TY - JOUR A1 - Inhestern, Laura A1 - Bultmann, Johanna Christine A1 - Beierlein, Volker A1 - Möller, Birgit A1 - Romer, Georg A1 - Koch, Uwe A1 - Bergelt, Corinna T1 - Understanding parenting concerns in cancer survivors with minor and young-adult children JF - Journal of psychosomatic research N2 - 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. KW - Adolescent KW - Adult KW - Adult Children/psychology KW - Child KW - Preschool KW - Comprehension KW - Cross-Sectional Studies KW - Female KW - Humans KW - Infant KW - Newborn KW - Male KW - Middle Aged KW - Neoplasms/epidemiology/psychology KW - Parent-Child Relations KW - Parenting/psychology KW - Social Support KW - Surveys and Questionnaires KW - Survivors/psychology KW - Young Adult Y1 - 2016 U6 - http://dx.doi.org/10.1016/j.jpsychores.2016.05.008 VL - 87 SP - 1 EP - 6 ER - TY - JOUR A1 - Inhestern, Laura A1 - Bultmann, Johanna Christine A1 - Beierlein, Volker A1 - Möller, Birgit A1 - Romer, Georg A1 - Koch, Uwe A1 - Bergelt, Corinna T1 - Elterliche Sorgen und psychische Belastung bei krebskranken Eltern mit minderjährigen und jungerwachsenen Kindern JF - Psychotherapie, Psychosomatik, medizinische Psychologie N2 - 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 Krebsüberlebenden 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 Krebsüberlebenden 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 unauffällige Werte. Alleinleben, jüngeres Alter des jüngsten Kindes, ein höheres Tumorstadium und das Vorhandensein einer weiteren körperlichen Erkrankung sind mit Sorgen in allen 3 Subskalen des PCQ positiv assoziiert. Ein niedriger Sozialstatus konnte als Kovariate für 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 Unterstützungsangebote für krebskranke Eltern sollten auch spezifische elterliche Sorgen thematisieren. Eltern mit Risikokonstellationen für eine erhöhte Belastung sollten besonders berücksichtigt werden, um bedarfsgerecht Unterstützung anbieten zu können. KW - Adolescent KW - Adult KW - Child KW - Preschool KW - Cost of Illness KW - Cross-Sectional Studies KW - Female KW - Humans KW - Male KW - Middle Aged KW - Neoplasms/psychology KW - Parenting KW - Parents/psychology KW - Social Support KW - Survivors KW - Young Adult Y1 - 2017 U6 - http://dx.doi.org/10.1055/s-0043-110139 VL - 67 SP - 279 EP - 287 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 - 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 - Kuhlmann, Anna-Lena A1 - Romer, Georg A1 - Möller, Birgit T1 - „Wenn man sich so besser fühlt …“ JF - Praxis der Kinderpsychologie und Kinderpsychiatrie N2 - If One Feels Better Like That …. Adolescent Sibling Relationship in the Context of Transgender Development A transgender development in youth can influence the relationship of concerned youth and their siblings. While in most surveys, the focus lies on transgender adolescents, both sides shall be interviewed here to capture the situation of siblings and to relate the results. For this purpose, guide interviews with ten transgender adolescents and twelve of their siblings were analysed in accordance to Grounded Theory. In most cases, participants were satisfied with the sibling relationship. After the coming-out of the transgender adolescent they showed both positive and negative reactions that, however, changed to respect and acceptance by time without exception. Doubt, compassion and grief were short lived and often replaced by joy for the transgender adolescent. Transgender youth were mostly satisfied with the reaction of their sibling though the amount of support varied. The time of coming-out and transition often led to an improvement in sibling relationship, more closeness and family cohesion. In general, siblings seem to be immediately concerned by transgenderism in adolescence. In clinical practice, they should thus be included from the beginning. By taking into account their situation, negative developments can be prevented, and the sibling relationship become usable as a resource. Zusammenfassung Eine transidente Entwicklung im Jugendalter kann die Beziehung der Betroffenen und ihrer Geschwister beeinflussen. Während in den meisten Untersuchungen der Fokus eher auf den transidenten Jugendlichen liegt, wurden hier beide Seiten befragt, um die Situation der Geschwister zu erfassen und die Ergebnisse zueinander in Beziehung setzen zu können. Hierzu wurden Leitfaden-gestützte Interviews mit zehn transidenten Jugendlichen sowie zwölf ihrer Geschwister nach den Regeln der Grounded Theory ausgewertet. In den meisten Fällen zeigten sich die Teilnehmenden mit der Geschwisterbeziehung zufrieden. Auf das Coming-out des transidenten Jugendlichen zeigten die Geschwister positive wie negativen Reaktionen, die sich jedoch im Laufe der Zeit ausnahmslos zu Respekt und Akzeptanz wandelten. Zweifel, Mitleid und Trauer waren nur von kurzer Dauer und wurden oft durch Freude für den transidenten Adoleszenten ersetzt. Die transidenten Jugendlichen zeigten sich mit der Reaktion des Geschwisters grundsätzlich zufrieden, obwohl das Maß an Unterstützung unterschiedlich war. Die Zeit des Coming-out und der Transition führte häufig zu einer Verbesserung der Geschwisterbeziehung, mehr Nähe und familiärem Zusammenhalt. Insgesamt zeigte sich, dass die Geschwister bei einer Transidentität im Jugendalter unmittelbar mitbetroffen sind und daher im klinischen Alltag von Anfang an mit einbezogen werden sollten. Durch Berücksichtigung ihrer Situation kann negativen Entwicklungen vorgebeugt und die Geschwisterbeziehung als Ressource nutzbar werden. KW - Adolescent KW - Grief KW - Humans KW - Sibling Relations KW - Siblings/psychology KW - Surveys and Questionnaires KW - Transgender Persons/psychology Y1 - 2020 U6 - http://dx.doi.org/10.13109/prkk.2020.69.6.524 SN - 0032-7034 VL - 69 SP - 524 EP - 540 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 - 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 - Bultmann, Johanna Christine A1 - Beierlein, Volker A1 - Romer, Georg A1 - Möller, Birgit A1 - Koch, Uwe A1 - Bergelt, Corinna T1 - Parental cancer: Health-related quality of life and current psychosocial support needs of cancer survivors and their children JF - International journal of cancer N2 - 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. KW - Adolescent KW - Adult KW - Child KW - Child Health Services KW - Cross-Sectional Studies KW - Female KW - Follow-Up Studies KW - Health Services Needs and Demand KW - Health Status KW - Humans KW - Male KW - Middle Aged KW - Needs Assessment KW - Neoplasms/psychology KW - Parents/psychology KW - Prognosis KW - Psychology KW - Quality of Life KW - Social Support KW - Stress KW - Psychological KW - Surveys and Questionnaires KW - Survivors/psychology Y1 - 2014 U6 - http://dx.doi.org/10.1002/ijc.28905 VL - 135 SP - 2668 EP - 2677 ER -