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NCT Number: NCT07272252

Narrative Nursing for Cesarean Mothers' Anxiety and Breastfeeding Confidence

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.

Recruiting

Interested in participating?

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Key information

Conditions

Postpartum Anxiety Breastfeeding Self-Efficacy Cesarean Section Wound Depression, Postpartum Depressive Disorder Female Urogenital Diseases and Pregnancy Complications Mental Disorders Mood Disorders Postpartum Depression (PPD) Pregnancy Complications Puerperal Disorders Urogenital Diseases

Age range

18 year–50 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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

Exclusion criteria

  • 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

Treatment and study plan

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.

Primary outcomes

  1. Postpartum anxiety at 48 hours

    Time frame: 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 outcomes

  1. Postpartum depression risk

    Time frame: 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.

  2. Breastfeeding self-efficacy

    Time frame: 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.

  3. Pain intensity

    Time frame: 48 hours and 2 weeks postpartum

    Mean Numerical Rating Scale (NRS, 0-10) for self-reported pain at 48 hours and 2 weeks.

  4. Breastfeeding continuation rate

    Time frame: 3 months postpartum

    Percentage of women who report any breastfeeding at 3 months.

Study contacts

Contact information is provided by the study sponsor or research team.

X i Huang

CONTACT

[email protected]

+86-156-8090-6987

Yinchun Tan

CONTACT

[email protected]

+86-152-8329-4749

Sponsors and collaborators

Lead sponsor

Xi Huang

Other

Collaborators

  • Xiamen University
  • Yilong People's Hospital

Registry information

Official study title

Psychological Effects and Breastfeeding Self-Efficacy of a Structured Four-Step Narrative Nursing Intervention in Cesarean Mothers: A Randomized Controlled Mixed-Methods Study

Acronym: NARRCARE

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Dec 9, 2025
Registry last updated
Dec 18, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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