title: Parental cancer: factors associated with children's psychosocial adjustment--a systematic review.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry and Psychotherapy, Hamburg, Germany. t.krattenmacher@uke.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Krattenmacher
authors.forename: Franziska
authors.initials: F
authors.lastname: Kühne
authors.forename: Johanna
authors.initials: J
authors.lastname: Ernst
authors.forename: Corinna
authors.initials: C
authors.lastname: Bergelt
authors.forename: Georg
authors.initials: G
authors.lastname: Romer
authors.forename: Birgit
authors.initials: B
authors.lastname: Möller
mesh_terms: D000223:Adaptation, Psychological; D002648:Child; D006801:Humans; D009369:Neoplasms / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D012917:Social Adjustment