Postpartum AnxietyNARRCARENCT07272252
Narrative Nursing for Cesarean Mothers' Anxiety and Breastfeeding Confidence
A study testing 4-step narrative nursing program in people with Postpartum Anxiety and Postpartum Depression (PPD), run by Xi Huang at 1 site in China.
Trial 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. Read more about this study
- Who is it for?
- Ages 18 to 50 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Postpartum Anxiety, Postpartum Depression (PPD), Breastfeeding Self-Efficacy
- What is being tested?
- 4-step narrative nursing program
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 160 participants
- Where
- 1 siteChina
- Study dates
- 1 Oct 2025to 25 Sep 2026
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 50 years
- Women only
- Healthy volunteers accepted
- Adult
Who may be able to join
- 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
Who cannot join
- 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
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
China1 site, 1 recruiting
- Recruiting
Yilong County Maternal and Child Health Hospital
Nanchong, Sichuan, 637600
Yinchun Tan, +86-152-8329-4749, 2027687568@qq.com
Xi Huang, +86-156-8090-6987, 24520241154909@stu.xmu.edu.cn
About this study
Official title: Psychological Effects and Breastfeeding Self-Efficacy of a Structured Four-Step Narrative Nursing Intervention in Cesarean Mothers: A Randomized Controlled Mixed-Methods Study
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.
Read more
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.
- Conditions
- Postpartum Anxiety, Postpartum Depression (PPD), Breastfeeding Self-Efficacy, Cesarean Section Wound
- Being tested
- 4-step narrative nursing program
- Keywords
- narrative nursing, storytelling intervention, cesarean section, postpartum anxiety, breastfeeding confidence, mixed-methods, randomized controlled trial, China
- Medical subject headings
- Depression, Postpartum
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
4-step narrative nursing programBehavioural
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.
| Study group | Role | What they receive |
|---|---|---|
| Routine perinatal care | No intervention | Participants receive standard ward education, nursing care, discharge instructions, and routine telephone follow-up without any additional narrative sessions. |
| 4-step narrative nursing | Experimental | 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. Receives: Behavioral: 4-step narrative nursing program |
What is being measured
The primary outcome is the main question the study is designed to answer.
Postpartum anxiety at 48 hours
Mean score on the State-Trait Anxiety Inventory (STAI-State, 20 items) assessed 48 hours after cesarean delivery. Lower scores indicate less anxiety.
Measured: 48 hours post-surgery
Secondary outcomes (4)
Postpartum depression risk
Proportion of women with Edinburgh Postnatal Depression Scale (EPDS) ≥ 10 at 48 hours, 2 weeks and 3 months.
Measured: 48 hours, 2 weeks, 3 months postpartum
Breastfeeding self-efficacy
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.
Measured: 48 hours, 2 weeks, 3 months postpartum
Pain intensity
Mean Numerical Rating Scale (NRS, 0-10) for self-reported pain at 48 hours and 2 weeks.
Measured: 48 hours and 2 weeks postpartum
Breastfeeding continuation rate
Percentage of women who report any breastfeeding at 3 months.
Measured: 3 months postpartum
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Dec 2025
- Study start1 Oct 2025
- Primary completion25 Sep 2026 (estimated)
- Study completion25 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Postpartum AnxietyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 160 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Xi Huang
- Sponsor type
- University, hospital or other
- Collaborators
- Xiamen University, Yilong People's Hospital
- Responsible party
- Sponsor-investigator, Xi Huang, Xiamen University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07272252
- Sponsor's protocol ID
- XMUNARRCARE2025
- Other IDs
- FJ2022B061, XMSHLXH2320, Basic Nursing II
- Acronym
- NARRCARE
- Status last verified
- Sep 2026
- First submitted
- 26 Nov 2025
- Last updated
- 16 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Yes, we plan to share individual participant data (IPD). The de-identified IPD underlying published results will be made available to qualified researchers beginning 9 months after article publication and ending 36 months post-publication. Data access will be granted after approval of a methodologically sound proposal and execution of a data-sharing agreement. Interested parties should contact the corresponding author.