of psychopathological symptoms, respectively. This study focuses on parental ways of coping with illness from both, the ill and healthy parent's perspective, and the relationship with family functioning and children's adjustment. Results show a significant impact of parental coping styles on children's health-related quality of life and psychopathological symptoms and, furthermore, that this relationship is mediated by aspects of family functioning. This study support the importance of family systems approaches. Implications for further studies and practical issues are discussed.}, subject = {Adaptation}, language = {de} } @article{KrattenmacherKuehneHalverscheidetal.2014, author = {Krattenmacher, Thomas and K{\"u}hne, Franziska and Halverscheid, Susanne and Wiegand-Grefe, Silke and Bergelt, Corinna and Romer, Georg and M{\"o}ller, Birgit}, title = {A comparison of the emotional and behavioral problems of children of patients with cancer or a mental disorder and their association with parental quality of life}, series = {Journal of psychosomatic research}, volume = {76}, journal = {Journal of psychosomatic research}, doi = {10.1016/j.jpsychores.2013.11.020}, pages = {213 -- 220}, year = {2014}, abstract = {OBJECTIVE To compare the emotional and behavioral problems of children of patients suffering from cancer or a mental disorder and their association with parental quality of life. METHODS A total of 223 children from 136 families and their 160 parents were investigated from multiple perspectives in a cross-sectional study. The consistency of different adjustment reports between family members was examined. Through mixed models, the differences between parental HRQoL and the children's symptomatology were studied with regard to the type of parental illness. The prediction of children's adjustment through parental HRQoL was further examined. Additionally, gender and age of the children were considered. RESULTS Half of the children exhibited psychosocial problems. Gender and age differences were independent of the type of parental disease. In families with parental cancer, the reports of children's adjustment were more consistent between family members than in families where a parental mental disorder was present. We found differences in HRQoL between families with mentally ill parents and those with parental cancer patients. Specifically, the healthy partners of mentally ill parents showed worse HRQoL compared with healthy partners of cancer patients. Healthy parents' reduced HRQoL was associated with worse adjustment in their children, regardless of the type of parental illness, but this result was not found for ill parents. CONCLUSION Family members confronted with parental cancer or mental disorders are more burdened compared with those from the normal population, independently of the type of disease. Our results indicate that the type of a parental disease has no direct effect on children's adjustment. However, there are disease-specific effects on parental HRQoL, which are associated with children's adjustment.}, subject = {Adolescent}, language = {en} } @article{KuhlmannRomerMoeller2020, author = {Kuhlmann, Anna-Lena and Romer, Georg and M{\"o}ller, Birgit}, title = {„Wenn man sich so besser f{\"u}hlt …"}, series = {Praxis der Kinderpsychologie und Kinderpsychiatrie}, volume = {69}, journal = {Praxis der Kinderpsychologie und Kinderpsychiatrie}, issn = {0032-7034}, doi = {10.13109/prkk.2020.69.6.524}, pages = {524 -- 540}, year = {2020}, abstract = {If One Feels Better Like That …. Adolescent Sibling Relationship in the Context of Transgender Development A transgender development in youth can influence the relationship of concerned youth and their siblings. While in most surveys, the focus lies on transgender adolescents, both sides shall be interviewed here to capture the situation of siblings and to relate the results. For this purpose, guide interviews with ten transgender adolescents and twelve of their siblings were analysed in accordance to Grounded Theory. In most cases, participants were satisfied with the sibling relationship. After the coming-out of the transgender adolescent they showed both positive and negative reactions that, however, changed to respect and acceptance by time without exception. Doubt, compassion and grief were short lived