Family Distress Research Articles

BackgroundCompulsive sexual behavior disorder (CSBD) involves persistent, repetitive sexual behaviors that continue despite efforts to stop, leading to significant distress or impairment in personal, family, social, educational, and occupational functioning. Most compulsive sexual behavior (CSB) research focuses on Western countries, leaving its characteristics in Japan largely unexplored. Although treatment-seeking behavior for CSB is documented in Western contexts, there is a need to understand this behavior in Japan to improve mental health services.AimsThis cross-sectional study aimed to clarify association between CSB, sociodemographic factors, maximum sexual behavior duration, life satisfaction, negative consequences, psychological co-morbidities, and treatment-seeking behaviors in Japan.MethodsParticipants were recruited from a national probability-based sample of adults aged 18-59 in Japan using a web-based questionnaire, with proportional representation of sex assigned at birth, age groups, and residential areas. A total of 1094 respondents (43.69% heterosexual cisgender men, Mage = 39.9 ± 11.6) were included.OutcomesParticipants completed the Compulsive Sexual Behavior Disorder Scale-19 (mean score = 24.35 ± 9.27), reporting sexual behavior frequency, time spent on sexual behaviors, life satisfaction, negative consequences related to sexual behaviors, treatment-seeking behaviors, and comorbid conditions such as depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), and Adult Attention-deficit Hyperactivity Disorder (ADHD) (Adult Attention-deficit Hyperactivity Disorder Self-Report Scale).ResultsIndividuals at high risk of CSBD (n = 28; 2.56%), based on the CSBD-19 cut-off score, were more likely to be cisgender heterosexual men than women (chi-squared test). Compared to low-risk individuals, those at high risk spent more maximum duration on pornography and masturbation, lower life satisfaction in health and intimate relationships, experienced negative consequences in various life domains (eg, sleep, social activities, work, family life, finances, and physical health), and exhibited symptoms of depression, anxiety, and ADHD. Three individuals at high risk of CSBD reported seeking treatment.Clinical ImplicationsIndividuals at high risk of CSBD experience negative consequences and psychological co-morbidities, making it critical to investigate contributing factors to provide effective treatment for CSB in Japan.Strengths and LimitationsThis study contributes to limited research on CSB in non-Western cultures using a nationally probability-based sample in Japan. The measures lacked detail, so future studies should include more specific questions to evaluate treatment-seeking and other conditions. The small sample size limits the generalizability of the findings when comparing high- and low-risk CSBD groups.ConclusionThis study identified characteristics of individuals at high risk of CSBD in Japan, highlighting the need to develop a support system specific to CSB to ensure effective treatment.

Financial distress related to critical illness worsens clinical outcomes and is affected by objective financial difficulty or subjective perception of financial distress. Sources of financial distress include nonmedical out-of-pocket expenses (NOPEs; eg, food), but their impact on perceived financial distress is poorly understood, especially in pediatric critical care. We examine the association among overall NOPEs, their components, and perceived financial distress in families with children who have a critical illness. This was a single-site cross-sectional survey (conducted from September 2021 to August2022) of caregivers of children admitted to the pediatric intensive care unit (PICU). Perceived financial condition was measured by the InCharge Financial Distress/Financial Well-Being tool and categorized as high (1.0-4.0), average (4.1-6.9), or low (≥7.0) distress. NOPEs included costs of transportation, food, childcare, and housing, reported as proportions of weekly income. We used ordinal logistic regression to examine the relationship between NOPEs and perceived financial distress. A total of 332 families were approached, and 279 provided consent (84%); 149 families returned surveys (53%). A total of 30% of families reported high distress, 45% reported average distress, and 25% reported low distress. Median proportion of total NOPEs relative to income was 34.7% for families with high distress, 12.7% for those with average distress, and 5.2% for those with low distress. The odds of increased financial distress was associated with the proportion of weekly income spent on total NOPEs (adjusted odds ratio [aOR], 1.02; 95% CI: 1.01-1.04) and on food (aOR, 1.22; 95% CI: 1.06-1.44). In this PICU population, proportions of weekly income spent on total NOPEs and, separately, on food were associated with perceived financial distress. Potential policy interventions could target reducing the burden of NOPEs to mitigate financial distress.

