TY - JOUR A1 - Kühne, Franziska A1 - Krattenmacher, Thomas A1 - Beierlein, Volker A1 - Grimm, Johann Christian A1 - Bergelt, Corinna A1 - Romer, Georg A1 - Möller, Birgit T1 - Minor Children of Palliative Patients: A Systematic Review of Psychosocial Family Interventions JF - Journal of Palliative Medicine Y1 - 2012 U6 - http://dx.doi.org/10.1089/JPM.2011.0380 VL - 15 IS - 8 SP - 931 EP - 945 ER - TY - JOUR A1 - Kühne, Franziska A1 - Krattenmacher, Thomas A1 - Bergelt, Corinna A1 - Beierlein, Volker A1 - Herzog, Wolfgang A1 - V Klitzing, Kai A1 - Weschenfelder-Stachwitz, Heike A1 - Romer, Georg A1 - Möller, Birgit T1 - There is still so much ahead of us - Family functioning in families of palliative cancer patients JF - Families, systems & health : the journal of collaborative family healthcare N2 - 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. KW - Adolescent KW - Adult KW - Aged KW - Analysis of Variance KW - Child KW - Child of Impaired Parents/psychology KW - Cross-Sectional Studies KW - Family Relations KW - Female KW - Germany KW - Humans KW - Male KW - Middle Aged KW - Neoplasms KW - Palliative Care KW - Self Report Y1 - 2013 U6 - http://dx.doi.org/10.1037/a0032274 VL - 31 SP - 181 EP - 193 ER - TY - JOUR A1 - Kühne, Franziska A1 - Krattenmacher, Thomas A1 - Bergelt, Corinna A1 - Bierbaum, Anna-Lena A1 - Christine Ernst, Johanna A1 - Flechtner, Hans-Henning A1 - Keller, Monika A1 - Klitzing, Kai V. A1 - Romer, Georg A1 - Möller, Birgit T1 - Elternschaft und Krebserkrankung: Dyadische Analyse von psychosozialer Belastung und gesundheitsbezogener Lebensqualität von krebskranken Eltern minderjähriger Kinder JF - Psychotherapie, Psychosomatik, medizinische Psychologie N2 - 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. KW - Adult KW - Child KW - Preschool KW - Cross-Sectional Studies KW - Employment KW - Family KW - Female KW - Humans KW - Infant KW - Linear Models KW - Male KW - Middle Aged KW - Neoplasms/complications/psychology KW - Neuropsychological Tests KW - Palliative Care KW - Parents/psychology KW - Psychiatric Status Rating Scales KW - Quality of Life KW - Stress KW - Psychological/etiology/psychology Y1 - 2013 U6 - http://dx.doi.org/10.1055/s-0033-1341454 VL - 63 SP - 473 EP - 481 ER - TY - JOUR A1 - Kühne, Franziska A1 - Krattenmacher, Thomas A1 - Bergelt, Corinna A1 - Ernst, Johanna C. A1 - Flechtner, Hans-Henning A1 - Führer, Daniel A1 - Herzog, Wolfgang A1 - Klitzing, Kai V. A1 - Romer, Georg A1 - Möller, Birgit T1 - Parental palliative cancer: psychosocial adjustment and health-related quality of life in adolescents participating in a German family counselling service JF - BMC palliative care N2 - UNLABELLED BACKGROUND Parental palliative disease is a family affair, however adolescent's well-being and coping are still rarely considered. The objectives of this paper were a) to identify differences in psychosocial adjustment and health-related quality of life (HRQoL) among adolescents and young adults with parents suffering from palliative cancer or cancers in other disease stages, b) to relate psychosocial adjustment and health-related quality of life to adolescent coping, and c) to explore significant mediator and predictor variables. METHODS Cross-sectional data were derived from a multi-site research study of families before child-centered counselling. N=86 adolescents and young adults were included, their mean age 13.78 years (sd 2.45), 56% being female. Performed analyses included ANCOVA, multiple linear regression, and mediation analysis. RESULTS Adolescents with parents suffering from palliative cancers reported significantly less total psychosocial problems, and better overall HRQoL. There were no significant group differences regarding coping frequency and efficacy. Our set of coping items significantly mediated the effect of parental disease stage on psychosocial problems and HRQoL. Further, parental disease status and general family functioning predicted psychosocial problems (R2adj =.390) and HRQoL (R2adj =.239) best. CONCLUSION The study indicates distress among adolescents throughout the entire parental disease process. Our analysis suggests that counselling services could offer supportive interventions which focus particularly on adolescent coping as well as family functioning. Y1 - 2012 U6 - http://dx.doi.org/10.1186/1472-684X-11-21 VL - 11 SP - 21 ER - TY - JOUR A1 - Möller, Birgit A1 - Barkmann, Claus A1 - Krattenmacher, Thomas A1 - Kühne, Franziska A1 - Bergelt, Corinna A1 - Beierlein, Volker A1 - Ernst, Johanna A1 - Brähler, Elmar A1 - Flechtner, Hans-Henning A1 - Herzog, Wolfgang A1 - Klitzing, Kai A1 - Führer, Daniel A1 - Resch, Franz A1 - Romer, Georg T1 - Children of cancer patients: prevalence and predictors of emotional and behavioral