TY - JOUR A1 - Ernst, Johanna Christine A1 - Beierlein, Volker A1 - Romer, Georg A1 - Möller, Birgit A1 - Koch, Uwe A1 - Bergelt, Corinna T1 - Use and need for psychosocial support in cancer patients: a population-based sample of patients with minor children JF - Cancer N2 - 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. KW - Adult KW - Anxiety Disorders/psychology KW - Child KW - Depressive Disorder/psychology KW - Family/psychology KW - Female KW - Germany KW - Health Services Needs and Demand KW - Humans KW - Male KW - Middle Aged KW - Neoplasms/psychology KW - Parenting/psychology KW - Registries KW - Social Support KW - Socioeconomic Factors Y1 - 2013 U6 - http://dx.doi.org/10.1002/cncr.28021 VL - 119 SP - 2333 EP - 2341 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 - Beierlein, Volker A1 - Bultmann, Johanna Christine A1 - Möller, Birgit A1 - Klitzing, Kai A1 - Flechtner, Hans-Henning A1 - Resch, Franz A1 - Herzog, Wolfgang A1 - Brähler, Elmar A1 - Führer, Daniel A1 - Romer, Georg A1 - Koch, Uwe A1 - Bergelt, Corinna T1 - Measuring family functioning in families with parental cancer: Reliability and validity of the German adaptation of the Family Assessment Device (FAD) JF - Journal of psychosomatic research N2 - OBJECTIVE The concept of family functioning is gaining importance in psycho-oncology research and health care services. The Family Assessment Device (FAD) is a well-established measure of family functioning. Psychometric properties inherent in the German 51-item adaptation of the FAD are examined in different samples of families with parental cancer. METHODS Acceptance, reliability, and validity of FAD scales are analysed in samples from different study settings (N=1701 cancer patients, N=261 partners, N=158 dependent adolescent children 11 to 18years old). RESULTS Missing items in the FAD scales (acceptance) are rare for adults (<1.1%) and adolescent children (<4.4%). In samples of adults and older adolescents (15 to 18years), all FAD scales except for the Roles scale are significantly reliable (0.75≤Cronbach's α≤0.88). The scales correlate highly (0.46≤Pearson's r≤0.59) with the criterion satisfaction with family life (convergent validity), and have smaller correlations (0.16≤r≤0.49) with measures of emotional distress and subjective well-being (divergent validity). In most FAD scales, adults seeking family counselling report worse family functioning (0.24≤Cohen's d≤0.59) than adults in other samples with parental cancer (discriminative validity). CONCLUSION Overall, the German 51-item adaptation of the FAD reveals good acceptance, reliability, and validity for cancer patients and their relatives. Particularly the scale General Functioning shows excellent psychometric properties. The FAD is suitable in the assessment of families with parental cancer for adults and adolescents older than 11years. KW - Adolescent KW - Adult KW - Child KW - Cross-Cultural Comparison KW - Family Relations/psychology KW - Female KW - Germany KW - Humans KW - Male KW - Parents/psychology KW - Psychometrics/statistics {\&} numerical data KW - Reproducibility of Results KW - Statistics as Topic KW - Surveys and Questionnaires Y1 - 2017 U6 - http://dx.doi.org/10.1016/j.jpsychores.2016.11.007 VL - 93 SP - 110 EP - 117 ER - TY - JOUR A1 - Bergelt, Corinna A1 - Ernst, Johanna Christine A1 - Beierlein, Volker A1 - Inhestern, Laura A1 - Holes, Sarah A1 - Möller, Birgit A1 - Romer, Georg A1 - Koch, Uwe T1 - Reaktive Veränderungen in Befinden und Verhalten von Kindern bei elterlicher Krebserkrankung--Ergebnisse einer epidemiologischen Patientenbefragung JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - 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. KW - Adolescent KW - Adult KW - Child KW - Child Behavior Disorders/diagnosis/epidemiology/psychology KW - Child of Impaired Parents/psychology KW - Child Reactive Disorders/diagnosis/epidemiology/psychology KW - Preschool KW - Cross-Sectional Studies KW - Female KW - Germany KW - Health Surveys KW - Humans KW - Infant KW - Male KW - Middle Aged KW - Neoplasms/epidemiology/psychology KW - Personality Assessment KW - Resilience KW - Psychological KW - Young Adult Y1 - 2012 U6 - http://dx.doi.org/10.13109/prkk.2012.61.6.378 SN - 0032-7034 VL - 61 SP - 378 EP - 395 ER - TY - JOUR A1 - Ernst, Johanna Christine A1 - Beierlein, Volker A1 - Romer, Georg A1 - Möller, Birgit A1 - Koch, Uwe A1 - Bergelt, Corinna T1 - Psychosoziale Versorgung von Kindern mit einem an Krebs erkrankten Elternteil - Eine Bestandsaufnahme spezifischer Versorgungsangebote in Deutschland JF - Psychotherapie, Psychosomatik, medizinische Psychologie N2 - 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. KW - Adult KW - Child KW - Child Health Services/statistics {\&} numerical data KW - Family KW - Germany KW - Health