The study updated a meta-analysis on emotional and behavioral problems among children with chronic physical health conditions (CPHCs) as assessed with the Achenbach System of Empirically Based Assessment. A systematic search in electronic databases (PsycInfo, Medline, Web of Science, and PSYNDEX) identified 1,337 studies that were analyzed with multilevel meta-analysis. Young people with CPHCs had, on average, higher levels of internalizing (g = .51 standard mean difference), externalizing (g = .25), and total behavior problems (g = .49) than peers without CPHCs or test norms. Elevations of total problems were larger than in the past meta-analysis. The largest elevations of internalizing problems were found for chronic fatigue syndrome, while the largest elevations of total problems and externalizing problems were observed in the case of thalassemia. Effect sizes tended to be larger when parent reports were used rather than adolescent self-reports. Effect sizes also varied by country and, in part, by duration of the CPHCs, sampling, target of comparison, equivalence of the compared groups, response rate, age, and gender. The results call for regular screening for psychological distress in children with CPHCs.

Sleep disturbances are under-identified and under-treated in oncology. To inform screening and intervention efforts at a large academic cancer center, we identified the prevalence and correlates of patient-reported sleep difficulties. This retrospective study evaluated 20,416 individuals who completed practice-based distress screening from 1/2017-6/2024. Sleep difficulties in the past 2 weeks were reported from 0 (none) to 10 (severe). Univariable and multivariable regression models evaluated the impact of sociodemographic (age, sex, race/ethnicity, financial concerns), and medical/psychosocial factors (cancer type/stage, time since diagnosis, distress, anxiety, depression, pain, relationship problems, tobacco and alcohol use) on clinically significant (≥ 5) and severe (≥ 7) sleep difficulties. All variables were obtained from patients' first screen except for cancer type, stage, and diagnosis date, which were from the cancer registry. Among the sample (59% female, 78% non-Hispanic white, 49% stage I-II, mixed cancer sites), 36% reported clinically significant sleep difficulties. In a multivariable model, the strongest correlates (OR ≥ 1.35) of sleep difficulties ≥ 5 were: age 40-64 (OR=1.35), financial concerns (OR=1.35), distress (OR=3.06), pain (OR=2.80), anxiety (OR=2.31), and depression (OR=1.69). Risk varied by cancer type, with upper GI, genitourinary, thoracic, and hematological cancers showing modestly higher odds. Sensitivity analyses (cutoff ≥7, within 90 days of diagnosis) showed broadly similar but not identical correlates. Sleep difficulties are prevalent and correlated with psychosocial concerns and cancer type. Future research should explore sleep trajectories and potential care pathways for patients screening positive.

Many patients with melanoma experience worry, anxiety and distress. Screening for psychological distress can facilitate early identification and management. However, little is known about such distress in melanoma survivors and patients at high risk of developing melanoma. The primary outcome was to assess the melanoma-related worry in melanoma survivors and patients at high risk of melanoma. Additionally, a secondary outcome was to determine the optimal Distress Thermometer (DT) cutoff for identifying those needing psycho-oncological support. We prospectively collected the distress-related patient-reported outcomes at the Department of Dermatology of the University Hospital in Basel, Switzerland between January 2021 and January 2024. Validated questionnaires including the DT, Melanoma Worry Scale, Patient Health Questionnaire, and Generalized Anxiety Disorder were used to assess the primary outcome. For the secondary outcome, receiver operating characteristic (ROC) analysis was used to estimate the optimal DT cutoff. The study population comprised 430 individuals, including 175 (41%) melanoma survivors and 255 (59%) patients at high risk for melanoma. Worry about getting a primary or subsequent melanoma was more prominent in melanoma survivors (26%) compared with patients at high risk for melanoma (16%). Patients at high risk for melanoma had less melanoma worry compared with melanoma survivors, with an odds ratio (OR) of 0.56 [95% confidence interval (CI) 0.34-0.93]. Melanoma worry predictors included being divorced (OR 3.08, 95% CI 1.28-7.38) and younger age (OR 0.97, 95% CI 0.95-0.99). Patients at high risk of melanoma showed significant higher distress [median DT 4, interquartile range (IQR) 2-6] compared with melanoma survivors (DT 2, IQR 1-5) (P < 0.001). ROC analysis estimated a DT score of 3 as the optimal cutoff for melanoma survivors, whereas a DT score of 6 was optimal in patients at high risk of melanoma. This study found that melanoma survivors exhibit greater disease-specific worry, whereas patients at high risk for melanoma show increased general distress, underscoring their distinct psycho-oncological needs. Adopting tailored DT cutoffs (≥ 3 for melanoma survivors, ≥ 6 for patients at high risk for melanoma) may improve the detection of clinically relevant distress. Importantly, interest in psychological support was observed across all DT scores, indicating the need for flexible, patient-centred approaches. These findings highlight the unmet need for psychosocial care in both melanoma survivors and patients at high risk of melanoma, and could aid dermatologists in screening patients for psychological distress.