and often replaced by joy for the transgender adolescent. Transgender youth were mostly satisfied with the reaction of their sibling though the amount of support varied. The time of coming-out and transition often led to an improvement in sibling relationship, more closeness and family cohesion. In general, siblings seem to be immediately concerned by transgenderism in adolescence. In clinical practice, they should thus be included from the beginning. By taking into account their situation, negative developments can be prevented, and the sibling relationship become usable as a resource. Zusammenfassung Eine transidente Entwicklung im Jugendalter kann die Beziehung der Betroffenen und ihrer Geschwister beeinflussen. W{\"a}hrend in den meisten Untersuchungen der Fokus eher auf den transidenten Jugendlichen liegt, wurden hier beide Seiten befragt, um die Situation der Geschwister zu erfassen und die Ergebnisse zueinander in Beziehung setzen zu k{\"o}nnen. Hierzu wurden Leitfaden-gest{\"u}tzte Interviews mit zehn transidenten Jugendlichen sowie zw{\"o}lf ihrer Geschwister nach den Regeln der Grounded Theory ausgewertet. In den meisten F{\"a}llen zeigten sich die Teilnehmenden mit der Geschwisterbeziehung zufrieden. Auf das Coming-out des transidenten Jugendlichen zeigten die Geschwister positive wie negativen Reaktionen, die sich jedoch im Laufe der Zeit ausnahmslos zu Respekt und Akzeptanz wandelten. Zweifel, Mitleid und Trauer waren nur von kurzer Dauer und wurden oft durch Freude f{\"u}r den transidenten Adoleszenten ersetzt. Die transidenten Jugendlichen zeigten sich mit der Reaktion des Geschwisters grunds{\"a}tzlich zufrieden, obwohl das Maß an Unterst{\"u}tzung unterschiedlich war. Die Zeit des Coming-out und der Transition f{\"u}hrte h{\"a}ufig zu einer Verbesserung der Geschwisterbeziehung, mehr N{\"a}he und famili{\"a}rem Zusammenhalt. Insgesamt zeigte sich, dass die Geschwister bei einer Transidentit{\"a}t im Jugendalter unmittelbar mitbetroffen sind und daher im klinischen Alltag von Anfang an mit einbezogen werden sollten. Durch Ber{\"u}cksichtigung ihrer Situation kann negativen Entwicklungen vorgebeugt und die Geschwisterbeziehung als Ressource nutzbar werden.}, subject = {Adolescent}, language = {de} } @article{KuehneHaagenBaldusetal.2013, author = {K{\"u}hne, Franziska and Haagen, Miriam and Baldus, Christiane and Diareme, Stavroula and Grether, Andrea and Schmitt, Florence and Stanescu, Dan and St{\"o}ckl, Margit and Thastum, Mikael and M{\"o}ller, Birgit and Romer, Georg}, title = {Implementation of preventive mental health services for children of physically ill parents: experiences in seven European countries and health care systems}, series = {General hospital psychiatry}, volume = {35}, journal = {General hospital psychiatry}, doi = {10.1016/j.genhosppsych.2012.10.005}, pages = {147 -- 153}, year = {2013}, abstract = {OBJECTIVE Parental physical disease is a family issue, but families' minor children are seldom considered. The current study analyzed experiences with implementation of counseling for families with physically ill parents and minor children during a European multisite pilot project. METHOD Implementation protocols of seven European partner centers collaborating in a joint research project were analyzed by Mayring's qualitative content analysis. Both an inductive approach and a deductive approach were chosen. Satisfaction of families and therapists was considered based on information from three partner centers. RESULTS Satisfaction with counseling was rather high. Mentioned problems referred to aspects related to liaison partners, family-related aspects and physicians' concerns. Recommendations related to contacting families, liaising with other professions, implementing counseling together with a research project, and training. Results are integrated in the current dissemination literature. CONCLUSION Successful implementation was mostly determined by aspects of interdisciplinary cooperation and communication, perceived relative advantage and organizational premises. With regard to this kind of innovative child-centered family mental health services, top-down and bottom-up implementation strategies should be combined, and strategies of maintenance and sustainability should be considered from the very beginning.