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系統識別號 U0026-3011201211295500
論文名稱(中文) 罹癌母親的憂鬱程度及家庭功能對青少年子女行為的影響
論文名稱(英文) The impact of depression in mothers with cancer and family functioning on adolescents' behaviors
校院名稱 成功大學
系所名稱(中) 護理學系碩博士班
系所名稱(英) Department of Nursing
學年度 101
學期 1
出版年 101
研究生(中文) 吳麗貞
研究生(英文) Li-Chen Wu
學號 t26991111
學位類別 碩士
語文別 中文
論文頁數 81頁
口試委員 召集委員-周振陽
口試委員-黃美智
指導教授-蘇英華
中文關鍵字 罹癌母親  憂鬱  家庭功能  青少年行為 
英文關鍵字 mothers with cancer  depression  family functioning  adolescents’ behaviors 
學科別分類
中文摘要 背景:癌症已成為全球的健康問題,癌症所帶來的衝擊不只是個人,更包含整個家庭。近年來,各年齡層罹癌的人數,有逐年增加且年輕化的趨勢,象徵著越來越多的未成年的子女面臨父母罹癌事件的影響。目前醫療照護體系雖強調以家庭為中心的照護理念,但父母罹癌後,家庭成員中的未成年子女,卻一直未受到應有的關注,其需求亦因而被忽略。父母罹癌後,具憂鬱問題者比例不低,因母親為主要照顧者,其憂鬱情緒對於子女的影響更勝於父親,家庭功能亦同時受到影響,未成年子女的調適情形不容小覷。而青少年子女常因承擔父母罹癌後的家務與情緒照顧等責任,與其原本生命週期發展任務產生衝突,致使青少年子女的適應問題更為複雜。

目的:瞭解罹癌母親憂鬱程度及家庭功能,對青少年子女行為表現之影響。
方法:本研究為橫斷式、描述相關性研究,採立意取樣方式,於南部某醫學中心門診及病房,共招募82位育有一位(含)以上,年齡在12~18歲青少年子女的罹癌母親參與本研究。以問卷進行資料收集,由罹癌母親完成問卷之填寫,包含研究者自擬之人口學基本資料問卷、中文版貝克憂鬱量表第二版(Beck Depression Inventory-Ⅱ, BDI-Ⅱ) ─測量罹癌母親的憂鬱程度、家庭功能量表(Family Function Scale, FFS)─測量罹癌母親的家庭功能、兒童行為檢核表(Child Behavior Checklist, CBCL)─測量青少年子女行為表現。資料分析方法包括以描述性統計分析罹癌母親的憂鬱程度、家庭功能,及其青少年子女行為表現;以單因子變異數分析、Kruskal Wallis Test檢定及皮爾森相關係數等方法分別分析罹癌母親的憂鬱程度及家庭功能對青少年子女行為的影響,以及三者間之關係。

結果:顯示約34.1%(n=28)的罹癌母親有憂鬱傾向,其中只有10.7%(n=3)尋求醫療專業協助。罹癌母親的家庭功能,於正向家庭功能面向中,以家庭責任向度得分最高,以情感表達向度得分最低;而負向家庭功能面向得分普遍偏低。罹癌母親所評估青少年子女行為表現,在問題面向中,內化行為問題面向的得分較高,其中又以「退縮/憂鬱」得分最高;但整體行為而言,以「注意力問題」的得分最高。罹癌母親的憂鬱程度與家庭功能呈負相關(r = -0.481, p<0.01),顯示罹癌母親憂鬱程度越嚴重,其家庭功能愈差。罹癌母親的憂鬱程度與青少年子女的行為表現呈正相關(r = 0.371, p<0.01);家庭功能與青少年子女的行為表現呈負相關(r = -0.554, p<0.01)。顯示當罹癌母親的憂鬱程度愈嚴重,或家庭功能愈差時,其青少年子女的行為問題相對愈多。

結論:本研究結果反映出,醫療體系對罹癌母親心理層面的照護似乎仍顯不足,且罹癌母親之憂鬱情緒對其青春期子女的影響不容忽視。國內健康醫療照護團隊一直以來,非常強調提供病患整體性的照護。然而,因缺乏相關知識、技巧和訓練,目前的醫療環境所提供給罹癌母親及其未成年子女的協助卻仍舊相當有限。本研究可幫助腫瘤專業照護人員瞭解母親罹癌事件對其青春期子女的影響,罹癌母親的憂鬱情形可作為疾病變化歷程中之評估高風險家庭的指標,以及時提供青少年子女必要之協助,提升青少年子女面對母親罹癌事件時的調適能力。我們堅信有受過癌症需求相關專業訓練的健康照護人員加入腫瘤照護醫療團隊中,將可協助父母親滿足其子女於母親罹癌事件過程的需求。
英文摘要 Background: Cancer has become a crucial global health problem that affects not only the individual but also the whole family. Recently, people getting are much younger than ever before. Most of them have children under 18 years old. Current health care system emphasizes the family-centered approach, but little attention has been given to the impact of parental cancer on children. Parental cancer can cause depressive mood or distress in both the parents and their children. A mother is usually the primary caregiver in the family. Therefore, children demonstrate more behavior problems when the mothers rather than their fathers are diagnosed with cancer. In addition, the mothers’ depressive moods would negatively influence both the children and their family functioning. Adolescence is a time typically struggling for independence and searching for their own identity. Adolescents thus often feel guilty when they go out with their friends instead of staying at home to help share household responsibilities.

Objective: To examine the impact of depression in mothers with cancer and family functioning on adolescents’ behaviors.

Method: A cross-sectional and correlational research design using purposive sampling was applied. Eighty-two mothers with adolescents between the ages of 12 and 18 were recruited from a medical center in Southern Taiwan. Instruments completed by mothers included a demographic data form, the Beck Depression Inventory-Ⅱ(BDI-Ⅱ), the Family Function Scale(FFS), and the Child Behavior Checklist (CBCL). Analysis included descriptive statistics, one-way ANOVA, Kruskal Wallis Test, and Pearson correlation to elucidate and examine maternal depression, family functioning, and adolescents’ behaviors, as well as relationships among the three variables.

