@article{ErnstBeierleinRomeretal.2011, author = {Ernst, Johanna Christine and Beierlein, Volker and Romer, Georg and M{\"o}ller, Birgit and Koch, Uwe and Bergelt, Corinna}, title = {Psychosoziale Versorgung von Kindern mit einem an Krebs erkrankten Elternteil - Eine Bestandsaufnahme spezifischer Versorgungsangebote in Deutschland}, series = {Psychotherapie, Psychosomatik, medizinische Psychologie}, volume = {61}, journal = {Psychotherapie, Psychosomatik, medizinische Psychologie}, doi = {10.1055/s-0031-1286303}, pages = {426 -- 434}, year = {2011}, abstract = {Children of a parent having cancer are at greater risk to develop mental health problems. Aim is to investigate specific psychosocial care for children having a parent with cancer, as well as to characterize and assess utilization and needs of affected minor children. Employees of institutions in Germany supplying psychosocial care to families with a parent having cancer were surveyed, using a semi-structured interview (n = 29). Specific psychosocial care for affected children is limited and heterogeneous in Germany. Regarding different distress stages of those families, the situation could be interpreted as eligible. However, this primarily reflects the low quality assurance of care. Results suggest that in addition to preventive care needs of children having a parent with cancer, increased needs exist in specific risk constellations, like in single parent families.}, subject = {Adult}, 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.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{BergeltErnstBeierleinetal.2012, author = {Bergelt, Corinna and Ernst, Johanna Christine and Beierlein, Volker and Inhestern, Laura and Holes, Sarah and M{\"o}ller, Birgit and Romer, Georg and Koch, Uwe}, title = {Reaktive Ver{\"a}nderungen in Befinden und Verhalten von Kindern bei elterlicher Krebserkrankung--Ergebnisse einer epidemiologischen Patientenbefragung}, series = {Praxis der Kinderpsychologie und Kinderpsychiatrie}, volume = {61}, journal = {Praxis der Kinderpsychologie und Kinderpsychiatrie}, issn = {0032-7034}, doi = {10.13109/prkk.2012.61.6.378}, pages = {378 -- 395}, year = {2012}, abstract = {Children of cancer patients are at risk for developing psychological symptoms. The parental appraisal of the child's psychological condition is a key variable for the utilization of child-centred psychosocial services. This study aimed at the systematic analysis of parental appraisals of changes in the emotional condition or behaviour of their children. We conducted an epidemiologic survey with a sample size of 1,809 patients with different cancer diagnoses, giving information about 2,581 children aged 21 years or younger at time of diagnosis. Quantitative information on children's distress during the disease and on changes in psychological condition or behaviour and qualitative information on the kind of changes were analysed. About half of the children were considered to be psychologically strongly affected during the disease. For about 25 \% negative changes in psychological condition or behaviour are reported, positive changes are reported for 20 \% of the children. Negative changes are most frequently described in young children (up to five years), positive changes are most frequently described in young adults (18 to 21 years). The results indicate that from the cancer parent's view many children are substantially distressed. Thus, the implementation of additional preventive psychosocial services seems reasonable and necessary.}, subject = {Adolescent}, language = {de} } @article{ErnstBeierleinRomeretal.2013, author = {Ernst, Johanna Christine and Beierlein, Volker and Romer, Georg and M{\"o}ller, Birgit and Koch, Uwe and Bergelt, Corinna}, title = {Use and need for psychosocial support in cancer patients: a population-based sample of patients with minor children}, series = {Cancer}, volume = {119}, journal = {Cancer}, doi = {10.1002/cncr.28021}, pages = {2333 -- 2341}, year = {2013}, abstract = {BACKGROUND Cancer patients and their minor children have been shown to experience psychological distress. The objectives of the current study were to 1) describe the need for and use of psychosocial support and 2) determine predictors of family-centered support use in patients with minor children. METHODS A population-based sample of 1809 patients was recruited via 2 cancer registries. The eligibility criteria were age 25 years to 55 years, an initial diagnosis received no longer than 6 years before this survey, and having at least 1 minor child. Medical characteristics and self-report measures were used. RESULTS Overall, approximately 38\% cases were identified as being borderline or probable anxiety cases and 16\% were identified as being borderline or probable depression cases. Since diagnosis, 44\% of the patients had used psychosocial support and 9\% had received family-focused and child-focused support. These patients perceived a lower quality of life and poorer family functioning. Approximately 73\% of patients with children wanted information concerning or psychosocial services to support their children or parenting. Use of family-centered support was not found to be predicted by disease-related factors (eg, cancer staging) but rather by subjective needs (eg, mental health and having a distressed child in the family). CONCLUSIONS The results of the current study emphasize the importance of child and parenting concerns in psychosocial care in oncology. Screenings for children and appropriate training programs for health care may increase awareness of this issue.}, subject = {Adult}, 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{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} } @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{BultmannBeierleinRomeretal.2014, author = {Bultmann, Johanna Christine and Beierlein, Volker and Romer, Georg and M{\"o}ller, Birgit and Koch, Uwe and Bergelt, Corinna}, title = {Parental cancer: Health-related quality of life and current psychosocial support needs of cancer survivors and their children}, series = {International journal of cancer}, volume = {135}, journal = {International journal of cancer}, doi = {10.1002/ijc.28905}, pages = {2668 -- 2677}, year = {2014}, abstract = {The presence of cancer and additional parental responsibilities can increase strain for individual patients as well as for their children. The construct of health-related quality of life (HRQL) is appropriate to measure a combination of physical, mental and social consequences as a result of disease. However, previous research has merely focused on symptom checklists. This study addresses the following questions: (i) does HRQL in children and their parents with cancer differ compared to the general population? (ii) Are there any variables that are associated with HRQL in children? (iii) What are current psychosocial support needs? A population-based survey of 976 survivors (<6 years post diagnosis) with minor children between 6 and 18 years (n = 1,449) was conducted with two German cancer registries. HRQL was assessed using SF-8 (survivors) and Kidscreen (children). The results were compared to normative populations, and predictors associated with HRQL in children were evaluated within a multilevel model. We found that the HRQL in children was better compared to the norm. Only children with support needs had worse HRQL. Older age, having a mother with cancer, having a parent not living together with a partner, and worse parental physical and mental health influenced HRQL in children. Illness characteristics were irrelevant. Even with a mean of 3.5 years after diagnosis, survivors had lower physical and mental health compared to the norm. Our findings reinforce the need for health professionals to pay attention to younger patients and their children. Even years after diagnosis, life might not have returned to normal.}, subject = {Adolescent}, language = {en} }