{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:43:52Z","timestamp":1791931432144,"version":"4.3.4"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the situation of childhood cancer survivors and their parents before and one year after a family-oriented rehabilitation program (FOR) and to identify factors influencing reintegration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included parents of children diagnosed with leukemia or central nervous system tumor. We assessed parental functioning using the functioning subscale of the Ulm Quality of Life Inventory for Parents (ULQIE) and children's school\/kindergarten related quality of life (parental assessment, subscale KINDL-R). Descriptive analyses, group comparisons and multiple regression analyses on data of 285 parents of 174 children diagnosed with leukemia or central nervous system tumor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Parents reported changes in their work situation (e.g., reduction of working hours) due to their child's diagnosis. Parental functioning increased significantly over time. Children's leukemia diagnosis and shorter time since the end of treatment were associated with higher functioning in parents one year after FOR. Parents reported difficulties in the child's work pace, concentration, stress resilience and empathy. The school\/kindergarten-related quality of life (QoL) of the children was lower than in the general population. One year after FOR, most children reintegrated fully in school\/kindergarten, partly with support (e.g., integration assistant). No significant predictors for children's reintegration were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Parents and children experience major changes in their work\/school\/kindergarten life. One year after FOR most parents reported a reintegration of their children, however the children's school\/kindergarten-related QoL remained below average compared to norm values. Even after rehabilitation families of childhood cancer survivors might benefit from psychosocial and practical support offers to support families with the reintegration into work\/school\/kindergarten.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1288567","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T04:40:13Z","timestamp":1709786413000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Reintegration into school, kindergarten and work in families of childhood cancer survivors after a family-oriented rehabilitation program"],"prefix":"10.3389","volume":"12","author":[{"given":"Laura","family":"Inhestern","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona L.","family":"Nasse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin A.","family":"Krauth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Kandels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Rutkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Escherich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Bergelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/j.ctrv.2010.02.003","article-title":"Epidemiology of childhood cancer","volume":"36","author":"Kaatsch","year":"2010","journal-title":"Cancer Treat Rev"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1952","DOI":"10.1016\/j.ejca.2007.05.031","article-title":"Health-related quality of life, anxiety and depression among adolescents and young adults with cancer: a prospective longitudinal study","volume":"43","author":"J\u00f6rng\u00e5rden","year":"2007","journal-title":"Eur J Cancer"},{"key":"B3","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1002\/pbc.20373","article-title":"Symptoms of post-traumatic stress in children with cancer and their parents: effects of informant and time from diagnosis","volume":"45","author":"Phipps","year":"2005","journal-title":"Pediatr Blood Cancer"},{"key":"B4","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1097\/00043426-200005000-00006","article-title":"Childhood cancer: a 4-year prospective study of the psychological adjustment of children and parents","volume":"22","author":"Sawyer","year":"2000","journal-title":"J Pediatr Hematol Oncol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e103340","DOI":"10.1371\/journal.pone.0103340","article-title":"Long-term positive and negative psychological late effects for parents of childhood cancer survivors: a systematic review","volume":"9","author":"Ljungman","year":"2014","journal-title":"PLoS One"},{"key":"B6","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1002\/pbc.22725","article-title":"Parental adjustment to the completion of their child\u2019s cancer treatment","volume":"56","author":"Wakefield","year":"2011","journal-title":"Pediatr Blood Cancer"},{"key":"B7","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1002\/pon.3073","article-title":"Coping in long-term survivors of childhood cancer: relations to psychological distress","volume":"22","author":"Wenninger","year":"2013","journal-title":"Psychooncology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1002\/pbc.21285","article-title":"Stress-related mental disorders in childhood cancer survivors","volume":"50","author":"Schrag","year":"2008","journal-title":"Pediatr Blood Cancer"},{"key":"B9","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1111\/j.1365-2354.2008.00954.x","article-title":"Children in remission from acute lymphoblastic leukaemia: mental health, psychosocial adjustment and parental functioning","volume":"18","author":"Reinfjell","year":"2009","journal-title":"Eur J Cancer Care"},{"key":"B10","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1002\/pbc.22795","article-title":"Health-related quality of life