Results: The results showed that 34.1% ill mothers (n=28) have depressive moods. However, only 10.7% of them (n=3) sought the medical help for depressive moods. As for the positive family functioning dimensions, ”family responsibility” was the dimension with the highest score and ”affective involvement” was the one with the lowest score. The scores of the negative family functioning dimensions were all low. The mothers’ reports revealed adolescents had more internalizing problems than externalizing problems and total problems. The withdrawn/depressed was the item with the highest score among the internalizing problems, while the attention problem was the one with the highest score among the total problems. Maternal depression and family functioning were significantly negatively correlated (r = -0.481, p<0.01). Adolescents’ behaviors was significantly correlated with maternal depression (r = 0.371, p<0.01) and significantly negatively associated with family functioning (r = -0.554, p<0.01), respectively. In other words, the higher the maternal depression level was, the poorer the family functioning was, and the more behavioral problems the adolescents had.

Conclusion: The findings in this study indicated that the psychological care the mothers with cancer received seemed not enough and the impact of maternal depression on their adolescents cannot be underestimated. Current health care system emphasizes the holistic medical care for people. However, the assistance offered by the medical environment is still extremely limited due to lack of relevant knowledge, skills, and training. Findings from this study can help oncologists understand the impact of mothers diagnosed with cancer on their adolescents. Affected mother’s depressive mood can be used as an indicator to identify families at high risk. Adolescents can thereby obtain necessary assistance in time to cope with their parents’ cancer more effectively. We believe that parents with cancer need trained healthcare professionals as part of their medical team would be able to navigate their way through cancer journey to meet their children' needs.
論文目次 摘要 Ⅰ
AbstractⅢ
致謝 Ⅴ
論文目錄 Ⅵ
表目錄 Ⅶ
圖目錄 Ⅷ
附件 Ⅷ
第壹章 緒論 1
第一節 研究背景及重要性 1
第二節 研究目的及假設 5
第三節 名詞解釋 5
第貳章 文獻查證 7
第一節 青少年發展 7
第二節 罹癌父母對青少年子女行為的影響 8
第三節 罹癌父母的憂鬱程度對於青少年子女行為的影響 10
第四節 罹癌父母的家庭功能對青少年子女行為的影響 12
第參章 研究方法 20
第一節 研究架構 20
第二節 研究對象 21
第三節 研究工具 21
第四節 資料收集步驟 25
第五節 倫理考量 27
第六節 資料分析方法 27
第肆章 研究結果 31
第一節 罹癌母親之人口資料、憂鬱程度、家庭功能與青少年子女行為表現 31
第二節 罹癌母親的憂鬱程度與家庭功能之關係 41
第三節 罹癌母親的憂鬱程度與青少年子女行為表現之關係 42
第四節 罹癌母親的家庭功能與青少年子女行為表現之關係 43
第伍章 討論 44
第一節 研究對象的特質 44
第二節 罹癌母親的憂鬱程度 46
第三節 罹癌母親的家庭功能 48
第四節 罹癌母親的青少年子女行為表現 50
第五節 罹癌母親的憂鬱程度與家庭功能之關係 52
第六節 罹癌母親的憂鬱程度及家庭功能與青少年子女行為表現之關係 54
第陸章 結論與建議 57
第一節 研究限制 57
第二節 建議 57
第三節 結論 60
參考文獻 61
表目錄
表2-1 家庭功能量表(Family Function Scale, FFS)相關研究 18
表3-1 家庭功能量表各次量表之題數一覽表 23
表3-2 父母填寫的兒童行為檢核表各次量表之題數一覽表 24
表3-3 資料分析法整理表 29
表4-1 罹癌母親人口學資料 32
表4-2 罹癌母親的憂鬱程度 36
表4-3 罹癌母親填寫憂鬱量表題項得分 37
表4-4 罹癌母親的家庭功能 38
表4-5 罹癌母親之青少年子女行為表現 39
表4-6 罹癌母親之青少年子女行為問題面向及八個行為問題症候群的比例 40
表4-7 罹癌母親憂鬱程度與整體家庭功能之關係 41
表4-8 罹癌母親的憂鬱程度與整體家庭功能及8個向度的家庭功能之關係 41
表4-9 罹癌母親不同憂鬱程度範圍在整體家庭功能之差異 41
表4-10 罹癌母親憂鬱程度與青少年子女行為表現之關係 42
表4-11 罹癌母親憂鬱程度與青少年子女行為問題面向之關係 42
表4-12 不同憂鬱程度的罹癌母親在青少年子女行為表現之差異 42
表4-13 罹癌母親家庭功能與青少年子女行為表現之相關 43
表4-14 罹癌母親8個向度的家庭功能與青少年子女行為問題面向之相關 43
圖目錄
圖3-1 研究架構 20
圖3-2 資料收集流程圖 26
附件
附件一 人口學基本資料問卷 76
附件二 國立成功大學受試者同意書 77
附件三 同意臨床試驗證明書 78
附件四 家庭功能量表(Family Function Scale, FFS)使用同意書 79
附件五 兒童行為檢核表使用同意書 80
附件六 貝克憂鬱量表第二版中文版使用同意書 81
參考文獻 ㄧ、中文部份
內政部統計處(2011,6月).一○○年第二十四週內政統計通報.取自http://sowf.moi.gov.tw/stat/week/week10024.doc
王淑惠 (2001) .由家庭功能與性格特質探討婦女憂鬱焦慮之共病現象(碩士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=id=%22089NCKU0 666004%22.&searchmode=basic
危芷芬(2001).華人的關係類型與人際義務(博士論文).取自http://ndltd.ncl.edu.tw/ cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=id=%22089NTU00071003%22.&searchmode=basic
行政院衛生署(2002,10月).口腔癌.取自http://www.doh.gov.tw/CHT2006/DM/SEARCH_RESULT.aspx
行政院衛生署(2010,8月).民國83年臺灣地區主要死亡原因.取自http://www.doh.gov.tw/CHT2006/DisplayStatisticFile.aspx?d=63888