HighlightsWhat are the main findings?CBD-rich cannabis treatment over 6 months was associated with reduced family accommodation (FA) and parental distress in families of autistic children.Qualitative findings showed improved family routines, parental well-being, and greater engagement in meaningful activities and social interactions.ImplicationsCBD-rich cannabis treatment may reduce FA and parental distress, while improving family routines and well-being.These results provide preliminary support for CBD-rich cannabis treatment in autistic children, though further controlled studies are needed.Background/Objectives: Parents of autistic children often face behavioral and participation challenges of their children, leading them to make accommodations to maintain a stable daily family routine. These family accommodations (FA) involve adapting family routines, actively engaging with the child’s support needs and symptoms, and avoiding specific situations. Methods: This open-label, mixed-methods study investigated the impact of CBD-rich cannabis treatment on FA. In the quantitative phase, analyses included 44 parents (from 87 initially recruited) who had complete FAS-RRB data at baseline, 3 months, and 6 months. In the following qualitative phase, 15 parents from the full sample participated in semi-structured interviews. Results: Quantitative results showed reductions in FA frequency and parental distress at 3 and 6 months. Qualitative findings revealed positive changes in family routines, enhanced well-being, and improved parental engagement in meaningful activities and social interactions. Conclusions: This study provides preliminary evidence that CBD-rich cannabis treatment may reduce family accommodation (FA) and parental distress, while improving family routines and well-being. However, given the open-label design and observed adverse events and withdrawals, the findings should be interpreted with caution.

The paper describes the case of a 5-year-old child presenting with acute headache and bilateral papilledema on fundus examination. Brain MRI was unremarkable, while subsequent ophthalmologic evaluations identified optic nerve drusen as the cause of the pseudopapilledema. Optic nerve drusen, calcified hyaline deposits within the optic disc, may mimic papilledema in children and are associated with visual field defects in a significant proportion of cases. This case highlights the importance of distinguishing true papilledema from pseudopapilledema to avoid unnecessary invasive procedures and reduce family distress.

Ear microtia is a congenital deformity that can range from mild underdevelopment to complete absence of the external ear. Often unilateral, it causes visible facial asymmetry leading to psychosocial distress for patients and families. Caregivers report feeling guilty and anxious, while patients experience increased rates of depression and social challenges. This is often a difficult time for the patient and their families, who often turn to AI chatbots for guidance before and after receiving definitive surgical care. This study evaluates the quality and readability of leading AI-based chatbots when responding to patient-centered questions about the condition. Popular AI chatbots (ChatGPT 4o, Google Gemini, DeepSeek, and OpenEvidence) were asked 25 queries about microtia developed from the FAQ section on hospital websites. Responses were evaluated using modified DISCERN criteria for quality and SMOG scoring for readability. ANOVA and post hoc analyses were performed to identify significant differences. Google Gemini achieved the highest DISCERN score (M=37.16, SD=2.58), followed by OpenEvidence (M=32.19, SD=3.54). DeepSeek (M=30.76, SD=4.29) and ChatGPT (M=30.32, SD=2.97) had the lowest DISCERN scores. OpenEvidence had the worst readability (M=18.06, SD=1.12), followed by ChatGPT (M=16.32, SD=1.41). DeepSeek was the most readable (M=14.63, SD=1.60), closely followed by Google Gemini (M=14.73, SD=1.27). Overall, the average DISCERN and SMOG scores across all platforms were 32.19 (SD=4.43) and 15.93 (SD=1.94), respectively, indicating a good quality and an undergraduate reading level. None of the platforms consistently met both quality and readability standards, though Google Gemini performed relatively well. As reliance on AI for early health information grows, ensuring the accessibility of chatbot responses will be crucial for supporting informed decision-making and enhancing the patient experience.

