Abstract: Objective: To explore the psychological experience process of family caregivers of children with cancer in the Pediatric Intensive Care Unit (PICU), with the aim of guiding clinical psychological nursing practice. Methods: A descriptive qualitative study was conducted from April to October 2025. Primary family caregivers of pediatric oncology patients in the PICU of a tertiary children's hospital in Beijing were recruited by purposive sampling. One-on-one semi-structured interviews were performed, and the data were analyzed using thematic analysis. Results: A total of 16 caregivers were enrolled, and 4 themes with 18 subthemes were identified: initial emotional shock (emotional breakdown, empathetic distress, fear of losing control, and despair); persistent anxiety (hypervigilance, decisional conflict, self-blame, and loss of control over the future); caregiving role dilemma (energy exhaustion, sense of caregiving deprivation, concern about being misunderstood by the child, family role conflict, and social withdrawal); and psychological resilience adaptation (emotional venting, self-comfort, resilience driven by responsibility, positive self-suggestion, and peaceful acceptance of reality). Conclusion: The psychological experience of family caregivers of children with cancer in the PICU is complex and multifaceted. Their multiple psychological distresses should be addressed to reduce the risk of traumatic stress, alleviate stage-specific pressures and dilemmas, and tap into their growth potential within adversity, so as to promote positive psychological growth.

Key words: critical illness; cancer; caregivers; psychological experience; Pediatric Intensive Care Unit; qualitative research