QR Code-Based Preoperative Education for Cesarean Birth: Anxiety, Pain, and Comfort

This study is designed as a randomized controlled trial to examine the effects of QR code-based preoperative education on anxiety, postpartum pain, and comfort among women undergoing elective cesarean birth. The study will be conducted in a hospital setting and will include pregnant women who meet the predefined inclusion criteria and provide informed consent.

Participants will be randomly allocated into two groups: an intervention group and a control group. Randomization will be performed using a predetermined allocation method to ensure comparability between groups. Women assigned to the intervention group will receive structured preoperative education delivered through QR code-based digital materials. These materials will include information on the cesarean birth process, perioperative expectations, postoperative pain management, and strategies to enhance physical and psychological comfort. Participants will be able to access the educational content using their personal mobile devices prior to surgery. The control group will receive routine preoperative care and standard information provided by the hospital.

Data collection will be carried out at multiple time points. Preoperative anxiety levels will be assessed prior to the cesarean procedure. Postpartum pain and comfort levels will be evaluated after delivery during the postoperative period. Validated measurement instruments will be used to collect outcome data. Sociodemographic and obstetric characteristics will also be recorded to describe the study population and to control for potential confounding variables.

The primary outcomes of the study are changes in preoperative anxiety and postoperative pain and comfort levels. The study does not involve the use of any pharmacological agents or medical devices and poses minimal risk to participants. The results are expected to provide evidence on the effectiveness of digital, easily accessible educational interventions in improving maternal outcomes in cesarean birth.

Inclusion criteria

• Pregnant women aged 18 years or older
• Scheduled for elective (planned) cesarean birth
• Able to read and understand Turkish and complete study questionnaires
• Able to provide written informed consent
• Has access to a smartphone and is able to use a QR code to view the educational materials (intervention arm)

Exclusion criteria

• Emergency cesarean birth or unplanned change to emergency surgery
• Presence of high-risk pregnancy or serious obstetric/medical complications requiring intensive management (e.g., severe preeclampsia/eclampsia, major hemorrhage risk, unstable systemic disease)
• Known psychiatric disorder or current use of medications that may substantially affect anxiety assessment (as judged by the clinical team)
• Communication barriers that prevent participation (e.g., severe visual/hearing impairment, cognitive impairment) or inability to complete questionnaires
• No smartphone access or inability/unwillingness to use QR code materials (for intervention delivery)
• Refusal to participate or withdrawal of consent at any time