行政院衛生署(2012,5月).100年國人主要死因統計.取自http://www.doh.gov.tw/ufile/doc/100y%e6%ad%bb%e5%9b%a0%e6%91%98%e8%a6%81(%e5%85%a8)_%e8%a8%98%e8%80%85%e6%9c%831010525.xls
行政院衛生署國民健康局(2006,12).中華民國92年癌症登記報告.取自http://www.bhp.doh.gov.tw/bhpnet/portal/PressShow.aspx?No=200712250054
行政院衛生署國民健康局(2006,12月).93年乳癌其別報告.取自http://www.bhp.doh.gov.tw/BHPnet/portal/PressShow.aspx?No=200712250364
行政院衛生署國民健康局(2007,7月).口腔癌.取自http://www.bhp.doh.gov.tw/BHPnet/Portal/PressShow.aspx?No=200712250318
行政院衛生署國民健康局(2011,4月).民國97年癌症登記年度報告.取自http://www.bhp.doh.gov.tw/Download/97Statistics/1.癌症登記年度報告(全)/Y97-癌症登記年度報告(全).pdf
行政院衛生署國民健康局(2012,6月).民國98年癌症登記報告.取自http://www.bhp.doh.gov.tw/BHPNet/Web/Service/FileCount.aspx?file=StatisticsFile&StatisticsFile=201206211209275273&StatisticsFileName=98%e5%b9%b4%e7%99%8c%e7%97%87%e7%99%bb%e8%a8%98%e5%a0%b1%e5%91%8a_1018.zip
余德慧(2005).本土化的心理療法.楊國樞、黃光國、楊中芳編,華人本土心理學.台北:遠流。
吳政航(2007).大學生家庭功能與壓力因應型態對憂鬱症狀之影響(碩士論文).取自http://etds.lib.ncku.edu.tw/etdservice/download_file?etdun=U0026-08122009135 62404&fileName=U0026-0812200913562404-1.pdf
易言嬡(2004).家家有本難唸的經:家有青少年子女的父母親職經驗之性別分析(碩士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=id=%22
林姿君(2007a).應用生活技能於國中生家長親職壓力及家庭功能之成效初探(碩士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi/ccd=QsNtPo/record? submitretturn=1&r1=1&h1=0#XXX
林玲華、陳景彥、劉嘉逸、陳美伶(2002).癌症住院病患憂鬱狀態的盛行率及預測因素‧臺灣醫學,6(4),535-545。
林雅娟(2007b).親職角色之探討‧網路社會學通訊期刊,61,1609-2503。
邱郁雯(2003).家庭功能、父母管教態度對4-6歲學齡前兒童行為與情緒問題之影響(碩士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s= id=%22091NCKU5666009%22.&searchmode=basic
施秀玉(2003).「家庭共學─親子團體」對親子互動之影響研究(碩士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=id=%22091NPTT1328017%22.&searchmode=basic
范聖育(2002).家庭功能與安寧療護主要照顧者生活品質的相關性探討(碩士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=%22%E8%8C%83 %E8%81%96%E8%82%B2%22.ad%20or%20%22%E8%8C%83%E8%81%96%E8%82%B2%22.au.&searchmode=basic#XXX
翁寶美(2006).父母癌逝青少年之悲傷歷程研究-以正向影響為焦點之探討(碩士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=id= %22095NHU05672008%22.&searchmode=basic
袁萍芳(2001).父(母)罹患癌症對兒童的影響(碩士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=id=%22090PCCU0164001%22.&searchmode=basic
張兆球、郭黎玉晶(1998).香港兒童對父母管教訊息的情緒反應和行為傾向‧本土心理學研究,9,281-305。
張逸翔(2010)‧『成長的哀愁與美麗』~三個青少年手足面對父親罹癌晚期預期性悲傷經驗(未發表的碩士論文)‧台北市:國立台北護理學院。
張嘉真、李美枝(2000).親子間情感行為的溯源與文化塑形‧中華心理衛生學刊,2,1-35。
陳坤虎、雷庚玲、吳英璋(2005).不同階段青少年之自我認同內容及危機探索之發展差異‧中華心理學刊,47(3),249-268。
陳怡婷(2003).家庭系統面臨親人重病事件的運作與轉變--以進入安寧病房的家庭為例(碩士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s= id=%22091NCUE0464009%22.&searchmode=basic
陳怡靜、陳彰惠(2006).婦癌患者身體心像、社會支持和憂鬱的相關性研究‧實證護理,2(4), 293-300。
陳秉華、游淑瑜(2001).台灣的家庭文化與家庭治療‧亞洲輔導學報,8(2),153-174。
陳美芸(2010).護理人員對「罹癌父母與子女溝通病情」此議題之看法探討(碩士論文).取自http://www.airitilibrary.com/searchdetail.aspx?DocIDs=U0026-06092 0102 1325200
黃光國(1998).兩種道德:臺灣社會中道德思維研究的再詮釋‧本土心理學研究,9,121-175。
黃囇莉(1996).中國人的和諧觀/衝突觀:和諧化辯證觀之研究取徑‧本土心理學研究,5,47-71。
楊國樞 (1992) .中國人的蛻變.台北:桂冠。
葉光輝、楊國樞(2008).中國人的孝道:心理學的分析.臺北市:臺灣大學出版中心。
劉慈惠(1999).幼兒母親對中國傳統教養與現代教養的認知‧新竹師院學報,12,311-345。
潘淑滿(2005).台灣母職圖像‧女學學誌,20,41 -91。
鄭淑華(2006) .乳癌存活者身體心像、憂鬱狀態與性生活調適之探討(碩士論文).取自http://www.cetd.com.tw/ec/thesisDetail.aspx?etdun=U0001-2607200615115100
鄭凱芸(2010a).父母罹癌與青少年子女的內在化問題‧社區發展季刊,130,108-119。
鄭凱芸(2010b).當父母罹癌時-青少女承擔親職之經驗(博士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=id=%22098THU00201011%22.&searchmode=basic
盧孟良、車先蕙、張尚文、沈武典(2002).中文版貝克憂鬱量表第二版之信度和效度‧台灣精神醫學會,16(4),301-309。
韓德彥(2009).憂鬱污名探究:病因歸因與面子顧慮之影響(博士論文).取自http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dnclcdr&s=id=%22098NTU05071005%22.&searchmode=basic
簡良霖(2006).大學生之家庭功能與性格對憂鬱症狀的影響(碩士論文).取自http://etds.lib.ncku.edu.tw/etdservice/download_file?etdun=U0026-0812200912115242&fileName=U0026-0812200912115242-1.pdf
羅文基、朱湘吉、陳如山(1991).生涯規劃與發展.台北市:空大。
Feldman, R. S. (2007) ‧人類發展學(黃久美等合譯)‧臺北市:華杏。(原著出版於 2006)
Rice, F. P., & Dolgin, K. G. (2004) ‧青少年心理學(黃俊豪、連廷嘉譯)‧臺北市:學富。(原著出版於 2002)

二、英文部份
Achenbach, T. M. (1991). Manual for the child behavior checklist/4-18 and1991 profile. Burlington, VT: Department of Psychiatry, University of Vermont.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4 th ed Text revision). Washington: American Psychiatric Association.