problems JF - Cancer N2 - 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. KW - Adolescent KW - Adult KW - Child KW - Child Behavior Disorders/etiology KW - Child of Impaired Parents/psychology KW - Female KW - Humans KW - Male KW - Mental Disorders/etiology KW - Neoplasms/psychology KW - Parents/psychology KW - Prevalence KW - Risk Factors KW - Surveys and Questionnaires KW - Young Adult Y1 - 2014 U6 - http://dx.doi.org/10.1002/cncr.28644 VL - 120 SP - 2361 EP - 2370 ER - TY - JOUR A1 - Romer, Georg A1 - Kühne, Franziska A1 - Bergelt, Corinna A1 - Möller, Birgit T1 - Seelische Gesundheitsvorsorge für Kinder krebskranker Eltern JF - Psychotherapeut Y1 - 2011 U6 - http://dx.doi.org/10.1007/s00278-011-0849-9 SN - 0935-6185 VL - 56 SP - 400 EP - 408 ER - TY - JOUR A1 - Kühne, Franziska A1 - Haagen, Miriam A1 - Baldus, Christiane A1 - Diareme, Stavroula A1 - Grether, Andrea A1 - Schmitt, Florence A1 - Stanescu, Dan A1 - Stöckl, Margit A1 - Thastum, Mikael A1 - Möller, Birgit A1 - Romer, Georg T1 - Implementation of preventive mental health services for children of physically ill parents: experiences in seven European countries and health care systems JF - General hospital psychiatry N2 - 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. KW - Adolescent KW - Child KW - Child Health Services KW - Child of Impaired Parents/psychology KW - Preschool KW - Counseling KW - Europe KW - Humans KW - Mental Health Services KW - Patient Satisfaction KW - Pilot Projects KW - Preventive Health Services/organization {\&} administration KW - Program Development KW - Qualitative Research KW - Surveys and Questionnaires Y1 - 2013 U6 - http://dx.doi.org/10.1016/j.genhosppsych.2012.10.005 VL - 35 SP - 147 EP - 153 ER - TY - JOUR A1 - Krattenmacher, Thomas A1 - Kühne, Franziska A1 - Halverscheid, Susanne A1 - Wiegand-Grefe, Silke A1 - Bergelt, Corinna A1 - Romer, Georg A1 - Möller, Birgit T1 - 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 JF - Journal of psychosomatic research N2 - 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. KW - Adolescent KW - Affective Symptoms/psychology KW - Child KW - Female KW - Humans KW - Male KW - Mental Disorders/psychology KW - Neoplasms/psychology KW - Parent-Child Relations KW - Parents/psychology KW - Quality of Life Y1 - 2014 U6 - http://dx.doi.org/10.1016/j.jpsychores.2013.11.020 VL - 76 SP - 213 EP - 220 ER - TY - JOUR A1 - Krattenmacher, Thomas A1 - Kühne, Franziska A1 - Führer, Daniel A1 - Ernst, Johanna A1 - Brähler, Elmar A1 - Herzog, Wolfgang A1 - Klitzing, Kai A1 - Flechtner, Hans-Henning A1 - Bergelt, Corinna A1 - Romer, Georg A1 - Möller, Birgit T1 - Kinder krebskranker Eltern - elterliches Coping, familiäres Funktionsniveau und psychosoziale Anpassung der Kinder JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - 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. KW - Adaptation KW - Psychological KW - Adolescent KW - Adult KW - Child KW - Child of Impaired Parents/psychology KW - Preschool KW - Family Relations KW - Female KW - Germany KW - Humans KW - Male KW - Neoplasms/psychology KW - Parents/psychology KW - Quality of Life/psychology KW - Social Adjustment KW - Surveys and Questionnaires Y1 - 2012 U6 - http://dx.doi.org/10.13109/prkk.2012.61.6.447 SN - 0032-7034 VL - 61 SP - 447 EP - 462 ER - TY - JOUR A1 - Krattenmacher, Thomas A1 - Kühne, Franziska A1 - Ernst, Johanna A1 - Bergelt, Corinna A1 - Romer, Georg A1 - Möller, Birgit T1 - Parental cancer: factors associated with children's psychosocial adjustment - a systematic review JF - Journal of psychosomatic research N2 - 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. KW - Adaptation KW - Psychological KW - Child KW - Humans KW - Neoplasms/psychology KW - Parents/psychology KW - Social Adjustment Y1 - 2012 U6 - http://dx.doi.org/10.1016/j.jpsychores.2012.01.011 VL - 72 SP - 344 EP - 356 ER - TY - JOUR A1 - Krattenmacher, Thomas A1 - Kühne, Franziska A1 - Führer, Daniel A1 - Beierlein, Volker A1 - Brähler, Elmar A1 - Resch, Franz A1 - Klitzing, Kai V. A1 - Flechtner, Hans-Henning A1 - Bergelt, Corinna A1 - Romer, Georg A1 - Möller, Birgit T1 - Coping skills and mental health status in adolescents when a parent has cancer: a multicenter and multi-perspective study JF - Journal of psychosomatic research N2 - 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. KW - Adaptation KW - Psychological/classification/physiology KW - Adolescent KW - Adult KW - Age Factors KW - Aged KW - Child KW - Cross-Sectional Studies KW - Female KW - Humans KW - Male KW - Mental Disorders/epidemiology/etiology KW - Middle Aged KW - Neoplasms/psychology KW - Parents KW - Psychiatric Status Rating Scales Y1 - 2013 U6 - http://dx.doi.org/10.1016/j.jpsychores.2012.10.003 VL - 74 SP - 252 EP - 259 ER -