Zusammenfassung
Die Diagnose einer Krebserkrankung und die Entscheidung für die extrem strapaziöse und langwierige Therapie führt bei betroffenen Kindern und Jugendlichen sowie ihren Familien zu vielschichtigen psychosozialen Belastungen, die das Risiko von psychischer Überforderung und Fehlanpassung in sich bergen. In diesem Beitrag wird ein psychologisches Beratungskonzept vorgestellt, das auf den Modellen und empirischen Befunden zur Krankheitsbewältigung bei Familien krebserkrankter Kinder aufbaut. Einleitend wird der Anpassungsprozeß der Familie an die Belastungsformen auf dem Hintergrund ihrer Vulnerabilität und sozialen Unterstützung diskutiert. Aus den korrelierenden Variablen gelungener Adaptation, die in früheren Studien herausgearbeitet werden konnten, lassen sich fundierte Ansatzpunkte für Interventionen herleiten. Die unterschiedlichen Interventionen des Beratungsangebotes dienen dabei 3 Grundfunktionen innerhalb des familiären Anpassungsprozesses: der Prävention und Reduktion von Belastungen, der Mobilisierung sozialer Unterstützung und der Verbesserung des Bewältigungsverhaltens.
Das Beratungsmodell ist bei 42 Familien empirisch anhand der Auswertung von Beratungsprotokollen und den Daten eines Nachbefragungsbogens sowie einer Ratingskala untersucht worden. Die Ergebnisse hierarchischer Clusteranalysen belegen, wie eng das Bewältigungsverhalten jedes Familienmitgliedes mit dem Anpassungsprozeß der Gesamtfamilie verknüpft ist. Sie verdeutlichen die Bedeutung des wechselseitigen Austausches von krankheitsbezogenen Informationen, von Kommunikation und emotionaler wie praktischer Unterstützung zwischen krankem Kind, Eltern, Geschwistern. Besonders ein familienorientiertes Beratungskonzept kann diese Austauschprozesse wirksam initiieren und aufrechterhalten.
Summary
The diagnosis of cancer and the start of the therapy with an unpredictable outcome puts numerous psychosocial stressors on the ill child and his or her family, which carry the risk of overstrain and psychological maladjustment. This contribution introduces a psychological counseling program based on the theoretical and empirical findings concerning the illness-coping behavior in families with cancer-sick children. It starts by delineating the adaption to the stressors imposed by the disease on the background of the family’s vulnerability and social support. Correlative variables to positive family adjustment that had been detected in previous studies are discussed and taken as objectives of the counseling program. The various intervention strategies of the counseling program enhance three basic functions in the context of the family’s coping process: Prevention and reduction of stressors, mobilization of social support, and improvement of coping behavior.
The counseling program has been evaluated in 42 families by cluster analysis among categories of counseling protocols and among data of a questionnaire and a Likert scale. The results reaffirm the close interrelationship between the individual coping behavior of a single family member and of the family as a whole. They strengthen the relevance of the mutual exchange of disease-related information, of communication, and of both emotional and practical support between ill child, parents, and siblings. Especially counseling programs that prefer a family-orientated approach can facilitate the family’s interaction in these realms and, thus, promote improved adaptation.
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Noeker, M., Petermann, F. (1990). Beratungsarbeit mit Familien krebskranker Kinder. In: Seiffge-Krenke, I. (eds) Krankheitsverarbeitung bei Kindern und Jugendlichen. Jahrbuch der medizinischen Psychologie, vol 4. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-75495-1_16
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