Andersen, B. L., & Jochimsen, P. R. (1985). Sexual functioning among breast cancer, gynecologic cancer, and healthy women. Journal of Consulting & Clinical Psychology, 53(1), 25-32.
Anderson, N. B., & Armstead, C. A. (1995). Toward understanding the association of socioeconomic status and health: A new challenge for the biopsychosocial approach. Psychosomatic Medicine, 57(3), 213-225.
Bailey, R. K., Geyen, D. J., Scott-Gurnell, K., Hipolito, M. M. S., Bailey, T. A., & Beal, J. M. (2005). Understanding and treating depression among cancer patients. International Journal of Gynecological Cancer, 15(2), 203-208.
Barnes, H. L., & Olson, D. H. (1985). Parent-adolescent communication and the circumplex model. Child Development, 56(2), 438-447.
Barnes, J., Kroll, L., Burke, O., Lee, J., Jones, A., & Stein, A. (2000). Qualitative interview study of communication between parents and children about maternal breast cancer. Western Journal of Medicine, 173(6), 385-389.
Belsky, J. (1997). Theory testing, effect-size evaluation, and differential susceptibility to rearing influence: the case of mothering and attachment. Child Development, 68(4), 598-600.
Ben-Porath, D. D. (2002). Stigmatization of individuals who receive psychotherapy: An interaction between help-seeking behavior and the presence of depression. Journal of Social and Clinical Psychologyl, 21(4), 400-413.
Billings, A. G., & Moos, R. H. (1983). Comparisons of children of depressed and nondepressed parents: a social-environmental perspective. Journal of abnormal child psychology , 11(4), 463-485.
Birenbaum, L. K., Yancey, D. Z., Phillips, D. S., Chand, N., & Huster, G. (1999). School-age children's and adolescents' adjustment when a parent has cancer. Oncology Nursing Forum, 26(10), 1639-1645.
Brown, R. T., Fuemmeler, B., Anderson, D., Jamieson, S., Simonian, S., Hall, R. K., & Brescia, F. (2007). Adjustment of children and their mothers with breast cancer. Journal of Pediatric Psychology, 32(3), 297-308.
Butler, E. A., Lee, T. L., & Gross, J. J. (2007). Emotion regulation and culture: are the social consequences of emotion suppression culture-specific?. Emotion, 7(1), 30-48.
Cantwell, D. P., & Baker, L. (1991). Manifestations of depressive affect in adolescence. Journal of Youth and Adolescence, 20(2), 121-133.
Chao, R. K. (1994). Beyond parental control and authoritarian parenting style: Understanding chinese parenting through the cultural notion of training. Child Development, 65(4), 1111-1119.
Christ, G. H., Siegel, K., & Sperber, D. (1994). Impact of parental termal cancer on adolescents. American Journal of Orthopsychiatry, 64(4), 604-613.
Cicchetti, D., & Toth, S. L. (1991). Internalizing and externalizing expressions of dysfunction. Hillsdale, NJ: Lawrence Erlbaum Associates.
Clemmens, D. A. (2009). The significance of motherhood for adolescents whose mothers have breast cancer. Oncology Nursing Forum, 36(5), 571-577.
Cohen, J. (1988). Statistical power analysis for behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.
Compas, B. E., Worsham, N. L., Epping-Jordan, J. E., Grant, K. E., Mireault, G., Howell, D. C., & Malcarne, V. L. (1994). When mom or dad has cancer: markers of psychological distress in cancer patients, spouses, and children. Health Psychology, 13(6), 507-515.
Connell, A. M., & Goodman, S. H. (2002). The association between psychopathology in fathers versus mothers and children's internalizing and externalizing behavior problems: a meta-analysis. Psychological Bulletin, 128(5), 746-773.
Cordova, M. J., Cunningham, L. L., Carlson, C. R., & Andrykowski, M. A. (2001). Social constraints, cognitive processing, and adjustment to breast cancer. Journal of Consulting & Clinical Psychology, 69(4), 706-711.
Costas-Muniz, R. (2012). Hispanic adolescents coping with parental cancer. Support Care Cancer, 20(2), 413-417.