Care Surveys KW - Humans KW - Neoplasms/therapy KW - Parents KW - Quality Assurance KW - Health Care KW - Single-Parent Family KW - Social Support Y1 - 2011 U6 - http://dx.doi.org/10.1055/s-0031-1286303 VL - 61 SP - 426 EP - 434 ER - TY - JOUR A1 - Becker, Inga A1 - Gjergji-Lama, Voltisa A1 - Romer, Georg A1 - Möller, Birgit T1 - Merkmale von Kindern und Jugendlichen mit Geschlechtsdysphorie in der Hamburger Spezialsprechstunde JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - Given the increasing demand for counselling in gender dysphoria in childhood in Germany, there is a definite need for empirical data on characteristics and developmental trajectories of this clinical group. This study aimed to provide a first overview by assessing demographic characteristics and developmental trajectories of a group of gender variant boys and girls referred to the specialised Gender Identity Clinic in Hamburg. Data were extracted from medical charts, transcribed and analysed using qualitative content analysis methods. Categories were set up by inductive-deductive reasoning based on the patients' parents' and clinicians' information in the files. Between 2006 and 2010, 45 gender variant children and adolescents were seen by clinicians; 88.9% (n = 40) of these were diagnosed with gender identity disorder (ICD-10). Within this group, the referral rates for girls were higher than for boys (1:1.5). Gender dysphoric girls were on average older than the boys and a higher percentage of girls was referred to the clinic at the beginning of adolescence (> 12 years of age). At the same time, more girls reported an early onset age. More girls made statements about their (same-sex) sexual orientation during adolescence and wishes for gender confirming medical interventions. More girls than boys revealed self-mutilation in the past or present as well as suicidal thoughts and/or attempts. Results indicate that the presentation of clinically referred gender dysphoric girls differs from the characteristics boys present in Germany; especially with respect to the most salient age differences. Therefore, these two groups require different awareness and individual treatment approaches. KW - Adolescent KW - Age Factors KW - Child KW - Preschool KW - Cooperative Behavior KW - Cross-Sectional Studies KW - Female KW - Gender Identity KW - Germany KW - Gonadal Steroid Hormones/therapeutic use KW - Humans KW - Interdisciplinary Communication KW - Male KW - Outpatient Clinics KW - Hospital KW - Psychotherapy KW - Puberty/drug effects/psychology KW - Referral and Consultation KW - Self Mutilation/epidemiology/psychology KW - Sex Factors KW - Suicidal Ideation KW - Transsexualism/diagnosis/epidemiology/psychology/therapy Y1 - 2014 SN - 0032-7034 VL - 63 SP - 486 EP - 509 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 - Möller, B. A1 - Stegemann, T. A1 - Romer, Georg T1 - Psychosoziale Belastungen bei Kindern körperlich kranker Eltern: Perspektiven der seelischen Gesundheitsvorsorge JF - Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz N2 - Irrespective of their well-known increased risk for mental health problems, children of somatically ill parents are a clinically underserved as well as under-researched group. In this article, the authors introduce the epidemiologic and clinical relevance of this topic and present a theoretical framework for understanding the sequelae of a serious parental illness on minor-age children, based on family dynamics and developmental concepts. This is followed by a comprehensive review of current empirical studies in this field, with a special emphasis on results from a transnational European collaborative study (COSIP = Children of Somatically Ill Parents), which was coordinated by the last author. The most important recommendations from intervention concepts published to date are summarized. Some outlooks for clinical practice as well as future research are presented. KW - Adaptation KW - Psychological KW - Adolescent KW - Anxiety Disorders/epidemiology/prevention {\&} control/psychology KW - Child KW - Child of Impaired Parents/psychology KW - Child Reactive Disorders/epidemiology/prevention {\&} control/psychology KW - Preschool KW - Cross-Cultural Comparison KW - Cross-Sectional Studies KW - Depressive Disorder/epidemiology/prevention {\&} control/psychology KW - Developmental Disabilities/epidemiology/prevention {\&} control/psychology KW - Family Relations KW - Family Therapy KW - Female KW - Germany KW - Health Education KW - Health Surveys KW - Humans KW - Infant KW - Newborn KW - Pregnancy KW - Risk Factors KW - Somatoform Disorders/epidemiology/prevention {\&} control/psychology KW - Stress KW - Psychological/complications Y1 - 2008 U6 - http://dx.doi.org/10.1007/s00103-008-0542-5 SN - 1436-9990 VL - 51 SP - 657 EP - 663 ER -