after completion of successful treatment for childhood cancer","volume":"56","author":"Engelen","year":"2011","journal-title":"Pediatr Blood Cancer"},{"key":"B11","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1177\/1043454204264396","article-title":"Integrating the child into home and community following the completion of cancer treatment","volume":"21","author":"Labay","year":"2004","journal-title":"J Pediatr Oncol Nurs"},{"key":"B12","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1093\/jpepsy\/jsh022","article-title":"Posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in families of adolescent childhood cancer survivors","volume":"29","author":"Kazak","year":"2004","journal-title":"J Pediatr Psychol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.pedn.2005.07.003","article-title":"Major stressors and their effects on the well-being of children with cancer","volume":"21","author":"McCaffrey","year":"2006","journal-title":"J Pediatr Nurs"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1751","DOI":"10.1002\/cncr.21390","article-title":"Educational and social late effects of childhood cancer and related clinical, personal, and familial characteristics","volume":"104","author":"Barrera","year":"2005","journal-title":"Cancer"},{"key":"B15","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1016\/j.ejon.2009.03.009","article-title":"What are the experiences of the child with a brain tumour and their parents?","volume":"13","author":"Soanes","year":"2009","journal-title":"Eur J Oncol Nurs"},{"key":"B16","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1046\/j.1365-2214.1996.788788.x","article-title":"Needs and responses of parents following the diagnosis of childhood cancer","volume":"22","author":"Sloper","year":"1996","journal-title":"Child: Care. Health Dev"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1002\/pon.5088","article-title":"The impact of childhood cancer on parents\u2019 socio-economic situation\u2014a systematic review","volume":"28","author":"Roser","year":"2019","journal-title":"Psychooncology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1002\/cncr.30436","article-title":"Short-term and long-term effects of childhood cancer on income from employment and employment status: a national cohort study in Sweden","volume":"123","author":"Lindahl Norberg","year":"2017","journal-title":"Cancer"},{"key":"B19","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1111\/j.1365-2354.2008.00976.x","article-title":"Experiences of parents of children surviving brain tumour: a happy ending and a rough beginning","volume":"18","author":"Lindahl Norberg","year":"2009","journal-title":"Eur J Cancer Care"},{"key":"B20","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1080\/07347332.2014.936653","article-title":"It\u2019s more than dollars and cents: the impact of childhood cancer on parents\u2019 occupational and financial health","volume":"32","author":"Wakefield","year":"2014","journal-title":"J Psychosoc Oncol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e0151966","DOI":"10.1371\/journal.pone.0151966","article-title":"Employment situation of parents of long-term childhood cancer survivors","volume":"11","author":"Mader","year":"2016","journal-title":"PLoS One"},{"key":"B22","author":"Schr\u00f6der","year":""},{"key":"B23","year":""},{"key":"B24","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1159\/000484609","article-title":"Family-oriented rehabilitation (FOR) and rehabilitation of adolescents and young adults (AYA) in pediatric oncology","volume":"40","author":"Krauth","year":"2017","journal-title":"Oncol Res Treat"},{"key":"B25","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1055\/s-0030-1261904","article-title":"DGRW-update: rehabilitation bei kindern und jugendlichen [DGRW-update: medical rehabilitation with children and adolescents]","volume":"49","author":"Bauer","year":"2010","journal-title":"Rehabilitation (Bonn)"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e014505","DOI":"10.1136\/bmjopen-2016-014505","article-title":"The role of rehabilitation measures in reintegration of children with brain tumours or leukaemia and their families after completion of cancer treatment: a study protocol","volume":"7","author":"Peikert","year":"2017","journal-title":"BMJ Open"},{"key":"B27","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1007\/s11764-021-01076-w","article-title":"Fear of progression in parents of childhood cancer survivors: prevalence and associated factors","volume":"16","author":"Peikert","year":"2022","journal-title":"J Cancer Surv"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1678","DOI":"10.1002\/pon.5508","article-title":"Fear of progression in parents of childhood cancer survivors: a dyadic data analysis","volume":"29","author":"Peikert","year":"2020","journal-title":"Psycho-Oncology"},{"key":"B29","doi-asserted-by":"publisher","first-page":"2965","DOI":"10.1007\/s11136-023-03436-8","article-title":"Parent-reported health-related quality of life in pediatric childhood cancer survivors and factors associated with poor health-related quality of life in aftercare","volume":"32","author":"Winzig","year":"2023","journal-title":"Qual Life Res"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1002\/pon.6175","article-title":"Emotional and behavioral problems of pediatric cancer survivors and their siblings: concordance of child self-report and parent proxy-report","volume":"32","author":"Paul","year":"2023","journal-title":"Psycho-Oncology"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e033730","DOI":"10.1136\/bmjopen-2019-033730","article-title":"Returning to daily