Objectives Caregivers are at risk of poor sleep and elevated distress during their child's cancer treatment. Russia is currently underrepresented in the international psycho‐oncology field, with no identified psychosocial standards of care, and limited or inconsistent psychological service provision, particularly for caregivers. This study aimed to determine the prevalence of Russian caregivers' psychological distress and identify factors associated with caregiver sleep duration when staying on the pediatric oncology ward. Methods We recruited 74 caregivers of children with cancer and 74 comparison caregivers in Rostov‐on‐Don, Russia. Participants completed a survey assessing clinical outcomes, sleep (St Mary's Hospital Sleep Questionnaire), and psychological distress (Depression Anxiety Stress Scales‐21 [DASS‐21]). Results Caregivers of children with cancer reported significantly higher scores for all DASS‐21 subscales and higher depression (48.6% vs. 24.6%), anxiety (47.3% vs. 12.3%), and stress (45.9% vs. 0%) scores from “moderate” to “extremely severe.” Caregivers of children with cancer reported significantly shorter sleep duration (5.82 vs. 7.49 h, t[143] = −6.22, p = 0.002), more night‐time awakenings (3.20 vs. 1.25, t[135] = 6.94, p < 0.001) and worse sleep quality (46.5% vs. 9.6%; x2[1] = 24.4, p < 0.001) than comparison caregivers. Caregivers with a higher total DASS‐21 score (B = −1.32, p = 0.032) and those who were closer to diagnosis (B = −1.53, p = 0.012) reported shorter sleep duration. Conclusions Russian caregivers of children with cancer experience high rates of psychological distress and poor sleep on the oncology ward. These findings provide an important target for future research and culturally relevant clinical interventions to improve caregivers' mental health and capacity for care.

Using a traditional Russian framework to understand parent-child relationships, we investigated the development of the motherchild relationship in consideration of mothers' distress and their children with cancer. Mothers of children with (n = 26) and without cancer (n = 26) completed the "Family Relationship Analysis" (FRA) and "Distress Thermometer" questionnaires. Children of participating parents (ages 6-12) (26 with cancer, 26 without cancer) completed the graphic discussion "My Social Circle" to determine the child's close relationships. All mothers and children participated in the "The Cooperation Test (CT)" to assess parent-child interactions.Distress was higher in mothers of children with cancer, with groups of mothers differing in methods for reducing distress. High distress was associated with ignoring their child's needs and excessiveness of demands/duties. Mothers of children with cancer indulged their children's demands and were more overprotective than mothers of healthy children. Children with cancer also placed their mothers further away in their social circle than children without. Overall, a clear interconnection between mother's distress and the characteristics of the mother-child relationship were found. These findings will contribute to interventions aimed at decreasing maternal distress and improving mother-child relationships in pediatric oncology.

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