Cummings, E. M., Keller, P. S., & Davies, P. T. (2005). Towards a family process model of maternal and paternal depressive symptoms: exploring multiple relations with child and family functioning. Journal of Child Psychology and Psychiatry, 46(5), 479-489.
Cunningham, A. J., Edmonds, C. V., & Williams, D. (1999). Delivering a very brief psychoeducational program to cancer patients and family members in a large group format. Psychooncology, 8(2), 177-182.
Davey, M. P., Askew, J., & Godette, K. (2003). Parent and adolescent responses to non-terminal parental cancer: A retrospective multiple-case pilot study. Families, Systems & Health, 21(3), 245-258.
Davis Kirsch, S. E., Brandt, P. A., & Lewis, F. M. (2003). Making the most of the moment: When a child's mother has breast cancer. Cancer Nursing, 26(1), 47-54.
Derogatis, L. R., & Melisaratos, N. (1983). The brief symptom Inventory: an introductory report. Psychological Medicine, 13(03), 595-605.
Downey, G., & Coyne, J. C. (1990). Children of depressed parents: an integrative review. Psychological Bulletin, 108(1), 50-76.
Draguns, J. G. (1990). Applications of cross-cultural psychology in the field of mental health. In R. W. Brislin (Eds.), Applied cross-cultural psychology (pp. 302-324). Thousand Oaks, CA, US: Sage Publications.
Dyson, R., & Renk, K. (2006). Freshmen adaptation to university life: Depressive symptoms, stress, and coping. Journal of Clinical Psychology, 62(10), 1231-1244.
Edwards, B., & Clarke, V. (2004). The psychological impact of a cancer diagnosis on families: the influence of family functioning and patients' illness characteristics on depression and anxiety. Psycho-Oncology, 13(8), 562-576.
Edwards, L., Watson, M., St. James-Roberts, I., Ashley, S., Tilney, C., Brougham, B., . . . Romer, G. (2008). Adolescent's stress responses and psychological functioning when a parent has early breast cancer. Psycho-Oncology, 17(10), 1039-1047.
Eid, M., & Diener, E. (2001). Norms for experiencing emotions in different cultures: inter- and intranational differences. Journal of Personality & Social Psychology, 81(5), 869-885.
Elgar, F. J., McGrath, P. J., Waschbusch, D. A., Stewart, S. H., & Curtis, L. J. (2004). Mutual influences on maternal depression and child adjustment problems. Clinical Psychology Review, 24(4), 441-459.
Epstein, N. B., Bishop, D. S., & Levin, S. (1978). The McMaster Model of family functioning. Journal of Marital and Family Therapy, 4(4), 19-31.
Erikson, E. H. (1968). Identity, youth, and crisis. New York : W. W. Norton.
Ernst, J., Gotze, H., Krauel, K., Romer, G., Bergelt, C., Flechtner, H. H., . . . von Klitzing, K. (2012). Psychological distress in cancer patients with underage children: gender-specific differences. Psychooncology. doi: 10.1002/pon.3070.
Faulkner, R. A., & Davey, M. (2002). Children and adolescents of cancer patients: The impact of cancer on the family. The American Journal of Family Therapy, 30(1), 63 - 72.
Febres, J., Rossi, R., Gaudiano, B. A., & Miller, I. W. (2011). Differential relationship between depression severity and patients' perceived family functioning in women versus in men. Journal of Nervous & Mental Disease, 199(7), 449-453.
Ferrell, B. R., Grant, M. M., Funk, B., Otis-Green, S., & Garcia, N. (1997). Quality of life in breast cancer survivors as identified by focus groups. Psycho-Oncology, 6(1), 13-23.
Fisch, M. (2004). Treatment of depression in cancer. Journal of the National Cancer Institute Monographs(32), 105-111.
Fitch, M. I., Bunston, T., & Elliot, M. (1999). When mom's sick: changes in a mother's role and in the family after her diagnosis of cancer. Cancer Nursing, 22(1), 58-63.
Forrest, G., Plumb, C., Ziebland, S., & Stein, A. (2009). Breast cancer in young families: a qualitative interview study of fathers and their role and communication with their children following the diagnosis of maternal breast cancer. Psycho-Oncology, 18(1), 96-103.
Foster, C. E., Webster, M. C., Weissman, M. M., Pilowsky, D. J., Wickramaratne, P. J., Talati, A., . . . King, C. A. (2008). Remission of maternal depression: relations to family functioning and youth internalizing and externalizing symptoms. Journal of Clinical Child & Adolescent Psychology, 37(4), 714-724.
Gates, M. F., & Lackey, N. R. (1998). Youngsters caring for adults with cancer. Image: Journal of Nursing Scholarship, 30(1), 11-15.
Gazendam-Donofrio, S. M., Hoekstra, H. J., van der Graaf, W. T. A., van de Wiel, H. B. M., Visser, A., Huizinga, G. A., & Hoekstra-Weebers, J. E. H. M. (2007). Family functioning and adolescents' emotional and behavioral problems: when a parent has cancer. Annals of Oncology, 18(12), 1951-1956.
Gazendam-Donofrio, S. M., Hoekstra, H. J., van der Graaf, W. T. A., van de Wiel, H. B. M., Visser, A., Huizinga, G. A., & Hoekstra-Weebers, J. E. H. M. (2011). Adolescents' emotional reactions to parental cancer: effect on emotional and behavioral problems. Journal of Pediatric Psychology, 36(3), 346-359.
Goldenberg, H., & Goldenberg, I. (2008). Family therapy: An overview. Belmont, CA :Thomson Brooks.
Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: a meta-analytic review. Clinical Child & Family Psychology Review, 14(1), 1-27.
Gotcher, J. M. (1993). The effects of family communication on psychosocial adjustment of cancer patients. Journal of Applied Communication Research, 21(2), 176-188.
Grabiak, B. R., Bender, C. M., & Puskar, K. R. (2007). The impact of parental cancer on the adolescent: an analysis of the literature. Psycho-Oncology, 16(2), 127-137.