life: a qualitative interview study on parents of childhood cancer survivors in Germany","volume":"10","author":"Peikert","year":"2020","journal-title":"BMJ Open"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e0239967","DOI":"10.1371\/journal.pone.0239967","article-title":"Parents\u2019 perception of their children\u2019s process of reintegration after childhood cancer treatment","volume":"15","author":"Inhestern","year":"2020","journal-title":"PloS One"},{"key":"B33","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.ijnurstu.2014.09.006","article-title":"Basic statistical reporting for articles published in biomedical journals: the \u201cstatistical analyses and methods in the published literature\u201d or the SAMPL guidelines","volume":"52","author":"Lang","year":"2015","journal-title":"Int J Nurs Stud"},{"key":"B34","volume-title":"German Childhood Cancer Registry\u2014Annual Report 2018 (1980\u20132017)","author":"Kaatsch","year":"2019"},{"key":"B35","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1026\/0084-5345.31.1.31","article-title":"Das ulmer lebensqualit\u00e4ts-inventar f\u00fcr eltern chronisch kranker kinder (ULQIE) [ULQIE: a quality-of-life inventory for parents of chronically ill children]","volume":"31","author":"Goldbeck","year":"2002","journal-title":"Z Klin Psychol Psychother"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"key":"B37","volume-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR","year":"2000"},{"key":"B38","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1097\/MLR.0b013e318160d093","article-title":"Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population","volume":"46","author":"L\u00f6we","year":"2008","journal-title":"Med Care"},{"key":"B39","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/S0165-0327(03)00198-8","article-title":"Measuring depression outcome with a brief self-report instrument: sensitivity to change of the patient health questionnaire (PHQ-9)","volume":"81","author":"L\u00f6we","year":"2004","journal-title":"J Affect Disord"},{"key":"B40","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"key":"B41","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.genhosppsych.2005.07.003","article-title":"Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population","volume":"28","author":"Martin","year":"2006","journal-title":"Gen Hosp Psychiatry"},{"key":"B42","first-page":"184","article-title":"Der kindl-R fragebogen zur erfassung der gesundheitsbezogenen lebensqualit\u00e4t bei kindern und jugendlichen\u2014revidierte form","volume-title":"Diagnostische Verfahren Zu Lebensqualit\u00e4t und Wohlbefinden","author":"Ravens-Sieberer","year":"2003"},{"key":"B43","author":"Ravens-Sieberer","year":""},{"key":"B44","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/1477-7525-7-77","article-title":"Measuring adolescents\u2019 HRQoL via self reports and parent proxy reports: an evaluation of the psychometric properties of both versions of the KINDL-R instrument","volume":"7","author":"Erhart","year":"2009","journal-title":"Health Qual Life Outcomes"},{"key":"B45","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/1477-7525-9-102","article-title":"Determinants of agreement between self-reported and parent-assessed quality of life for children in Germany\u2014results of the German health interview and examination survey for children and adolescents (KiGGS)","volume":"9","author":"Ellert","year":"2011","journal-title":"Health Qual Life Outcomes"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.3109\/0284186X.2016.1167956","article-title":"Parents of children diagnosed with cancer: work situation and sick leave, a five-year post end-of-treatment or a child\u2019s death follow-up study","volume":"55","author":"Wikman","year":"2016","journal-title":"Acta Oncol (Madr)"},{"key":"B47","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1002\/pon.3414","article-title":"Health and well-being in adolescent survivors of early childhood cancer: a report from the childhood cancer survivor study","volume":"23","author":"Mertens","year":"2014","journal-title":"Psychooncology"},{"key":"B48","doi-asserted-by":"publisher","first-page":"7965","DOI":"10.1007\/s00520-021-06401-8","article-title":"Neuropsychological assessment in pediatric oncology survivorship care: utilization of services, results of evaluation, and educational and behavioral health outcomes","volume":"29","author":"Oswald","year":"2021","journal-title":"Support Care Cancer"},{"key":"B49","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1007\/s00103-007-0244-4","article-title":"Gesundheitsbezogene lebensqualit\u00e4t von kindern und jugendlichen in deutschland","volume":"50","author":"Ravens-Sieberer","year":"2007","journal-title":"Bundesgesundheitsblatt"},{"key":"B50","doi-asserted-by":"publisher","first-page":"2610","DOI":"10.1080\/09638288.2019.1708484","article-title":"Reintegration into school of childhood brain tumor survivors: a qualitative study using the international classification of functioning, disability and health\u2014children and youth framework","volume":"43","author":"Vanclooster","year":"2021","journal-title":"Disabil Rehabil"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1288567\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T04:40:19Z","timestamp":1709786419000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1288567\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,7]]},"references-count":50,"alternative-id":["10.3389\/fped.2024.1288567"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1288567","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,7]]},"article-number":"1288567"}}