Breast cancer survivorship in Germany increases the risk of dropping out of paid work. The influence of work- and illness-related factors varies considerably between the early and late phases of recovery after breast cancer treatment. The comparative analysis demonstrates the relevance of labour market and pension legislation in Germany.

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OBJECTIVE. There is little evidence of the gain in illness-related knowledge obtained in breast cancer self-help groups. This paper seeks to explore whether participants in self-help groups know more about breast cancer than non-participants and to examine the level of knowledge of leaders of self-help groups in comparison to the other two groups. METHODS. A sample of 727 women affected by breast cancer was interviewed with a self-administered questionnaire assessing knowledge on disease, prevention, and aftercare. The interviewing took place during three different surveys conducted between 2005 and 2009. The data of the second and third survey were used in order to create a larger data base and to include self-help group leaders. RESULTS. Participants in self-help groups knew significantly more than non-participants, although only in the subtests lymph edema and breast-examination. Leaders of support groups scored highest in all subtests. Involvement in a support group was most decisive for respondents' knowledge, but other factors such as age, education, and medical history also had effects. CONCLUSION. Self-help groups provide a considerable potential for acquiring illness-related knowledge. As the participation rate in German breast cancer self-help groups is still quite low, it seems reasonable to generate more interest in this kind of support.

BackgroundEvidence suggests an increased risk of smoking among single mothers as compared to their cohabitating counterparts. This article examines the role of psychosocial stress in mediating the relationship between single motherhood and smoking.MethodsData were derived from a cross-sectional population based sample of German women (n = 3129) with underage children (0–18 years of age). Perceived stress was measured with 13 items covering socioeconomic as well as family- and parenting-related stressors. According to Baron and Kenny (1986) a series of logistic regression models was applied to investigate the role of psychosocial stress as a mediator on the relationship between single motherhood and smoking.ResultsAbout 44.0% of single mothers smoked daily, whereas only 26.2% of cohabitating mothers did. Single mothers reported more stress related to their economic situation, occupation and family than partnered mothers. Out of the original 13 stressors only 'conflicts with the partner or ex-partner’ and 'financial worries’ remained significant in explaining single mothers’ higher risk of smoking. Against expectation, stress due to household requirements and family demands was associated with lower odds of single mothers’ smoking. After controlling for psychosocial stress, the odds ratio of single mothers’ moderate smoking (< 20 cig./day) decreased slightly from 1.75 to 1.66 (explained fraction XF = 12.0%) and with respect to heavy smoking (≥ 20 cig./day) more pronounced from 2.56 to 2.01 (XF = 35.3%).ConclusionsIt can be stated that single mothers’ heavy more than moderate smoking appeared to be mediated by perceived psychosocial stress. Out of all stressors considered, financial worries were of paramount significance in explaining single mothers’ heavy smoking while some family-related stressors rather appeared to keep single mothers from smoking. Overall, a higher stress exposure explains partly but not sufficiently single mothers’ increased smoking rates.

Siegrists concept of effort-reward imbalance (ERI) had been shown to be associated with a broad range of health impairments, in particular cardiovascular diseases and depression. The original questionnaire was designed to assess ERI in the field of occupational work. This paper reports on a newly developed questionnaire for the assessment of ERI in household and family work. Analogous to the original version, it is divided into two components: (i) dysbalance of effort and reward (extrinsic component), and (ii) over-commitment (intrinsic components). The questionnaire was tested with data drawn from a clinical sample of mothers (n = 567) in rehabilitation clinics. Factor analyses have reproduced the two main dimensions "effort" and "reward". Relevant aspects of reward at home were (i) meaningfulness, (ii) social gratification, (iii) appreciation from the spouse, and (iv) affection for the child. Finally a 19-item questionnaire for assessing ERI in household and family work (ERI-M) and a four-item measure for measuring parental over-commitment (Over-M) are available. The psychometric properties of both instruments are good to satisfactory.