Narrative Nursing for Cesarean Mothers' Anxiety and Breastfeeding Confidence

NCT07272252 | Recruiting

• 4 other identifiers: XMUNARRCARE2025FJ2022B061XMSHLXH2320Basic Nursing II
• Study Type: interventional
• Target: 160
• Locations: 1 country
• Sites: 1

Brief Summary

This study tests whether a nurse-led "4-step narrative nursing" program can reduce anxiety and improve breastfeeding confidence in mothers who are having a planned or non-emergency cesarean section. What is the problem? About 30-40% of Chinese cesarean mothers feel high anxiety after surgery, and 1 in 5 is at risk for postpartum depression. Low confidence in breastfeeding is also common. What will we do? We will randomly assign 160 mothers (1:1) to either: Usual care - standard education and ward care, or Usual care plus narrative nursing - four short (10-20 min) conversations with a trained nurse: Before surgery - help the mother talk about her fears. 24-48 h after surgery - encourage her to "name" pain or worries and separate them from herself. Before discharge - guide her to find positive moments and build a "strong-mom" story. Two weeks later by phone - strengthen the new story and review feeding success. What will we measure? Main result: anxiety score at 48 h (STAI scale). Other results: depression risk, breastfeeding confidence, pain, and feeding rates up to 3 months. Possible benefits: Lower anxiety, better mood, higher breastfeeding rates. No drugs or extra procedures are involved, only talking. Risks: Minimal; some mothers may feel emotional during conversations, but nurses can pause or refer to counselling if needed.

Conditions

Postpartum Anxiety; Postpartum Depression (PPD); Breastfeeding Self-Efficacy; Cesarean Section Wound

Keywords

narrative nursing; storytelling intervention; cesarean section; postpartum anxiety; breastfeeding confidence; mixed-methods; randomized controlled trial; China

Outcome Measures

Primary Outcomes (1)

• Postpartum anxiety at 48 hours

  Mean score on the State-Trait Anxiety Inventory (STAI-State, 20 items) assessed 48 hours after cesarean delivery. Lower scores indicate less anxiety.

  48 hours post-surgery

Secondary Outcomes (4)

• Postpartum depression risk

  48 hours, 2 weeks, 3 months postpartum

• Breastfeeding self-efficacy

  48 hours, 2 weeks, 3 months postpartum

• Pain intensity

  48 hours and 2 weeks postpartum

• Breastfeeding continuation rate

  3 months postpartum

Study Arms (2)

Routine perinatal care

NO INTERVENTION

Participants receive standard ward education, nursing care, discharge instructions, and routine telephone follow-up without any additional narrative sessions.

4-step narrative nursing

EXPERIMENTAL

Participants receive usual care plus four nurse-led narrative sessions (pre-op externalization, post-op deconstruction, pre-discharge reconstruction, and 2-week meaning-reconstruction phone call) aimed at reducing anxiety and enhancing breastfeeding confidence.

Behavioral: 4-step narrative nursing program

Interventions

4-step narrative nursing program BEHAVIORAL

Four nurse-led storytelling sessions (pre-operative externalization, post-operative deconstruction, pre-discharge reconstruction, and 2-week meaning-reconstruction phone call) aimed at reducing anxiety and increasing breastfeeding self-efficacy.

4-step narrative nursing

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Women aged 18-50 years
• Scheduled for elective or non-emergency cesarean section at ≥37 weeks
• Able to communicate in Mandarin and provide written informed consent
• Expected hospital stay ≥24 h
• Singleton pregnancy with stable maternal and neonatal condition allowing routine mother-baby contact

You may not qualify if:

• Severe psychiatric disorders (schizophrenia, bipolar disorder, active suicidal ideation)
• Maternal or neonatal need for ICU/NICU admission
• Emergency cesarean section preventing baseline assessment
• Communication or cognitive impairment precluding interview

Sponsors & Collaborators

• Xi Huang: lead
• Xiamen University: collaborator
• Yilong People's Hospital: collaborator

Study Sites (1)

Yilong County Maternal and Child Health Hospital

Nanchong, Sichuan, 637600, China

RECRUITING

MeSH Terms

Conditions

Depression, Postpartum

Condition Hierarchy (Ancestors)

Puerperal Disorders; Pregnancy Complications; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Depressive Disorder; Mood Disorders; Mental Disorders

Central Study Contacts

X i Huang

CONTACT

+86-156-8090-6987; 24520241154909@stu.xmu.edu.cn

Yinchun Tan

CONTACT

+86-152-8329-4749; 2027687568@qq.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Single-center, two-arm, randomized, parallel-group, superiority trial with blinded outcome assessment.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Master's student

Study Record Dates

• First Submitted: November 26, 2025
• First Posted: December 9, 2025
• Study Start: October 1, 2025
• Primary Completion: January 1, 2026
• Study Completion: March 1, 2026
• Last Updated: December 18, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF
• Time Frame: IPD and supporting information will be made available beginning 9 months after the primary results paper has been accepted for publication and ending 36 months after that date. An extension may be granted if a justifiable request is received before the closing date.
• Access Criteria: Access is limited to qualified researchers with IRB/REC-approved, methodologically sound proposals relevant to the approved indication. Only de-identified participant data and the data dictionary will be provided. Requests should be e-mailed to 【corresponding-author@univ.edu】 with a 1-page protocol and statistical analysis plan. A data-sharing agreement outlining terms of use, confidentiality, and no attempt to re-identify participants must be signed before access is granted. Data will be shared through a password-protected secure cloud link; download is logged and audited.

Locations

CN (1)