Volker Beierlein

Use and need for psychosocial support in cancer patients: a population-based sample of patients with minor children.

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.

Messung der gesundheitsbezogenen Lebensqualität mit dem SF-8 Deutsche Normdaten aus einer repräsentativen schriftlichen Befragung

Zusammenfassung. Der Short-Form Health Survey SF-8 ist ein Instrument zur Messung der gesundheitsbezogenen Lebensqualitat, einem wichtigen Outcomekriterium klinischer Studien und in den Gesundheitswissenschaften. Das Instrument ist eine Kurzform des haufig verwendeten SF-36, mit dem acht Dimensionen der subjektiven Gesundheit gemessen sowie zwei Summenskalen Korperlicher und Psychischer Gesundheit berechnet werden konnen. Der SF-8 wurde im Jahr 2004 im Rahmen einer bundesweit durchgefuhrten Mehrthemenbefragung eingesetzt. Basierend auf diesen Daten konnen erstmalig reprasentative Normdaten zum SF-8 (N = 2 552) aus einer schriftlichen Befragung fur die deutsche Bevolkerung vorgelegt werden. Die Referenzdaten werden alters- sowie geschlechtsdifferenziert berichtet und auf Zusammenhange mit soziodemografischen Merkmalen analysiert. Seltene fehlende Werte in den Antworten weisen auf eine gute Akzeptanz des Instruments hin. Auch wenn der SF-8 in verschiedenen Subskalen mit Deckeneffekten behaftet ist, kann sein Einsatz aufgrund seiner Okonomie empfohlen werden. Schlusselworter: SF-8, gesundheitsbezogene Lebensqualitat, Normdaten, schriftliche Befragung Measuring health-related quality of life with the SF-8: German norms from a representative self-administered survey

Children of cancer patients: Prevalence and predictors of emotional and behavioral problems

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.

Psychosoziale Versorgung von Kindern mit einem an Krebs erkrankten Elternteil – Eine Bestandsaufnahme spezifischer Versorgungsangebote in Deutschland

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.

Parental cancer: Health-related quality of life and current psychosocial support needs of cancer survivors and their children.

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.

Psychometric properties of the Parenting Concerns Questionnaire in cancer survivors with minor and young adult children.

Although cancer patients with minor children have become more of a focus of psycho‐oncological research, little is known about specific parenting concerns. Instruments to assess the concerns and worries of parents with cancer are rare. The Parenting Concerns Questionnaire (PCQ) addresses this issue. We analyzed parenting concerns in cancer survivors and evaluated the German version of the PCQ.

Measuring family functioning in families with parental cancer: Reliability and validity of the German adaptation of the Family Assessment Device (FAD)

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≤Cronbachs α≤0.88). The scales correlate highly (0.46≤Pearsons 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≤Cohens 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.

Understanding parenting concerns in cancer survivors with minor and young-adult children

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.