Survivors of childhood, adolescent, and young adult cancers (CAYA) experience unique survivorship needs that are often unaddressed. We characterized young adult CAYA survivors' perspectives on the acceptability and utility of a novel model for routinely identifying and addressing their needs in survivorship care. Our onco-primary care program implemented routine needs-based care using age-appropriate needs and distress screening at survivorship visits. Survivors completed a screener and ranked their top three concerns for discussion, and clinicians discussed and addressed survivors' prioritized concerns. Research personnel recruited English-speaking survivors ages 18-39 with a history of cancer during their clinic visit. Twelve survivors completed semi-structured interviews about their needs-based care experience. We conducted iterative thematic content analysis to identify themes. The sample was 41.7% male and included some diversity of race and ethnicity (e.g., 16.7% Asian American, 25.0% Hispanic). We defined five themes: (1) Being asked relevant, age-appropriate questions made survivors feel "seen" and enhanced connection to the care team. (2) The model helped survivors identify their concerns and overcome barriers to talking about them with the clinician. (3) Prioritizing concerns was challenging but facilitated focus in the visit. (4) Completing the assessment at the visit and at every visit was acceptable. (5) Survivors were satisfied with communication and how their needs were addressed. Young adult CAYA survivors had positive perceptions of routine age-appropriate needs assessment followed by clinician discussion in survivorship. This model was relevant, useful, and acceptable, and enhanced their perceptions of providers and satisfaction with care.

Sleep disturbance is a prevalent and debilitating comorbidity in older patients with knee osteoarthritis (KOA), significantly impacting their quality of life. While pain is a known contributor, the complex interplay between physical symptoms, psychological distress, and social factors remains inadequately understood. This study aimed to determine the prevalence of poor sleep quality and to elucidate the intricate pathways through which pain, post-traumatic stress symptoms (PTSD), and social support influence sleep among community-dwelling older KOA patients. A multi-stage cluster random sampling method was employed to recruit 314 older patients with KOA from communities in Changsha. Data were collected on demographic characteristics, sleep quality (Pittsburgh Sleep Quality Index, PSQI), pain severity (Numerical Rating Scale, NRS), social support (Social Support Rating Scale), and symptoms of anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), and PTSD (Posttraumatic Stress Disorder Checklist-Civilian Version, PCL-C). Poor sleep quality was defined as a PSQI global score > 7. Multivariable logistic regression and path analysis were performed to identify influencing factors and mediating pathways. The prevalence of poor sleep quality (PSQI > 7) was 49.0% (154/314), with a mean cohort PSQI score of 8.18 ± 4.39. Bivariate analyses revealed that poor sleep quality was significantly associated with female gender, lower educational attainment, greater pain severity, higher levels of depressive and anxiety symptoms, higher PTSD scores, and lower social support (all p < .001). Path analysis, using a well-fitting model (TLI = 0.961, RMSEA = 0.070), identified depressive symptoms (total effect β = 0.396) and pain (total effect β = 0.329) as the most significant predictors of poorer sleep quality. The model further revealed that depressive symptoms played a crucial mediating role, channeling the indirect effects of both pain and PTSD onto sleep. Nearly half of the community-dwelling older adults with KOA suffer from poor sleep quality, underscoring a significant health burden. The risk is driven by a complex web of factors, not limited to pain. Our findings highlight that depressive symptoms and social support are critical mediators in the relationship between pain, trauma, and sleep. This suggests that effective management of sleep disturbances in this population necessitates a holistic, integrated approach that combines pain control with routine screening and management of psychological distress and reinforcement of social support systems.

