Cancer patients experiencing acute complications frequently present to emergency departments, where traditional care often overlooks the psychological distress and self-care challenges accompanying tumor progression and treatment-related crises. This study investigates the effect of problem-oriented nursing intervention on psychological stress and self-care ability in tumor patients requiring emergency care. A total of 160 patients admitted to the emergency department of Tongji Shanxi Hospital from June 2021 to December 2023 for cancer- or treatment-related complications were enrolled. Based on the nursing plan, participants were assigned to a control group receiving routine care (n = 80) or an observation group receiving problem-oriented nursing intervention (n = 80). All participants provided informed consent before enrollment. Anxiety and depression were measured using the Hamilton Anxiety Scale and Hamilton Depression Rating Scale, while social phobia was evaluated using the Social Phobia Inventory. Quality of life was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey, and self-management behavior and confidence were assessed using the Chronic Disease Self-Management Scale and Self-Efficacy Scale for Chronic Disease, respectively. The results showed no significant differences in baseline characteristics between the two groups (p>0.05). After intervention, the observation group demonstrated significantly lower anxiety and depression scores, along with reduced fear, avoidance, and physical discomfort, compared with the control group (p<0.05). Furthermore, physical functioning, pain perception, general health, and mental health scores, as well as self-management and self-efficacy, were significantly higher in the observation group (p<0.05) compared to the control group. Problem-oriented nursing intervention significantly reduces psychological stress and enhances self-care ability and quality of life in tumor patients requiring emergency care.