The objective of this review was to evaluate health care professionals' experiences when families participate in clinician handovers in adult, pediatric, and neonatal intensive care units (ICUs). Previous studies report the emotional distress families experience when a relative is admitted to intensive care, including an increased risk of post-traumatic stress disorder symptoms after discharge. Family involvement in patient care in ICU can improve safety and quality health care outcomes. Furthermore, family participation in clinician handovers may improve satisfaction with care, staff communication, and interpersonal relationships with families. However, health care professionals' attitudes toward family participation in multidisciplinary ward rounds are diverse, and little is known about their perspectives toward family participation in clinician handovers. Studies were included if they involved health care professionals and any type of family participation during handover, from bedside presence to participation in decision-making. Clinician handovers included multidisciplinary ward rounds or nursing handovers. Settings were adult, pediatric, or neonatal intensive care units in rural or metropolitan regions in any country. Studies in other clinical contexts were excluded. Qualitative studies were included, as well as mixed methods studies if qualitative data could be clearly extracted. Databases searched included CINAHL Plus (EBSCOhost), MEDLINE (Ovid), Scopus, Embase (Ovid), Emcare (Ovid), PsycINFO (Ovid), ProQuest Central (including ProQuest Dissertations and Theses), Web of Science, MedNar, and Google Scholar, with limiters being English and the year range 2000 to present. The last search was in October 2024. Two reviewers independently screened the titles and abstracts and assessed the full-text articles that met inclusion criteria for methodological quality. Findings were extracted using the JBI data extraction tool and assigned a level of credibility. Meta-aggregation was used to synthesize the findings. Two reviewers discussed any disagreements to reach consensus and consulted a third reviewer when necessary. Eleven studies published from 2003-2024 were included for data extraction. Five studies were qualitative and 6 were mixed methods. Six studies were conducted in the United States, 4 in Canada, and 1 in Australia. Three studies were in adult ICUs, 5 in pediatric, 1 in neonatal, and 2 did not specify the ICU type. All studies were on multidisciplinary bedside rounds, while none were conducted on nursing handovers. The findings revealed that health care professionals generally supported family participation in clinician handovers due to benefits such as improved communication between the health care team and families. However, they also identified barriers, including families' emotional responses to bad news and impact on workflow and teaching opportunities during handovers. Planning, leadership, and clear communication were highlighted as crucial for successfully facilitating family participation in rounds. While this review found that health care professionals value family participation in multidisciplinary bedside rounds, they experienced challenges. Future research is required to explore family participation in clinician handovers. Significant planning, investment and preparation is required to include families in ICU handovers. PROSPERO CRD42020223011.

BackgroundWith the rapid increase in demand for palliative care, patients’ families face serious psychological distress; however, there are fewer intervention studies on psychological distress in family members.ObjectiveThis study aimed to provide an overview of interventions and their effectiveness on psychological distress in family members of palliative care patients.MethodsThis study utilized a scoping review methodology, based on the framework proposed by Arksey and O’Malley, by searching six databases (including PubMed, Cochrane, Embase, Ovid medline, Scopus, and Web of Sciences) to screen the eligible research literature. Studies on psychological distress interventions for family members of palliative care patients were included, and data on study design, intervention type, and intervention effect were extracted, summarized, and analyzed.ResultsA search of six databases initially yielded 23,697 records. After deduplication and screening, 34 eligible studies were retained (n = 34). These reports originated from The USA (n = 13), Europe (n = 11), Asia (n = 6), and Australia (n = 4). Study designs comprised randomized controlled trials, pre- and post-test comparisons, and pilot studies. The interventions identified included psychological and psychosocial interventions; problem-solving and cognitive-behavioral interventions; web-based or mobile app interventions; relaxation, art, and music therapy interventions; communication, expression, and group interventions; dignity therapy; and structured family meetings. More than half of the studies demonstrated significant improvements in family caregivers’ psychological distress.ConclusionsAlthough psychological distress interventions for family members of palliative care patients have been effective, there are still limitations in the study and further research is needed to meet the needs of different groups of family members and to better support their mental health.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12904-025-01873-5.