Psychological distress, particularly symptoms of depression and anxiety (D&A), is highly prevalent among family caregivers of individuals living with cancer, who often assume central roles in care coordination, treatment adherence, symptom monitoring, and emotional support. Rates of distress among caregivers frequently equal or exceed those observed in patients themselves. Despite increased attention to caregivers' mental health needs, routine distress screening remains limited in oncology care settings. Advances in mobile health technology and artificial intelligence (AI) offer opportunities to address these needs by providing accessible and user-driven tools. The Ellipsis Caregiver Assessment Enhancement (eCARE; Ellipsis Health, Inc) is a speech-based, AI-enabled mobile app designed to screen and monitor symptoms of depression and anxiety. By collecting brief voice recordings and in-app survey data, eCARE offers a scalable approach for integrating caregiver distress monitoring into cancer care. This single-arm trial will evaluate the feasibility and acceptability of the eCARE app among family members who are the primary caregivers of patients diagnosed with cancer within the past 5 years. Specifically, the study aims to (1) determine feasibility based on platform completion rates, (2) assess acceptability using validated measures, and (3) identify barriers and facilitators influencing the uptake and sustained use of eCARE. In Phase 1, a total of 60 United States-based family caregivers will be recruited from community health clinics, cancer and caregiving advocacy groups, and online postings. Screened and enrolled caregivers will complete 6 eCARE sessions over an 8-week period. Pre- and posttest surveys assess depression, anxiety, caregiving burden, and relational processes. Feasibility will be evaluated based on the proportion of participants who complete at least 66% of weekly assessments, and acceptability will be assessed using the acceptability of intervention measure (AIM). In Phase 2, a total of 20 caregivers will be invited to participate in semi-structured online interviews to explore user experience, including perceived benefits, barriers to use, and preferences for future implementation. Qualitative data will be analyzed thematically to inform tool refinement. The study has received Institutional Review Board approval from the University of Houston. Participant recruitment and enrollment began in June 2024, with data collection expected to conclude by August 2025. Data analysis will begin in December 2025, with preliminary results anticipated by May 2026. This study will generate preliminary evidence on the feasibility, acceptability, and utility of a speech-based, AI-enabled smartphone tool for monitoring D&A symptoms among family cancer caregivers. Findings will inform the design of a larger, fully powered trial and guide future implementation of remote psychological distress monitoring strategies in oncology care. By offering a low-burden, caregiver-centered approach, eCARE has the potential to expand access to psychosocial support and facilitate timely identification of needs and coordination of services across cancer care settings. DERR1-10.2196/83276.

Chronic pain is common, complex, undertreated, and linked with lower quality of life. The primary care setting provides an opportunity to standardize screening for chronic pain and distress and facilitate early intervention via integrated psychological treatment. This study describes the use of a digital pain and distress screener to improve identification of those who could benefit from integrated psychological treatment to manage chronic pain in primary care. An electronic pain and distress screening tool was implemented in an academic internal medicine clinic at an urban hospital. Data regarding screening completion, percentage of positive screens, and number of integrated psychology referrals were pulled from the electronic medical record. 1,676 unique pain and distress screenings were completed between March 2024 and January 2025. Forty-three percent of patients screened positive (n = 837). Thirty-nine patients were referred for integrated psychological treatment and 20 completed at least one visit. Older adult patients completed the digital pain and distress screener at similar rates to other digital screenings with positive screening rates similar to the known prevalence of comorbid pain and distress. Referral rates were low though a high proportion of referrals began treatment. With modifications to workflow, the pain and distress screening could facilitate early and effective intervention.

