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
- Are there results?
- Not yet: the study is under way
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.
Study at a glance
From the registry record, last updated by the sponsor on 16 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- 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
- ClinicalTrials.gov ID
- NCT07272252
- Acronym / sponsor ID
- NARRCARE / XMUNARRCARE2025
- Conditions
- Postpartum Anxiety, Postpartum Depression (PPD), Breastfeeding Self-Efficacy, Cesarean Section Wound
- Keywords
- narrative nursing, storytelling intervention, cesarean section, postpartum anxiety, breastfeeding confidence, mixed-methods, randomized controlled trial, China
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 160 participants (estimated)
- Lead sponsor
- Xi HuangUniversity, hospital or other
- Collaborators
- Xiamen University, Yilong People's Hospital
- Study start
- 1 Oct 2025 (actual)
- Primary completion
- 25 Sep 2026 (estimated)
- Study completion
- 25 Sep 2026 (estimated)
- First posted
- 9 Dec 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 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 | Behavioral: 4-step narrative nursing programParticipants 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. |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- 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
Key exclusion criteria (4 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| 4-step narrative nursing programFour 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. | Behavioural | 4-step narrative nursing |
Primary outcome
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.
4 secondary outcomes
Postpartum depression risk
Time frame: 48 hours, 2 weeks, 3 months postpartum
Breastfeeding self-efficacy
Time frame: 48 hours, 2 weeks, 3 months postpartum
Pain intensity
Time frame: 48 hours and 2 weeks postpartum
Breastfeeding continuation rate
Time frame: 3 months postpartum
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Sep 2026.
- Individual participant dataSharing planned: 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.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
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.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 16 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact X i Huang (+86-156-8090-6987, 24520241154909@stu.xmu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Postpartum anxiety at 48 hours (time frame: 48 hours post-surgery). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Sep 2026.