BackgroundAdolescent substance use (alcohol, tobacco, e-cigarette, marijuana, and other illegal drug use) is a growing public health concern in Latin America. In Central America, Costa Rica consistently reports among the greatest rates of alcohol and marijuana use among secondary school students in the region. However, nationally representative, peer-reviewed studies examining prevalence and etiologic factors remain scarce. This study aimed to examine the prevalence, distribution and associated etiological factors of substance use among Costa Rican adolescents.MethodsWe analyzed data from the 2021 VI National Survey on Psychoactive Substance Use in the Secondary School Population, a cross-sectional, nationally representative survey of 3,524 students (weighted N ≈ 354,330) aged 11–20 years. We described the lifetime prevalence of alcohol, tobacco, e-cigarette, marijuana, and other illegal drug use and examined associations with sociodemographic, familial, and emotional distress variables using multivariate logistic regression.ResultsAlcohol was the most commonly used substance (55.9%), followed by e-cigarettes (13.3%), tobacco (9.8%), other illegal drugs (7.4%), and marijuana (7.2%). Substance use was associated with older age, higher weekly allowance, working while studying, and family substance use. Emotional distress indicators—loneliness, sadness, and suicidal thoughts—were significantly associated with alcohol, tobacco, and other illegal drug use. Parental school monitoring was protective against alcohol use. Notably, e-cigarette use was inversely associated with suicidal thoughts and family smoking.ConclusionThis is the first peer-reviewed study to report nationally representative estimates of adolescent substance use in Costa Rica. Findings underscore the multifactorial etiology of substance use and highlight the need for culturally tailored, evidence-based prevention interventions in Costa Rica and Central America.

Background/Objectives: Parent caregivers of children with medical complexity experience high levels of chronic stress and trauma symptoms. Despite ongoing and continuous involvement with the healthcare system, parents often do not seek support for their own mental health concerns. Parent mental wellness is a critical component of reducing family distress. This study aimed to explore how various factors such as resilience, coping, and support impacted well-being and trauma symptom severity. Methods: Parents/caregivers from a complex care clinic in a mid-Atlantic children’s hospital were recruited for this study. A total of 125 participants completed the study which included a battery of measures focused on trauma symptoms, well-being, coping, and resilience. Results: PTSD symptom severity was significantly negatively related to resilience and subjective well-being. Significant mediators included informational support, indicating that collaboration between healthcare providers and caregivers/parents is critical. Conclusions: This study highlights potential target intervention areas to promote well-being and reduce trauma symptom severity, such as resiliency promotion and enhancement and increasing informational support provided by healthcare professionals.

Family distress and associated factors in persons with dementia at risk of getting lost.

Communicating Bad News in Emergency Health Care: Challenges and Best Practices – A Literature Review

Research on youth Inpatient Psychiatric Units (IPUs) is increasing, yet much remains unknown about the treatment setting. Youth IPU research often treats all patients as part of observable groups (e.g., diagnosis), which may miss unobserved patterns in patient needs. To examine differences in patients in youth IPUs in a nuanced, person-centered way, this study uses Latent Profile Analysis (LPA) to examine profile patterns in Patient Reported Outcome Measures administered at admission to youth aged 12-17 on an IPU (n = 496). The LPA identified five profiles characterizing patients: High Internal Distress, Moderate Internal Distress, High Family and Environmental Distress, Moderate Family and Environmental Distress, and Mild Distress. We analyzed these profiles based on race/ethnicity, sex assigned at birth, insurance type, diagnoses, age, length of stay, and treatment satisfaction at discharge. Treatment implications of the LPA and significant findings are discussed and methods of advancing personalization of care are recommended.

Effective communication between nurses and family members in intensive care units (ICU) is fundamental for a suitable nurse-family relationship. Despite this, there are certain difficulties that affect communication, which cause negative emotions in family members. The aim of this study was to identify the main communication problems that intensive care nurses face with relatives of critically ill patients admitted to the ICU and to determine the role that the nurse plays in communication with family members. A scoping review was conducted following the Arksey and O'Malley framework and the Joanna Briggs Institute guidelines. The review process took place between 2023 and 2024. Studies were included if they involved relatives of adult patients (> 18 years) in adult ICU settings and addressed concepts related to nurse-family communication, communication difficulties or the nurse-family relationship. Studies published between 2006 and 2022 were identified, using the EMBASE, Medline, CINAHL complete, Scopus, SCI-Expanded and SSCI databases and recovering a total of 1020 studies. Twenty-seven scientific articles were included that identified communication difficulties between ICU nurses and family members. Care overload, language barrier, lack of specific training in interpersonal skills and communication, and the use of technical language are some of the most frequent difficulties. ICU nurses face multiple difficulties to effective family communication, yet they are essential facilitators in humanising care. Structured training and institutional protocols are crucial to improving communication quality, reducing family distress and optimising the outcomes of critical care with family members. Knowledge of the communication difficulties that exist in the nurse-family relationship in the ICU can help nurses improve communication and reduce the suffering of family members during the critical care patient's stay.

