title: Multinational study of cancer patients and their children: factors associated with family functioning.
abstract: OBJECTIVE
  This study examined factors associated with family functioning in cancer patients' families with dependent children.
  
  
  METHODS
  A sample of 381 families (639 parents and 489 children) was recruited simultaneously in six European countries. Patients and family members completed a background questionnaire, the Family Assessment Device (FAD), the Beck Depression Inventory, and the short form version of the Medical Outcomes Health Survey. Descriptive statistics and a multilevel model that allowed a multi-informant design were used. Analyses were carried out with all participants, and separately with parent-rated and children-rated FAD scores.
  
  
  RESULTS
  In descriptive analyses, children reported more impairment in family functioning than parents, but the difference was not significant. Depression prevalence was 35% for ill mothers and 28% for ill fathers. In the multilevel analyses with all participants (ie, adults and children) the ill parent's depression was significantly associated with impaired family functioning on five of seven FAD subscales. In analyses with only children, the perception of impairment of family functioning was not associated with parental depression. Additionally, poorer physical status of the ill parent was significantly associated with impairment on roles and communication.
  
  
  CONCLUSIONS
  The ill parent's depression was the most significant factor associated with impairment in family functioning. Screening for depression, active diagnostics, and appropriate treatment of cancer patient's and partner's depression may be important to protect their children from mental disorders. Therefore, support systems need to be more family-oriented and child-centered in their approaches to cancer psychosocial care.
authors.affiliation: Child Psychiatry Clinic, University Hospital of Turku, PO Box 51-FI-20521, Turku, Finland. Florence.schmitt@tyks.fi
authors.forename: Florence
authors.initials: F
authors.lastname: Schmitt
authors.forename: Jorma
authors.initials: J
authors.lastname: Piha
authors.forename: Hans
authors.initials: H
authors.lastname: Helenius
authors.forename: Christiane
authors.initials: C
authors.lastname: Baldus
authors.forename: Christian
authors.initials: C
authors.lastname: Kienbacher
authors.forename: Barbara
authors.initials: B
authors.lastname: Steck
authors.forename: Mikael
authors.initials: M
authors.lastname: Thastum
authors.forename: Maggie
authors.initials: M
authors.lastname: Watson
authors.forename: Georg
authors.initials: G
authors.lastname: Romer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003863:Depression / Q000209:etiology; D005060:Europe; D005190:Family / Q000523:psychology*; D005220:Fathers / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology; D009369:Neoplasms / Q000523:psychology*; D002666:Psychology, Child; D012380:Role