}, subject = {Adolescent}, language = {en} } @article{KuehneKrattenmacherBeierleinetal.2012, author = {K{\"u}hne, Franziska and Krattenmacher, Thomas and Beierlein, Volker and Grimm, Johann Christian and Bergelt, Corinna and Romer, Georg and M{\"o}ller, Birgit}, title = {Minor Children of Palliative Patients: A Systematic Review of Psychosocial Family Interventions}, series = {Journal of Palliative Medicine}, volume = {15}, journal = {Journal of Palliative Medicine}, number = {8}, doi = {10.1089/JPM.2011.0380}, pages = {931 -- 945}, year = {2012}, language = {en} } @article{KuehneKrattenmacherBergeltetal.2013, author = {K{\"u}hne, Franziska and Krattenmacher, Thomas and Bergelt, Corinna and Beierlein, Volker and Herzog, Wolfgang and V Klitzing, Kai and Weschenfelder-Stachwitz, Heike and Romer, Georg and M{\"o}ller, Birgit}, title = {There is still so much ahead of us - Family functioning in families of palliative cancer patients}, series = {Families, systems \& health : the journal of collaborative family healthcare}, volume = {31}, journal = {Families, systems \& health : the journal of collaborative family healthcare}, doi = {10.1037/a0032274}, pages = {181 -- 193}, year = {2013}, abstract = {Adopting a systems approach, parental cancer has its impact on patients, spouses, and dependent children. The purpose of the current study was to examine family functioning dependent on parental disease stage and on family member perspective in families of cancer patients with adolescent children. The cross-sectional study was conducted within a German multisite research project of families before their first child-centered counseling encounter. The sample comprised individuals nested within N = 169 families. Analyses performed included analysis of covariance (ANCOVA) and intraclass correlation. Open answers were analyzed following quantitative content analysis procedures. Between 15\% and 36\% of family members reported dysfunctional general functioning scores. Parents indicated more dysfunctional scores on the Family Assessment Device scale Roles, and adolescents more dysfunctional Communication scores. Regarding assessment of family functioning, there was higher agreement in families with parents in a palliative situation. For adolescents with parents in palliation, incidents because of the disease tend to become more dominant, and spending time with the family tends to become even more important. As our study pointed out, parental cancer, and especially parental palliative disease, is associated with both perceived critical and positive aspects in family functioning. Supporting families in these concerns as well as encouraging perceptions of positive aspects are important components of psycho-oncological interventions for families with dependent children.}, subject = {Adolescent}, language = {en} } @article{KuehneKrattenmacherBergeltetal.2013, author = {K{\"u}hne, Franziska and Krattenmacher, Thomas and Bergelt, Corinna and Bierbaum, Anna-Lena and Christine Ernst, Johanna and Flechtner, Hans-Henning and Keller, Monika and Klitzing, Kai V. and Romer, Georg and M{\"o}ller, Birgit}, title = {Elternschaft und Krebserkrankung: Dyadische Analyse von psychosozialer Belastung und gesundheitsbezogener Lebensqualit{\"a}t von krebskranken Eltern minderj{\"a}hriger Kinder}, series = {Psychotherapie, Psychosomatik, medizinische Psychologie}, volume = {63}, journal = {Psychotherapie, Psychosomatik, medizinische Psychologie}, doi = {10.1055/s-0033-1341454}, pages = {473 -- 481}, year = {2013}, abstract = {The purpose of this study was the analysis of psychological distress and health-related quality of life (HRQoL) of parents with minor children during curative resp. palliative treatment.Cross-sectional design with a sample of N=89 parent dyads. Dyadic analysis of demographic, illness and family variables via mixed linear models.Patients and healthy partners indicated psychological distress on different subscales. Intradyadic correlations were small-moderate. Most important predictors of psychological distress and HRQoL were treatment stadium, gender, family functioning, and employment status.Dependent on demographic variables, psychooncological support was evident mainly for parents in palliative care and for families with dysfunctional functioning.}, subject = {Adult}, language = {de} }