Harris, C. A., & Zakowski, S. G. (2003). Comparisons of distress in adolescents of cancer patients and controls. Psycho-Oncology, 12(2), 173-182.
Hartos, J. L., & Power, T. G. (1997). Mothers' awareness of their early adolescents' stressors. The Journal of Early Adolescence, 17(4), 371-389.
Helseth, S., & Ulfsæt, N. (2003). Having a parent with cancer: Coping and quality of life of children during serious illness in the family. Cancer Nursing, 26(5), 355-362.
Heru, A. M., & Ryan, C. E. (2004). Burden, reward and family functioning of caregivers for relatives with mood disorders: 1-year follow-up. Journal of Affective Disorders, 83(2-3), 221-225.
Heru, A. M., Ryan, C. E., & Vlastos, K. (2004). Quality of life and family functioning in caregivers of relatives with mood disorders. Psychiatric Rehabilitation Journal, 28(1), 67-71.
Hockley, J. (2000). Psychosocial aspects in palliative care-communicating with the patient and family. Acta Oncologica, 39(8), 905-910.
Hops, H., Tildesley, E., Lichtenstein, E., Ary, D., & Sherman, L. (1990). Parent-adolescent problem-solving interactions and drug use. American Journal of Drug Alcohol Abuse, 16(3-4), 239-258.
Hosaka, T., & Aoki, T. (1996). Depression among cancer patients. Psychiatry and Clinical Neurosciences, 50(6), 309-312.
Houck, C. D., Rodrigue, J. R., & Lobato, D. (2007). Parent-adolescent communication and psychological symptoms among adolescents with chronically ill parents. Journal of Pediatric Psychology, 32(5), 596-604.
Huizinga, G. A., Visser, A., van der Graaf, W. T. A., Hoekstra, H. J., Klip, E. C., Pras, E., & Hoekstra-Weebers, J. E. H. M. (2005). Stress response symptoms in adolescent and young adult children of parents diagnosed with cancer. European Journal of Cancer, 41(2), 288-295.
Huizinga, G. A., Visser, A., van der Graaf, W. T. A., Hoekstra, H. J., & Hoekstra-Weebers, J. E. H. M. (2005). The quality of communication between parents and adolescent children in the case of parental cancer. Annals of Oncology, 16(12), 1956-1961.
Huizinga, G. A., Visser, A., Wt, Hoekstra, H. J., Stewart, R. E., & Hoekstra-Weebers, J. E. (2011). Family-oriented multilevel study on the psychological functioning of adolescent children having a mother with cancer. Psycho-Oncology, 20(7), 730-737.
Issel, L. M., Ersek, M., & Lewis, F. M. (1990). How children cope with mother's breast cancer. Oncoogyl Nursing Forum, 17(3 Suppl), 5-13.
Jackson, S., Bijstra, J., Oostra, L., & Bosma, H. (1998). Adolescents' perceptions of communication with parents relative to specific aspects of relationships with parents and personal development. Journal of adolescence, 21(3), 305-322.
Kaplan, H. S. (1992). A neglected issue: the sexual side effects of current treatments for breast cancer. Journal of Sex & Marital Therapy, 18(1), 3-19.
Keitner, G. I., & Miller, I. W. (1990). Family functioning and major depression: an overview. American Journal of Psychiatry, 147(9), 1128-1137.
Keitner, G. I., Heru, A. M., & Glick, I. D. (2010). Clinical manual of couples and family therapy. Washington, DC: American Psychiatric Publishing.
Keitner, G. I., Miller, I. W., Epstein, N. B., Bishop, D. S., & Fruzzetti, A. E. (1987). Family functioning and the course of major depression. Comprehensive Psychiatry, 28(1), 54-64.
Kissane, D. W., Bloch, S., Dowe, D. L., Snyder, R. D., Onghena, P., McKenzie, D. P., & Wallace, C. S. (1996). The Melbourne family grief study, I: Perceptions of family functioning in bereavement. American Journal of Psychiatry, 153(5), 650-658.
Krattenmacher, T., Kühne, F., Ernst, J., Bergelt, C., Romer, G., & Möller, B. (2012). Parental cancer: Factors associated with children's psychosocial adjustment — a systematic review. Journal of psychosomatic research, 72(5), 344-356.
Kristjanson, L. J., Chalmers, K. I., & Woodgate, R. (2004). Information and support needs of adolescent children of women with breast cancer. Oncology Nursing Forum, 31(1), 111-119.
Lepore, S. J., Silver, R. C., Wortman, C. B., & Wayment, H. A. (1996). Social constraints, intrusive thoughts, and depressive symptoms among bereaved mothers. Journal of Personality Social Psychology, 70(2), 271-282.
Leung, P. W. L., Kwong, S. L., Tang, C. P., Ho, T. P., Hung, S. F., Lee, C. C., . . . Liu, W. S. (2006). Test–retest reliability and criterion validity of the Chinese version of CBCL, TRF, and YSR. Journal of Child Psychology and Psychiatry, 47(9), 970-973.
Lewis, F. M., & Darby, E. L. (2003). Adolescent adjustment and maternal breast cancer: a test of the "faucet hypothesis". Journal of Psychosocial Oncology, 21(4), 81-104.
Lewis, F. M., & Hammond, M. A. (1996). The Father's, mother's, and adolescent's functioning with breast cancer. Family Relations, 45(4), 456-465.
Lewis, F. M., Hammond, M. A., & Woods, N. F. (1992). The family's functioning with newly diagnosed breast cancer in the mother: the development of an explanatory model. Journal of Behavioral Medicine, 16(4), 351-370.
Lieberman, M. A., & Fisher, L. (1999). The effects of family conflict resolution and decision making on the provision of help for an elder with Alzheimer's disease. Gerontologist, 39(2), 159-166.