ABSTRACTBackground & AimsCancer treatments and survival rates have significantly improved, yet distress in patients and their relatives remains overlooked, leaving them with needs unmet. One contributing factor is inadequate screening, which could be improved by digitalisation. This study examined differences in distress among outpatients, inpatients, and their relatives, along with acceptance and usability of digital screening tools.Methods149 participants including relatives, outpatients, and inpatients were randomised using established analogue screening versus digital screening with text‐based instructions or digital screening with video‐based instructions for the Distress Thermometer and rated their distress. Participants then provided ratings for usability and acceptance of digital screening measures.ResultsOverall distress levels on average were high for all, inpatients, outpatients and relatives. There were no significant differences between groups in overall distress levels. Inpatients without wish for counseling reported greater physical distress and lower psychological and psychosocial distress than inpatients with wish for counseling, who were similar to relatives and outpatients. Participants expressed high overall satisfaction with digital screening measurements. Digital screening with text‐based instructions seems to be superior to analogue screening or video‐based screening, regardless of age and gender, when people have hands‐on experience. Patients and relatives using analogue screening are more skeptical of digital screening, especially elderly and female users.ConclusionOur study offered valuable insights into the varying distress levels of inpatients, outpatients, and relatives, which leads to the implication that outpatients and relatives should also be screened closely. The decisive variable was wish for counseling. There is a need for more counseling options for both cancer patients and their relatives. Our findings support the use of digital screening methods for patients and relatives. The hands‐on experience seems to be crucial for a higher acceptance.

Mothers with preeclampsia may experience severe mental health problems during both the prenatal and postnatal periods. Therefore, it is essential to address their psychological needs, particularly after childbirth. This study aimed to explore the experiences of mothers with a history of preeclampsia within the Iranian socio-cultural context using a qualitative approach. This study employed a qualitative content analysis design. Eleven women with a history of preeclampsia and 21 maternal healthcare providers and policymakers were selected through purposive sampling in Kermanshah, Iran. Data were collected through semi-structured interviews until data saturation was achieved. The interviews were transcribed verbatim and analyzed using conventional content analysis, during which codes, subcategories, and main categories were identified through an inductive process. Data analysis resulted in four main categories: (1) mothers' mental trauma following preeclampsia, (2) neglect of mothers' mental health by families and professionals, (3) mothers' and families' need for support in coping with preeclampsia complications, and (4) the need for long-term mental health follow-up. The findings highlight the importance of preventing emotional trauma in women with preeclampsia. Early screening for psychological distress and implementing appropriate interventions-such as family-centered care, education for mothers and families about preeclampsia and its consequences, and preparation for coping with related complications-can significantly improve the mental health and long-term quality of life of these women.

Background. Advances in breast cancer (BC) treatment have led to a large and growing population of survivors. This necessitates a clinical paradigm shift from a sole focus on survival to the comprehensive management of long-term health and quality of life. Objective. To critically analyze and synthesize current evidence-based data on key aspects of post-treatment BC care, emphasizing the transition from passive surveillance to proactive strategies for rehabilitation and secondary prevention. Materials and methods. A systematic analysis of data from key randomized clinical trials (RCTs), meta-analyses (Cochrane, EBCTCG), and clinical guidelines (ESMO, NCCN) was conducted. The review covers the efficacy of follow-up protocols, the impact of lifestyle factors, methods for managing endocrine therapy complications, and modern approaches to fertility preservation. Results. The analysis reveals a scientific consensus on the inefficacy of intensive instrumental screening in asymptomatic patients. Conversely, the role of lifestyle modification is strongly evidenced, with body weight control and regular physical activity being key factors in reducing the risk of recurrence and mortality. Managing long-term complications of endocrine therapy, such as osteoporosis and genitourinary syndrome, requires a proactive approach, including the use of bone-modifying agents (which also possess antitumor effects) and safe methods of local hormonal treatment. The POSITIVE trial represents a breakthrough in oncofertility, proving the safety of temporarily interrupting therapy to pursue pregnancy, which fundamentally changes counseling for young patients. Conclusion. The modern concept of BC survivorship care demands a shift towards personalized survivorship care plans. These plans must integrate evidence-based surveillance strategies, proactive management of side effects, mandatory screening and correction of psychological distress, and active patient engagement in lifestyle modification. Future research should focus on developing effective models for implementing these comprehensive approaches into routine clinical practice.

