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.
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
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
Xi Huang
Lead sponsor
Xiamen University
Sponsor institution
Xiamen University
Collaborator
Yilong People's Hospital
Collaborator