ObjectiveTo examine the relationship between family functioning and health-related quality of life (HRQOL) outcomes following traumatic brain injury (TBI) in service members and veterans (SMVs).ParticipantsParticipants were 359 United States SMVs classified into three groups: non-injured controls (NIC, n = 62); uncomplicated mild TBI (MTBI; n = 189); and complicated mild, moderate, severe, and penetrating TBI (STBI; n = 108). Participants completed 10 HRQOL measures from the TBI-QOL and Neuro-QOL, and the Family Assessment Device-General Functioning subscale (FAD-GF) 2-or-more years post-injury. Using the FAD-GF, the NIC, MTBI, and STBI participants were divided into six subgroups: Group 1 = NIC Healthy Family Functioning (HFF) (n = 34); Group 2 = NIC Unhealthy Family Functioning (UnHFF) (n = 28); Group 3 = MTBI HFF (n = 88); Group 4 = MTBI UnHFF (n = 101); Group 5 = STBI HFF (n = 58); and Group 6 = STBI UnHFF (n = 50).ResultsParticipants with UnHFF had a significant and meaningfully higher number of clinically elevated HRQOL scores compared to those with HFF in the MTBI (p < 0.001, =0.07) and STBI (p = 0.001, =0.10) groups, but not in the NIC group (p = 0.107, =0.04). There were no differences in the total number of clinically elevated HRQOL scores when comparing the MTBI and STBI HFF groups to controls (p = 0.074 to 0.841). The MTBI and STBI UnHFF groups had a significant and meaningfully higher number of clinically elevated HRQOL scores when compared to controls (p < 0.001 to p = 0.018; =0.07 to.14). The MTBI UnHFF group was 10 to 28 times more likely to have poor HRQOL outcome compared to controls. The STBI UnHFF group was 6 to 17 times more likely to have poor HRQOL outcome compared to controls.ConclusionUnHFF was strongly associated with poor long-term HRQOL. HFF was strongly associated with good long-term HRQOL outcome. Assessment and management of family distress may facilitate better TBI recovery and readiness in warfighters.

BackgroundSocial avoidance is a critical barrier to functional recovery among adolescents with depressive disorders. Although family environment is recognized as a key contextual factor, the psychological mechanisms linking family environment to social avoidance remain unclear. This study investigated the chain mediating roles of basic psychological needs and core self-evaluations in this relationship.MethodsA cross-sectional study included 369 adolescents (12–18 years, 68.8% female) diagnosed with depressive disorders. Data were collected using the Family Environment Scale, Social Avoidance and Distress Scale, Basic Psychological Needs Scale, and Core Self-Evaluations Scale. Mediation analysis was conducted using SPSS 27.0 with PROCESS Macro Model 6.ResultsFamily environment was significantly associated with social avoidance (β = –0.4682, p < 0.001). The chain mediation model entering basic psychological needs and core self-evaluations as chain mediators accounted for 66.36% of the total effect (indirect effect = –0.3107, 95% CI [–0.3834, –0.2429]). In terms of effect‐size breakdown, the simple mediation via basic psychological needs contributed 18.37% of the total effect (β = –0.0860, 95% CI [–0.1422, –0.0367]), the simple mediation via core self-evaluations accounted for 24.90% (β = –0.1166, 95% CI [–0.1714, –0.0673]), and the chain mediation path through both mediators explained 23.07% (β = –0.1080, 95% CI [–0.1529, –0.0710]). Specifically, a more supportive family environment was strongly linked to higher basic psychological needs satisfaction (β = 0.8936, p < 0.001); basic psychological needs were then associated with core self-evaluations (β = 0.2853, p < 0.001), which in turn were related to lower social avoidance (β = –0.4238, p < 0.001).ConclusionsThis study found a chain mediation model where family environment affects basic psychological needs, which affects core self-evaluations, which in turn affects social avoidance. Based on these findings, interventions may focus on improving family communication and enhancing psychological empowerment to strengthen adolescents’ core self-evaluations and satisfaction of basic psychological needs. Accordingly, integrated family support and mental health services may help alleviate social avoidance in adolescents with depressive disorders.