ABSTRACT One of the most common metabolic diseases in the world is diabetes. Healthcare services in Taiwan place a strong emphasis on self-care interventions and self-management techniques. This study intends to investigate the association of related factors with diabetes distress in older patients with type 2 diabetes mellitus (T2DM), as there is a dearth of information on the topic. Targeting T2DM patients from the internal medicine outpatient clinic of a regional hospital in Taiwan, this study used a cross-sectional survey. Between May 1 and July 31, 2023, purposive sampling was used to recruit a total of 181 older patients. Three validated and previously published scales were used in study: Chinese Version of the Problem Areas in Diabetes, Diabetes Knowledge Questionnaire, and Diabetes Self-Care Behaviors Scale. Regression analysis identified four key factors associated with diabetes distress: diabetes knowledge, diabetes self-care behaviors, diabetic neuropathy, and HbA1c. It suggest older T2DM patients with diabetic neuropathy, HbA1c > 7%, lower diabetes knowledge, and poor diabetes self-care behaviors are more likely to experience increased diabetes distress. Findings can help clinicians identify risk factors for diabetes distress and understand the mechanisms associated with it in older T2DM patients. It emphasizes how diabetes distress in older T2DM patients is associated with diabetes education, self-care practices, diabetic neuropathy, and HbA1c levels. Improving patient outcomes requires early distress screening and diabetes distress assessment integration into standard care. Reducing distress and promoting improved diabetes control can be achieved by improving healthcare providers’ capacity to recognize diabetes distress and offer tailored interventions.

IntroductionPsychosocial distress in cancer patients can have a significant impact on quality of life and adherence to treatment. Psychosocial distress is often systematically recorded in an inpatient setting. Psychosocial distress is also assessed in outpatient oncological care using psycho-oncological screening. However, there is currently little evidence that considers the psychosocial distress, the perceived need for support and the disease-related sociodemographic factors in outpatient cancer patients.MethodsIn this cross-sectional study, routine data from N = 868 outpatient cancer patients were analyzed. Psychosocial distress was assessed using the Distress Thermometer (DT) and specific problem areas were identified using the Problem Checklist (PCL). Sociodemographic and medical factors were examined with regard to their influence on the experience of distress and the perceived need for psycho-oncological support.Results46.1% of cancer patients reported high distress (DT ≥ 5) and 10% indicated a perceived need for psycho-oncological support. Younger age, female gender, and the first year after diagnosis were significantly associated with high distress. The most common physical and psychosocial problems included skin problems, exhaustion, sleep disorders, pain, worries, and anxiety.DiscussionThe results underscore the need for standardized distress screening in outpatient care, in order to identify need for support at an early stage and provide targeted interventions. Future studies should examine the factors that may influence utilization in more detail so that barriers can be further reduced and psycho-oncological interventions can be offered in an outpatient setting in a manner that is tailored to needs and requirements.

