@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{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{RomerKuehneBergeltetal.2011, author = {Romer, Georg and K{\"u}hne, Franziska and Bergelt, Corinna and M{\"o}ller, Birgit}, title = {Seelische Gesundheitsvorsorge f{\"u}r Kinder krebskranker Eltern}, series = {Psychotherapeut}, volume = {56}, journal = {Psychotherapeut}, issn = {0935-6185}, doi = {10.1007/s00278-011-0849-9}, pages = {400 -- 408}, year = {2011}, language = {de} } @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{InhesternBultmannBeierleinetal.2016, 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 = {Understanding parenting concerns in cancer survivors with minor and young-adult children}, series = {Journal of psychosomatic research}, volume = {87}, journal = {Journal of psychosomatic research}, doi = {10.1016/j.jpsychores.2016.05.008}, pages = {1 -- 6}, year = {2016}, abstract = {OBJECTIVE Parents with cancer are concerned about the impact of their disease on their children. However, parenting concerns and associated factors in cancer survivors have not previously been analyzed. The purpose of this study is to examine parenting concerns and to test a path model for understanding parenting concerns in cancer survivors. METHODS In a cross-sectional study, a total of 1416 parents with cancer (mean age 47.5years, 74\% women) having minor or young-adult children were recruited through two cancer registries. Parenting concerns were assessed using the Parenting Concerns Questionnaire. Structural equation modeling (SEM) was used to analyze the associations between social support, parenting confidence, emotional distress, family functioning and parenting concerns. RESULTS Mothers reported higher total parenting concerns than fathers (p<0.001). We observed strong effects of emotional distress and parenting confidence on parenting concerns. Family dysfunctioning was associated with lower concerns. An indirect association between social support and parenting concerns was identified. CONCLUSION Parenting concerns in cancer survivors display the need for interventions and after care programs that focus on affected families with minor and young adult children. The results of the structural path model illustrate the associations between psychological and interactional factors. Supporting parents with cancer in their parenting confidence and strengthen social support and family functioning may not only reduce the long-term burden on the parents themselves but also the burden on the entire family.}, subject = {Adolescent}, 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{InhesternBeierleinBultmannetal.2017, author = {Inhestern, Laura and Beierlein, Volker and Bultmann, Johanna Christine and M{\"o}ller, Birgit and Romer, Georg and Koch, Uwe and Bergelt, Corinna}, title = {Anxiety and depression in working-age cancer survivors: a register-based study}, series = {BMC cancer}, volume = {17}, journal = {BMC cancer}, doi = {10.1186/s12885-017-3347-9}, pages = {347}, year = {2017}, abstract = {BACKGROUND Anxiety and depression can be a long-term strain in cancer survivors. Little is known about the emotional situation of cancer survivors who have to deal with work- and family-related issues. The purpose of this study was to investigate anxiety and depression in working-age cancer survivors and associated factors. METHODS A register-based sample of 3370 cancer survivors (25 to 55 years at time of diagnosis) diagnosed up to six years prior to the survey was recruited from two German cancer registries. Demographic and medical characteristics as well as self-reported measures were used. RESULTS Overall, approximately 40\% of the survivors reported moderate to high anxiety scores and approximately 20\% reported moderate to high depression scores. Compared to the general population, working-age cancer survivors were more anxious but less depressed (p < .001). Subgroups with regard to time since diagnosis did not differ in anxiety or depression. Anxiety and depression in cancer survivors were associated with various variables. Better social support, family functioning and physical health were associated with lower anxiety and depression. CONCLUSIONS Overall, we found higher anxiety levels in cancer survivors of working-age than in the general population. A considerable portion of cancer survivors reported moderate to high levels of anxiety and depression. The results indicate the need for psychosocial screening and psycho-oncological support e.g. in survivorship programs for working-age cancer survivors. Assessing the physical health, social support and family background might help to identify survivors at risk for higher emotional distress.}, subject = {Adaptation}, language = {en} } @article{MoellerBarkmannKrattenmacheretal.2014, author = {M{\"o}ller, Birgit and Barkmann, Claus and Krattenmacher, Thomas and K{\"u}hne, Franziska and Bergelt, Corinna and Beierlein, Volker and Ernst, Johanna and Br{\"a}hler, Elmar and Flechtner, Hans-Henning and Herzog, Wolfgang and Klitzing, Kai and F{\"u}hrer, Daniel and Resch, Franz and Romer, Georg}, title = {Children of cancer patients: prevalence and predictors of emotional and behavioral problems}, series = {Cancer}, volume = {120}, journal = {Cancer}, doi = {10.1002/cncr.28644}, pages = {2361 -- 2370}, year = {2014}, abstract = {BACKGROUND Children of patients with cancer are at increased risk for developing emotional and behavioral problems. This study explored the prevalence and predictors of emotional and behavioral problems in Children of cancer patients in a multisite research project. METHODS A cross-sectional sample of N = 235 families was recruited simultaneously in 5 university medical centers. The participants, including parents (N = 402) and children (N = 324; ages 11-21 years) completed standardized questionnaires. Emotional and behavioral problems in children were measured by the Strengths and Difficulties Questionnaire (SDQ). On the basis of previous research and using a mixed-model approach, child-, parent-, family- and cancer-related variables were examined in addition to socioeconomic status as potential predictors. Descriptive statistics and a multiple random coefficient model were used in the analyses. RESULTS Compared to norms, Children of cancer patients show increased mean levels of emotional and behavioral symptoms. The best predictor of emotional and behavioral problems from the perspectives of the child, the healthy parent, and the ill parent was general family dysfunction. Although family dysfunction was identified as the main predictor, the analysis revealed that the main part of variance was related to the individual child's level. CONCLUSIONS The results indicate that screening for child mental health problems and family dysfunction in oncological and psychosocial treatment units can identify the families most in need of psychosocial support. Psychological services need to be both family-oriented and child-centered and focus on family dysfunction to prevent mental health problems in children.}, subject = {Adolescent}, language = {en} } @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} }