Background: Family functioning is related to the tolerance level of the individual and resilience from the growth of mental health and well-being. This research was carried out to explore the demographic difference between family functioning, distress tolerance, and resilience in adolescents. Method: Cross-Sectional research design was used. A sample of N=663 students from different educational backgrounds was selected using convenience sampling. A Family Assessment Device (FAD), Distress Tolerance Scale, and Resilience Scale were used and data was collected both online and manually. Results: The findings of the research indicated significant gender differences in family functioning, distress tolerance, and resilience of adolescents. A significant difference was found in the resilience of the firstborn and lastborn. Findings underscore differences across birth order, educational level, family income, and family relationships in family functioning distress tolerance, and resilience, moreover, a significant difference was found in the dimension of family functioning, distress tolerance, and resilience in adolescents. Conclusion: This Study concluded that family income or socioeconomic status also has a great impact on the family functioning in affective control, behavior response, problem-solving, family roles, and affective response. Distress tolerance with its dimensions that include tolerance, regulation, and absorption is also influenced by the socioeconomic status or family income background. Resilience in the form of emotional regulation was found to be different in adolescents based on the family income low to high.

Among families of patients treated in intensive care units (ICUs), insufficient communication and support may increase family distress that can lead to adverse health outcomes. Family-focused care is recommended, but high-quality experimental research is lacking. To determine whether a nurse-led, interprofessional, multicomponent family support intervention improves family satisfaction, communication quality, and support to families. This study was a multicenter, cluster-randomized clinical trial with 1:1 allocation of ICUs using minimization. Family members of critically ill patients who were treated for at least 48 hours at 16 adult ICUs in 12 hospitals in Switzerland were enrolled between May 2022 and January 2024. The first follow-up after patient ICU discharge was completed in February 2024. Data of all participants were analyzed using linear mixed-effects models, with the individual as the unit of inference. Intervention ICUs implemented a novel family nurse role that engaged and liaised with families, offered relationship-focused, psychoeducational support, and ensured interprofessional communication along the ICU trajectory. Control ICUs continued with usual care. The primary outcome was the family satisfaction with ICU care through the Family Satisfaction with ICU survey (range, 0-100), assessed after patient ICU discharge. Secondary outcomes included the quality of family-clinician communication, measured by the Questionnaire on Quality of Physician-Patient Interaction (range, 1-5), and cognitive and emotional support, assessed by the Family Perceived Support Questionnaire (range, 14-70). Of 2057 consecutively invited family members, 412 were enrolled in the intervention and 473 in the control arm (median age, 54 [IQR, 42-65] years; 429 partners [48%]; and 568 women [64%]). The intervention improved overall family satisfaction with ICU care by a mean difference (MD) between groups of 2.39 (95% CI, 0.31-4.47; P = .02). Sensitivity analyses adjusting for cluster- and individual-level characteristics in combination with multiple imputation confirmed this result. Satisfaction with involvement in decision-making was more strongly increased than satisfaction with care. Furthermore, the intervention improved communication (MD, 0.37; 95% CI; 0.16-0.58; P = .002), and cognitive and emotional support (MD, 8.71; 95% CI, 4.71-12.71, P < .001). This randomized clinical trial found that a nurse-led, interprofessional family support intervention in ICU had a small, statistically significant, but clinically uncertain benefit on family satisfaction, and relevantly improved quality of communication and cognitive/emotional support of family. ClinicalTrials.gov Identifier: NCT05280691.

