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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. Cancer 2013;. © 2013 American Cancer Society.
Cancer 04/2013; · 4.77 Impact Factor
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Thomas Krattenmacher,
Franziska Kühne,
Daniel Führer,
Volker Beierlein,
Elmar Brähler,
Franz Resch,
Kai V Klitzing,
Hans-Henning Flechtner,
Corinna Bergelt,
Georg Romer, Birgit Möller
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ABSTRACT: 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.
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.
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.
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.
Journal of psychosomatic research 03/2013; 74(3):252-9. · 2.91 Impact Factor
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ABSTRACT: 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.
BMC Palliative Care 10/2012; 11(1):21. · 1.12 Impact Factor
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ABSTRACT: Although the whole family is affected by a parent's palliative disease, palliative care research does not yet routinely consider patients' minor children. Children's and adolescents' psychosocial functioning may be impaired during prolonged parental disease with poor prognosis. Therefore, more and more health care providers are establishing clinical initiatives for families of palliative patients with minor children. However, the number of these family interventions, as well as their theoretical and empirical backgrounds and evidence base, has yet to be determined. The purpose of this study was to systematically review structured and published interventions for this target group, as well as empirical studies on these interventions. The evidence base and impact of interventions on families were considered. Literature published between 1980 and present focusing on psychosocial family-, child- or parent-centered interventions during palliative care was retrieved from PsycINFO®, Embase, MEDLINE®, CINAHL®, and PSYNDEX databases. Five interventions met the inclusion criteria. Programs focused on different populations, had diverse empirical and theoretical backgrounds and features, and were evaluated by studies of varying methodological quality. This systematic review illustrates the lack of well designed and elaborated intervention concepts and evaluation studies in this field, highlighting the necessity of conceptual and methodological rigor to inform clinical practice on a sustainable basis in the future.
Journal of palliative medicine 08/2012; 15(8):931-45. · 1.84 Impact Factor
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ABSTRACT: 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.
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.
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.
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.
Journal of psychosomatic research 05/2012; 72(5):344-56. · 2.91 Impact Factor
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ABSTRACT: 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.
Praxis der Kinderpsychologie und Kinderpsychiatrie 01/2012; 61(6):378-95. · 0.58 Impact Factor
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Thomas Krattenmacher,
Franziska Kühne,
Daniel Führer,
Johanna Ernst,
Elmar Brähler,
Wolfgang Herzog,
Kai von Klitzing,
Hans-Henning Flechtner,
Corinna Bergelt,
Georg Romer, Birgit Möller
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ABSTRACT: 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.
Praxis der Kinderpsychologie und Kinderpsychiatrie 01/2012; 61(6):447-62. · 0.58 Impact Factor
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ABSTRACT: Proper archiving or later reconstruction and verification of results in data analysis requires thorough logging of all manipulative
actions on the data and corresponding parameter settings. Unfortunately such documentation tasks often enforce extensive and
error prone manual activities by the user. To overcome these problems we present Alida, an approach for fully automatic documentation of data analysis procedures. Based on an unified operator interface all operations
on data including their sequence and configurations are registered during analysis. Subsequently these data are made explicit
in XML graph representations yielding a suitable base for visual and analytic inspection. As example for the application of
Alida in practice we present MiToBo , a toolbox for image analysis implemented on the basis of Alida and demonstrating the advantages of automatic documentation for image analysis procedures.
Keywordsautomatic documentation–meta data–XML–processing graph–image analysis
09/2011: pages 1-10;
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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.
PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie 09/2011; 61(9-10):426-34. · 1.02 Impact Factor
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VISAPP 2010 - Proceedings of the Fifth International Conference on Computer Vision Theory and Applications, Angers, France, May 17-21, 2010 - Volume 2; 01/2010
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ABSTRACT: Cell tissue in microscope images is often grained and its intensities do not well agree with Gaussian distribution assumptions widely used in many segmentation approaches. We present a new cascaded segmentation scheme for inhomogeneous cell tissue based on active contour models. Cell regions are iteratively expanded from initial nuclei regions applying a data-dependent number of optimization levels. Experimental results on a set of microscope images from a human hepatoma cell line prove high quality of the results with regard to the cell segmentation task and biomedical investigations.
20th International Conference on Pattern Recognition, ICPR 2010, Istanbul, Turkey, 23-26 August 2010; 01/2010
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ABSTRACT: Proteomics is a rapidly growing field of modern biology. Since quantitative data of proteins involved in dynamic processes of living organisms are essential for understanding the basics of life, techniques like 2-DE and related procedures for automatic data interpretation are at the heart of this research field. They are strongly required to enable analysis and interpretation of the emerging amount of available data. Analyzing and interpreting gel image data usually requires the comparison of gels from different experiments and, thus, a prior registration of gels. This can be accomplished using featureless, feature-based or hybrid registration approaches combining both techniques. Recently, the latter ones have shown high performance, and it is undoubtful that in general robust and reliable features are an essential ingredient and valuable source of information for high-quality image registration. In this paper we provide a thorough overview and elaborate analysis of the capabilities of available feature detectors for gel image registration. Particularly, a detailed and extensive comparative study is presented where common spot-specific detectors are included as well as image-content independent detectors that were not applied to the task of gel image registration until now. The study incorporates tests on several thousand synthetically deformed images from different experimental conditions. As a result it provides valuable quantitative data allowing for direct objective comparisons of various detectors, and is well suited to guide the design of new registration algorithms.
Electrophoresis 12/2009; 30(23):4137-48. · 3.30 Impact Factor
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IEEE Workshop on Applications of Computer Vision (WACV 2009), 7-8 December, 2009, Snowbird, UT, USA; 01/2009
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Proceedings of the German Conference on Bioinformatics, GCB 2008, September 9-12, 2008, Dresden, Germany.; 01/2008
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Proceedings of the British Machine Vision Conference 2007, University of Warwick, UK, September 10-13, 2007; 01/2007
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VISAPP 2007: Proceedings of the Second International Conference on Computer Vision Theory and Applications, Barcelona, Spain, March 8-11, 2007 - Volume 1; 01/2007
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VISAPP 2006: Proceedings of the First International Conference on Computer Vision Theory and Applications, 2 Volumes, Setúbal, Portugal, February 25-28, 2006; 01/2006
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Proceedings of the International Conference on Imaging Science, Systems and Technology, CISST '03, June 23 - 26, 2003, Las Vegas, Nevada, USA, Volume 2; 01/2003
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Pattern Recognition, 25th DAGM Symposium, Magdeburg, Germany, September 10-12, 2003, Proceedings; 01/2003
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Pattern Recognition, 24th DAGM Symposium, Zurich, Switzerland, September 16-18, 2002, Proceedings; 01/2002
