Psychological Effects and Breastfeeding Self-Efficacy of a Structured Four-Step Narrative Nursing Intervention in Cesarean Mothers: A Randomized Controlled Mixed-Methods Study
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 160
- 试验地点
- 1
- 主要终点
- Postpartum anxiety at 48 hours
研究概览
简要总结
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Outcomes Assessor)
盲法说明
Single-center, two-arm, randomized, parallel-group, superiority trial with blinded outcome assessment.
入排标准
- 年龄范围
- 18 Years 至 50 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •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
排除标准
- •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
研究组 & 干预措施
Routine perinatal care
Participants receive standard ward education, nursing care, discharge instructions, and routine telephone follow-up without any additional narrative sessions.
4-step narrative nursing
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.
干预措施: 4-step narrative nursing program (Behavioral)
结局指标
主要结局
Postpartum anxiety at 48 hours
时间窗: 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.
次要结局
- 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)
研究者
Xi Huang
Master's student
Xiamen University