Metastatic breast cancer (MBC) patients in low- and middle-income countries (LMICs) face unique psychosocial challenges due to advanced disease presentation, financial burdens, and limited access to supportive care. Psychological distress (PD), a critical determinant of treatment adherence and quality of life, remains under-recognized and under-treated in these settings. The Distress Thermometer (DT), a simple screening tool endorsed by the National Comprehensive Cancer Network (NCCN), offers potential for systematic PD assessment. This study assessed the performance of the DT in identifying PD among MBC patients and evaluated its correlation with clinical and sociodemographic factors at a tertiary cancer center (NSIA-LUTH) in Lagos, Southwest Nigeria. A cross-sectional study was conducted involving 313 patients diagnosed with metastatic breast cancer. Eligible participants, aged ≥ 18years and cognitively intact, completed the DT alongside a comprehensive problem checklist. Psychological distress was defined as a DT score ≥ 4. Sociodemographic, clinical, and psychosocial data were retrieved from electronic medical records. The median age of participants was 53years, with 98.7% being female. The most common metastatic sites were lungs (53.0%), spine (48.2%), and liver (13.4%). Triple-negative breast cancer was predominant (51.1%). Moderate to severe distress (DT score ≥ 4) was identified in 46% of patients. Primary concerns included insurance-related issues (73.2%), treatment-related concerns (62.3%), and transportation difficulties (59.4%). Psychological manifestations were dominated by worry (62.3%) and anhedonia (50.8%). Physical symptom burden was substantial, with sleep disturbance (57.2%), pain (56.2%), and eating difficulties (52.4%) being most prevalent. Strong family-based support systems were noted, with 75% of patients having primary caregivers. Patients experienced an average of 2.81 concurrent psychosocial challenges and 4.36 concurrent physical symptoms. Psychological distress is highly prevalent (46%) among MBC patients in this LMIC setting, driven by insurance-related concerns, transportation difficulties, and substantial symptom burden.. The DT successfully identified patients with clinically significant distress (DT ≥ 4), supporting its feasibility for routine psychosocial screening in resource-limited oncology settings.

Comorbid psychological distress (anxiety and depression) in inflammatory bowel disease (IBD) is common and associated with poorer outcomes and increased healthcare burden. Scalable and accessible integrated care is needed. This study examined the feasibility of implementing routine digital mental health screening and digital cognitive-behavioral therapy (COMPASS-IBD) for psychological distress in a large IBD service. During implementation, distress was identified by screening or IBD clinician referral. Further triage determined eligibility to receive COMPASS-IBD with trainee therapist support (12 weeks). Pre- and post-intervention outcomes examined reach, acceptability, implementation, and potential effectiveness of the new pathway. Screening was completed by 827 patients (from November 2022 to September 2023), with 196 patients meeting clinical cutoffs and referred for IBD psychology triage. An additional 82 patients were directly referred via IBD clinicians. Of 91 eligible patients, 65 (71.4%) were enrolled into COMPASS-IBD. Distress significantly reduced post-intervention (Patient Health Questionnaire Anxiety and Depression Scale = -6.203; 95% confidence interval, -8.76 to -3.64; P < .001; Cohen's d = -0.553). Symptoms of anxiety, depression, and IBD-related quality of life significantly improved, but IBD symptomatology did not. Full adherence (≥5 online and ≥3 therapist sessions) to COMPASS-IBD was completed by 32.3% of patients. After initially increasing, the IBD psychology waitlist decreased in wait time (30.8%) and number (63.4%) by the end of study implementation. Patients were accepting of the new treatment pathway. Routine mental health screening and COMPASS-IBD were successfully implemented in an outpatient IBD service, but support from trainee psychologists and the research team was required. This new integrated pathway can identify and treat psychological distress in IBD with minimal service resource.

Patient Attitudes toward Distress Screening and Referral in Glaucoma Care.

Treatment and Referral of Youth With Opioid Addiction in the Pediatric Emergency Department: A Pilot Study.