Brain death as a presentation of fulminant Guillain Barré syndrome is rare with only twenty cases reported in the literature. This condition should be treated immediately despite high mortality as survivors recover with early treatment and supportive care. A 15-year-old boy with a history of recovery from Guillain Barré syndrome nine months ago, presented with coma, respiratory paralysis, fixed and dilated pupils. CT angiogram of the brain confirmed adequate cerebral perfusion, nerve conduction studies detected sensory motor axonal polyneuropathy and stool biofire was positive for Campylobacter jejuni. His prolonged hospital stay on life support systems was complicated with dysautonomia, shock, respiratory failure and ventilator associated pneumonia. Prompt treatment with endotracheal intubation, ventilation, intravenous immunoglobulins, supportive therapy and physiotherapy enabled the patient to recover and gradually regain motor power. At day 90, he was on tracheostomy and standing with support. Reviewing the literature, there are sporadic case reports of fulminant Guillain Barre syndrome recovering with rigorous and prolonged treatment. Clinicians should be vigilant about this variant as timely treatment could save lives and instill hope in distressed families. Dysautonomia, cranial nerve involvement, ventilator dependency and sepsis contribute to high mortality. This case report is unique as it highlights the trials and tribulations of management of this rare variant of Guillain Barre syndrome with emphasis on the necessity to maintain life sustaining measures and prolonged treatment in affected patients. The clinical course and treatment response was documented daily till the patient was on the road to recovery.

AimsThis study aimed to identify stress‐related factors associated with loneliness among Japanese university students and examine gender differences in these associations to apply gender‐specific mental health interventions.MethodsA total of 1642 university students (900 men, 742 women, mean age 20.0 ± 1.7 years) participated in an annual mental health survey conducted in 2024 for a university in Osaka Prefecture. Participants completed the Short‐Form UCLA Loneliness Scale, the Counseling Center Assessment of Psychological Symptoms, and the Perceived Stress Scale. Multiple linear regression analyses were performed separately for men and women, with loneliness as the dependent variable.ResultsDepression and social anxiety were significant predictors of loneliness in both genders. Higher levels of loneliness were associated with living with others, lower alcohol consumption, and higher perceived stress in men, whereas family stress was associated with loneliness in women. Living alone, alcohol use, and perceived stress did not significantly predict loneliness in women.ConclusionsDepression and social anxiety are key factors associated with loneliness among university students, irrespective of their gender. Living alone, alcohol use, perceived stress, and family distress were gender‐specific factors associated with loneliness. Mental health interventions should consider gender‐specific needs, particularly addressing family‐related stress in women and enhancing socialization in men, to effectively reduce loneliness and its associated negative outcomes.

BackgroundNurses in the neonatal intensive care units face continuous emotional demands as they care for critically ill infants and support distressed families. Repeated exposure to trauma and parental grief can lead to compassion fatigue – a state of emotional exhaustion that reduces the ability to empathize. The purpose of the study was to explore how nurses experience compassion fatigue while working in neonatal intensive care units.MethodsQualitative, exploratory design. Eleven individual interviews with nurses and nurse specialists were conducted in August and September in 2023, at three neonatal intensive care units in three different hospitals in Norway. The reflexive thematic analysis described by Braun and Clark was used to analyze the findings. COREQ guidelines were used to ensure the quality of the reported data.ResultsTwo main themes with sub-themes reflecting the nurses` experiences were revealed. Theme 1: “The Voice of Compassion fatigue”, with sub-themes: “A double burden of care” and “The Silent Stray of Responsibility”, and Theme 2: “Perceived Consequences of Compassion Fatigue”, with sub-theme: “Reaching the Bottom of the Container of Care”. Perceived consequences affect the nurses physically and mentally and jeopardize their patient and private relationships.ConclusionNeonatal Nurses experience compassion fatigue due to emotional strain and the hidden burden of caring for critically ill infants and their families. This may lead to physical and psychological exhaustion, affecting both patient care and personal life. These findings highlight the need for systematic support to safeguard nurses’ emotional well-being.Trial and protocol registrationNot applicable.