Breastfeeding Self-Efficacy, Cesarean Section Wound, Postpartum Anxiety, Postpartum Depression (PPD)
Conditions
Keywords
narrative nursing, storytelling intervention, cesarean section, postpartum anxiety, breastfeeding confidence, mixed-methods, randomized controlled trial, China
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.
Interventions
BEHAVIORAL4-step narrative nursing program
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.
Sponsors
Xi Huang
Xiamen University
Yilong People's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
Single-center, two-arm, randomized, parallel-group, superiority trial with blinded outcome assessment.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
1. Women aged 18-50 years 2. Scheduled for elective or non-emergency cesarean section at ≥37 weeks 3. Able to communicate in Mandarin and provide written informed consent 4. Expected hospital stay ≥24 h 5. Singleton pregnancy with stable maternal and neonatal condition allowing routine mother-baby contact
Exclusion criteria
1. Severe psychiatric disorders (schizophrenia, bipolar disorder, active suicidal ideation) 2. Maternal or neonatal need for ICU/NICU admission 3. Emergency cesarean section preventing baseline assessment 4. Communication or cognitive impairment precluding interview
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postpartum anxiety at 48 hours | 48 hours post-surgery | Mean score on the State-Trait Anxiety Inventory (STAI-State, 20 items) assessed 48 hours after cesarean delivery. Lower scores indicate less anxiety. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postpartum depression risk | 48 hours, 2 weeks, 3 months postpartum | Proportion of women with Edinburgh Postnatal Depression Scale (EPDS) ≥ 10 at 48 hours, 2 weeks and 3 months. |
| Breastfeeding self-efficacy | 48 hours, 2 weeks, 3 months postpartum | Mean score on the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF, 14 items) at 48 hours, 2 weeks and 3 months. Higher scores indicate greater confidence. |
| Pain intensity | 48 hours and 2 weeks postpartum | Mean Numerical Rating Scale (NRS, 0-10) for self-reported pain at 48 hours and 2 weeks. |
| Breastfeeding continuation rate | 3 months postpartum | Percentage of women who report any breastfeeding at 3 months. |
Countries
China
Contacts
CONTACTX i Huang
CONTACTYinchun Tan
Outcome results
None listed