@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{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{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}
}
@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{MoellerSchreierLietal.2009,
  author    = {M{\"o}ller, Birgit and Schreier, Herbert and Li, Alice and Romer, Georg},
  title     = {Gender identity disorder in children and adolescents},
  series = {Current problems in pediatric and adolescent health care},
  volume    = {39},
  journal   = {Current problems in pediatric and adolescent health care},
  doi       = {10.1016/j.cppeds.2009.02.001},
  pages     = {117 -- 143},
  year      = {2009},
  subject      = {Adolescent},
  language  = {en}
}