Psychological Assessment of Parenting Stress and Emotional Support: A Moderated Mediation Model of Psychological Distress and Well-Being Among Childbearing-Age Women with Thyroid Cancer

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Abstract
Women of reproductive age diagnosed with thyroid cancer face a distinctive psychological burden arising from the concurrent demands of disease management and primary caregiving, yet the mechanisms linking parenting stress to diminished well-being in this group remain poorly characterized. The present study applied a stress-buffering framework to examine whether psychological distress (anxiety and depressive symptoms) statistically mediated the association between parenting stress and well-being, and whether social support attenuates these pathways. We recruited a convenience sample of 400 consecutive eligible mothers between July and December 2025 at a tertiary cancer center in China. All were of reproductive age (18–49 years), had cytologically confirmed papillary thyroid carcinoma and at least one child aged ≤12 years, and completed the survey during their initial hospitalization, before surgery. Validated instruments assessed parenting stress, anxiety and depression, social support, and well-being; analyses included bivariate correlations, mediation, and moderated mediation models. Well-being correlated inversely with parenting stress (r = −0.447, p < 0.01) and anxiety and depression (r = −0.573, p < 0.01), and positively with social support (r = 0.515, p < 0.01). Psychological distress partially mediated the parenting stress–well-being association, with the indirect effect constituting 44.32% of the total effect (−0.210, 95% CI: −0.321 to −0.125). Parenting stress was positively associated with HADS scores (β = 0.322, p < 0.001), though this association was weaker at higher levels of social support (interaction β = −0.106, p = 0.006). Both parenting stress (β = −0.148, p = 0.001) and HADS scores (β = −0.367, p < 0.001) were independently associated with lower well-being, while social support moderated the parenting stress–well-being association (interaction β = 0.098, p = 0.003). In conclusion, parenting stress and psychological distress were jointly associated with diminished well-being in this population, but social support emerged as a modifiable protective correlate. Psychosocial interventions targeting stress reduction, emotional regulation, and support mobilization may thus hold particular promise for improving outcomes among young women with thyroid cancer.

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