Lindqvist, B., Schmitt, F., Santalahti, P., Romer, G., & Piha, J. (2007). Factors associated with the mental health of adolescents when a parent has cancer. Scandinavian journal of psychology , 48(4), 345-351.
Lovejoy, M. C., Graczyk, P. A., O'Hare, E., & Neuman, G. (2000). Maternal depression and parenting behavior: A meta-analytic review. Clinical Psychology Review, 20(5), 561-592.
Mesters, I., van den Borne, H., McCormick, L., Pruyn, J., de Boer, M., & Imbos, T. (1997). Openness to discuss cancer in the nuclear family: scale, development, and validation. Psychosomatic Medicine, 59(3), 269-279.
Miller, I. W., Ryan, C. E., Keitner, G. I., Bishop, D. S., & Epstein, N. B. (2000). The McMaster approach to families: theory, assessment, treatment and research. Journal of Family Therapy, 22(2), 168-189.
Miller, S., Lo, C., Gagliese, L., Hales, S., Rydall, A., Zimmermann, C., . . . Rodin, G. (2011). Patterns of depression in cancer patients: an indirect test of gender-specific vulnerabilities to depression. Social psychiatry and psychiatric epidemiology, 46(8), 767-774.
National Cancer Institute . (2011, June). Depression. Retrieved from http://www.cancer.gov/cancertopics/pdq/supportivecare/depression/HealthProfessional/page1
National Cancer Institute. (2011, November). Contents of the SEER cancer statistics review, 1975-2008. Retrieved from http://seer.cancer.gov/csr/1975_2008/sections.html
Nelson, E., & While, D. (2002). Children's adjustment during the first year of a parent's cancer diagnosis. Journal of Psychosocial Oncology, 20(1), 15-36.
Nelson, E., Sloper, P., Charlton, A., & While, D. (1994). Children who have a parent with cancer: a pilot study. Journal of Cancer Education, 9(1), 30-36.
Northouse, L. L. (1988). Social support in patients’ and husbands’ adjustment to breast cancer. Nursing Research, 37, 91–95.
Northouse, L. L., Cracchiolo-Caraway, A., & Appel, C. P. (1991). Psychologic consequences of breast cancer on partner and family. Seminars in Oncology Nursing, 7(3), 216-223.
Oktay, Z. S., & Walper, C. A. (1991). Breast cancer in the life course: Women experience. New York: Spring.
Osborn, T. (2007). The psychosocial impact of parental cancer on children and adolescents: a systematic review. Psycho-Oncology, 16(2), 101-126.
Osterman, F., & Grubic, V. N. (2000). Family functioning of recovered alcohol-addicted patients: a comparative study. Journal of Substance Abuse Treatment, 19(4), 475-479.
Pasquini, M., & Biondi, M. (2007). Depression in cancer patients: a critical review. Clinical Practice and Epidemiology in Mental Health 3(2), 1-9.
Pederson, S., & Revenson, T. A. (2005). Parental illness, family functioning, and adolescent well-being: a family ecology framework to guide research. Journal of Family Psychology, 19(3), 404-419.
Porter, L. S., Keefe, F. J., Hurwitz, H., & Faber, M. (2005). Disclosure between patients with gastrointestinal cancer and their spouses. Psycho-Oncology, 14(12), 1030-1042.
Pyke, K. D., & Bengtson, V. L. (1996). Caring More or Less: Individualistic and collectivist systems of family eldercare. Journal of Marriage and Family, 58(2), 379-392.
Romer, G., Saha, R., Haagen, M., Pott, M., Baldus, C., & Bergelt, C. (2007). Lessons learned in the implementation of an innovative consultation and liaison service for children of cancer patients in various hospital settings. Psycho-Oncology, 16(2), 138-148.
Rutter, M. (2005). How the environment affects mental health. British Journal of Psychiatry, 186, 4-6.
Sagrestano, L. M., Paikoff, R. L., Holmbeck, G. N., & Fendrich, M. (2003). A longitudinal examination of familial risk factors for depression among inner-city African American adolescents. Journal of Family Psychology, 17(1), 108-120.
Sammarco, A. (2001). Psychosocial stages and quality of life of women with breast cancer. Cancer Nursing, 24(4), 272-277.
Sanford, M., Boyle, M., McCleary, L., Miller, J., Steele, M., Duku, E., & Offord, D. (2006). A pilot study of adjunctive family psychoeducation in adolescent major depression: feasibility and treatment effect. Journal of the American Academy of Child & Adolescent Psychiatry, 45(4), 386-495
Schmitt, F., Piha, J., Helenius, H., Baldus, C., Kienbacher, C., Steck, B., . . . Romer, G. (2008). Multinational study of cancer patients and their children: factors associated with family functioning. Journal of Clinical Oncology, 26(36), 5877-5883.
Schmitt, F., Santalahti, P., Saarelainen, S., Savonlahti, E., Romer, G., & Piha, J. (2008). Cancer families with children: factors associated with family functioning--a comparative study in Finland. Psycho-Oncology, 17(4), 363-372.
Sherman, A. C., & Simonton, S. (1999). Family Therapy for Cancer Patients: Clinical Issues and Interventions. The Family Journal, 7(1), 39-50.
Shirk, S. R., Gudmundsen, G. R., & Burwell, R. A. (2005). Links among attachment-related cognitions and adolescent depressive symptoms. Journal of Clinical Child and Adolescent Psychology, 34(1), 172-181.
Sieh, D. S., Meijer, A. M., Oort, F. J., Visser-Meily, J. M. A., & Van der Leij, D. A. V. (2010). Problem behavior in children of chronically ill parents: a meta-analysis. Clinical child and family psychology review, 13(4), 384-397.
Silberg, J. L., Maes, H., & Eaves, L. J. (2010). Genetic and environmental influences on the transmission of parental depression to children’s depression and conduct disturbance: an extended Children of Twins study. Journal of Child Psychology and Psychiatry, 51(6), 734-744.
