title: Parental palliative cancer: psychosocial adjustment and health-related quality of life in adolescents participating in a German family counselling service.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany. f.kuehne@uke.de.
authors.forename: Franziska
authors.initials: F
authors.lastname: Kühne
authors.forename: Thomas
authors.initials: T
authors.lastname: Krattenmacher
authors.forename: Corinna
authors.initials: C
authors.lastname: Bergelt
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Ernst
authors.forename: Hans-Henning
authors.initials: HH
authors.lastname: Flechtner
authors.forename: Daniel
authors.initials: D
authors.lastname: Führer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Herzog
authors.forename: Kai V
authors.initials: KV
authors.lastname: Klitzing
authors.forename: Georg
authors.initials: G
authors.lastname: Romer
authors.forename: Birgit
authors.initials: B
authors.lastname: Möller