Screening for Psychological Distress in Patients with Breast Cancer and Psychiatric Referral Acceptance Rate

Existential distress is a debilitating condition in end-of-life cancer patients. The Psycho-existential Symptom Assessment Scale (PeSAS) was developed to screen psycho-existential symptoms in palliative care, but limited research has examined its use. This study aimed to implement the Italian version of the PeSAS in palliative care services and to evaluate changes in healthcare providers' (HCPs) competence after experiential training. It also aimed to estimate the frequency of psycho-existential symptoms and explore the scale structure using network analysis. Two-hour experiential workshops were conducted in 5 Italian palliative care services by a clinical psychologist specialized in psycho-oncology and palliative care. Training covered psycho-existential distress, role-play, and feedback. Pre- and post-workshop questionnaires assessed clinicians' self-efficacy in evaluating physical, psycho-existential, and suicidal symptoms, managing distress, and providing psychosocial support. Patient cross-sectional data were analyzed with descriptive statistics, t-tests, chi-square tests, and exploratory graph analysis. One hundred one clinicians from 3 services participated. Significant results were found in HCPs' self-efficacy, with the largest effect in assessing suicidal symptoms (Cohen's d=0.54), followed by managing distress (d=0.47) and evaluating psycho-existential symptoms (d=0.40). Of 210 patients screened, 194 were included. PeSAS scores were strongly associated with Hopelessness (strength=1.30) and depression (1.18), while being trapped by illness (-1.64) and wishing to die (-1.12) had weaker associations. The Italian PeSAS is feasible for integration into palliative care. Strong associations highlight targets for interventions, while weaker associations suggest the need for additional approaches. PeSAS enhances HCPs' ability to address the psycho-existential needs in end-of-life care.

The present study examined developmental pathways beginning in pregnancy and extending into early childhood that contribute to child emotion regulation (ER). Leveraging data from a sample of 157 mixed-sex couples, who largely identified as White and non-Hispanic/Latino, and their typically developing children (50.3% female), we examined whether parental emotion-related socialization behaviors (ERSBs; i.e., general emotion talk, specific supportive and nonsupportive responses to children's negative emotions) at preschool age (child age 3) mediated the link between parental trauma-related distress spanning pregnancy to toddler age (2-years postpartum) and child maladaptive ER at the transition to formal schooling (age 5). Chronic elevations in maternal trauma-related distress contributed directly and indirectly to child maladaptive ER at age 5, and maternal nonsupportive responses emerged as a potential pathway driving the intergenerational transmission of emotion dysregulation. In contrast, paternal trauma-related distress neither undermined ERSBs nor contributed to child maladaptive ER. Instead, chronic elevations in paternal trauma-related distress predicted more supportive responses to children's negative emotions. Results highlight the utility of repeated screening for trauma-related distress and prevention and early intervention efforts targeting parental trauma-related distress and nonsupportive responses to children's negative emotions. These strategies may help promote adaptive ER at school entry and reduce risk for later psychopathology.

Objective: To explore the efficacy of nursing interventions based on humanistic care theory in alleviating implantable venous access port-related anxiety in cancer patients. Methods: A convenience sampling method was used to select 100 cancer patients undergoing implantable venous access port treatment at a tertiary hospital’s oncology center from January to December 2024. Participants were randomized into control and experimental groups (n = 50 each). The control group received routine care (catheter maintenance, health education, and monitoring), while the experimental group received additional humanistic care interventions for 14 days post-insertion, including staged trust-building communication (25–30 min pre- and post-insertion), knowledge dissemination (visual aids and post-procedure review), distress screening and coping skill-building (10 min daily for 3 days), pain management (local anesthesia and dynamic assessment), relaxation training (breathing exercises and intraoperative music therapy), family involvement, and structured follow-ups (days 3, 7, 14). Outcomes were assessed using the Self-Rating Anxiety Scale (SAS), SF-36 Quality of Life Scale, and compliance rates. Results: Post-intervention, the experimental group exhibited significantly lower SAS scores (40.6 ± 5.4 vs. 49.3 ± 6.8, P &lt; 0.05) and higher SF-36 scores (72.8 ± 8.6 vs. 62.4 ± 7.9, P &lt; 0.05) compared to the control group. Compliance rates were also superior in the experimental group (90% vs. 80%, P &lt; 0.05). Conclusion: Nursing interventions grounded in humanistic care theory effectively reduce implantable venous access port-related anxiety, enhance quality of life, and improve treatment compliance in cancer patients, supporting their clinical adoption.