Somerset, W., Stout, S. C., Miller, A. H., & Musselman, D. (2004). Breast cancer and depression. Oncology, 18(8), 1021-1034.
Spira, M., & Kenemore, E. (2000). Adolescent daughters of mothers with breast cancer: Impact and implications. Clinical Social Work Journal, 28(2), 183-195.
Stein, J. A., Riedel, M., & Rotheram-Borus, M. J. (1999). Parentification and its impact on adolescent children of parents with AIDS. Family Process, 38(2), 193-208.
Su, Y., & Ryan-Wenger, N. A. (2007). Children's adjustment to parental cancer: a theoretical model development. Cancer Nursing, 30(5) , 362-383.
Tamis-LeMonda, C. S., Way, N., Hughes, D., Yoshikawa, H., Kalman, R. K., & Niwa, E. Y. (2008). Parents' goals for children: The dynamic coexistence of individualism and collectivism in cultures and individuals. Social Development, 17(1), 183-209.
Tamrouti-Makkink, I. D., Dubas, J. S., Gerris, J. R. M., & van Aken, M. A. G. (2004). The relation between the absolute level of parenting and differential parental treatment with adolescent siblings’ adjustment. Journal of Child Psychology and Psychiatry, 45(8), 1397-1406.
Tan, G., Waldman, K., & Bostick, R. (2002). Psychosocial issues, sexuality, and cancer. Sexuality & Disability, 20(4), 297-318
Thastum, M., Johansen, M. B., Gubba, L., Olesen, L. B., & Romer, G. (2008). Coping, social relations, and communication: A qualitative exploratory study of children of parents with cancer. Clinical Child Psychology and Psychiatry, 13(1), 123-138.
Thastum, M., Watson, M., Kienbacher, C., Piha, J., Steck, B., Zachariae, R., . . . Romer, G. (2009). Prevalence and predictors of emotional and behavioural functioning of children where a parent has cancer: a multinational study. Cancer, 115(17), 4030-4039.
Thompson, R. A., & Nelson, C. A. (2001). Developmental science and the media. Early brain development. American Psychologist, 56(1), 5-15.
Tsai, J. L., Levenson, R. W., & McCoy, K. (2006). Cultural and temperamental variation in emotional response. Emotion, 6(3), 484-497.
Vahdaninia, M., Omidvari, S., & Montazeri, A. (2010). What do predict anxiety and depression in breast cancer patients? A follow-up study. Social Psychiatry Psychiatric Epidemiology, 45(3), 355-361.
Vannatta, K., Ramsey, R. R., Noll, R. B., & Gerhardt, C. A. (2010). Associations of child adjustment with parent and family functioning: comparison of families of women with and without breast cancer. Journal of Developmental & Behavioral Pediatrics, 31(1), 9-16.
Visser, A., Huizinga, G. A., Hoekstra, H. J., van der Graaf, W. T. A., Klip, E. C., Pras, E., & Hoekstra-Weebers, J. E. H. M. (2005). Emotional and behavioural functioning of children of a parent diagnosed with cancer: a cross-informant perspective. Psycho-Oncology, 14(9), 746-758.
Visser, A., Huizinga, G. A., Hoekstra, H. J., van der Graaf, W. T. A., & Hoekstra-Weebers, J. E. H. M. (2006). Parental cancer. Cancer, 106(5), 1178-1187.
Visser, A., Huizinga, G. A., Hoekstra, H. J., van der Graaf, W. T., Gazendam-Donofrio, S. M., & Hoekstra-Weebers, J. E. (2007). Emotional and behavioral problems in children of parents recently diagnosed with cancer: a longitudinal study. Acta Oncologica, 46(1), 67-76.
Visser, A., Huizinga, G. A., van der Graaf, W. T. A., Hoekstra, H. J., & Hoekstra-Weebers, J. E. H. M. (2004). The impact of parental cancer on children and the family: a review of the literature. Cancer Treatment Reviews, 30(8), 683-694.
Visser, A., Huizinga, G., Hoekstra, H., Graaf, W. A., & Hoekstra-Weebers, J. H. M. (2007). Temperament as a predictor of internalising and externalising problems in adolescent children of parents diagnosed with cancer. Supportive Care in Cancer, 15(4), 395-403.
Vollman, M. W., Lamontagne, L. L., & Hepworth, J. T. (2007). Coping and depressive symptoms in adults living with heart failure. The Journal of cardiovascular nursing, 22(2), 125-130.
Watson, M., St James-Roberts, I., Ashley, S., Tilney, C., Brougham, B., Edwards, L., . . . Romer, G. (2006). Factors associated with emotional and behavioural problems among school age children of breast cancer patients. British Journal of Cancer, 94(1), 43-50.
Weaver, K. E., Rowland, J. H., Alfano, C. M., & McNeel, T. S. (2010). Parental cancer and the family: a population-based estimate of the number of US cancer survivors residing with their minor children. cancer, 116(18), 4395-4401.
Weinstock, L. M., Keitner, G. I., Ryan, C. E., Solomon, D. A., & Miller, I. W. (2006). Family functioning and mood disorders: a comparison between patients with major depressive disorder and bipolar I disorder. Journal of Consulting and Clinical Psychology, 74(6), 1192-1202.
Weissman, M. M., Wickramaratne, P., Nomura, Y., Warner, V., Pilowsky, D., & Verdeli, H. (2006). Offspring of depressed parents: 20 years later. American Journal of Psychiatry, 163(6), 1001-1008.
Welch, A. S., Wadsworth, M. E., & Compas, B. E. (1996). Adjustment of children and adolescents to parental cancer. Parents' and children's perspectives. Cancer, 77(7), 1409-1418.
Wiggs, C. M. (2011). Mothers and daughters: intertwining relationships and the lived experience of breast cancer. Health Care Women International, 32(11), 990-1008.
World Health Organizaion (2012, February). Cancer. Retrieved from http://www.who.int/mediacentre/factsheets/fs297/en/index.html.
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