Narrative Nursing and Perioperative Psychological Outcomes in Women Undergoing Cervical Cerclage: The Potential Indirect Role of Fear of Childbirth

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research Pub Date : 2026-08-23 DOI:10.1111/jog.70431

Zeyang Zhang, Sudan Liu, Yufan Yuan, Lanlan He, Lian Zhao, Wenjie Ning

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引用次数: 0

Abstract

Background

Women undergoing cervical cerclage commonly experience fear of childbirth, anxiety, and depressive symptoms, while evidence on the psychological effects of narrative nursing in this population remains limited. This study evaluated the association of narrative nursing with perioperative psychological changes and explored the potential indirect role of fear of childbirth in these associations.

Methods

This quasi-experimental study included 230 women undergoing cervical cerclage between January 2023 and December 2024. Participants were nonrandomly allocated to either a narrative nursing group (n = 115) or a routine nursing group (n = 115) according to the nursing model implemented at the hospital campus where they received care. Fear of childbirth, anxiety, and depression were assessed using the Mandarin Chinese versions of the W-DEQ-A, SAS, and SDS at baseline before surgery (T0), on postoperative day 3 (T1), and before discharge (T2). Longitudinal changes were analyzed using linear mixed-effects models incorporating group, time, and group × time interaction terms. Exploratory single-mediator analyses with 5000 bootstrap resamples were conducted using the T1 W-DEQ-A score as the potential mediator and the T2 SAS or SDS score as the outcome.

Results

Significant group × time interactions were observed for W-DEQ-A, SAS, and SDS scores (all p ≤ 0.005). Compared with routine nursing, narrative nursing was associated with lower adjusted W-DEQ-A scores at T1 and T2, lower SAS scores at T1 and T2, and a lower SDS score at T2. At T2, the adjusted between-group differences were −5.7 points for the W-DEQ-A, −3.3 points for the SAS, and −2.6 points for the SDS. Exploratory mediation analyses identified significant indirect associations through T1 fear of childbirth for both T2 anxiety (estimated indirect association, −0.54; 95% bootstrap CI, −0.93 to −0.23) and T2 depression (estimated indirect association, −0.45; 95% bootstrap CI, −0.81 to −0.18). The direct associations remained statistically significant in both models.

Conclusion

Narrative nursing was associated with greater short-term reductions in fear of childbirth, anxiety, and depression among women undergoing cervical cerclage. Exploratory findings were consistent with a potential partial indirect role of fear of childbirth.

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宫颈环切术妇女的叙事护理和围手术期心理结果：分娩恐惧的潜在间接作用。

背景：接受宫颈环切术的妇女通常会经历分娩恐惧、焦虑和抑郁症状，而关于叙事护理在这一人群中的心理影响的证据仍然有限。本研究评估了叙事护理与围手术期心理变化的关系，并探讨了分娩恐惧在这些关系中的潜在间接作用。方法：这项准实验研究包括230名在2023年1月至2024年12月间接受宫颈环切术的妇女。根据在医院校园实施的护理模式，参与者被非随机分配到叙述护理组（n = 115）或常规护理组（n = 115）。在术前（T0）、术后第3天（T1）和出院前（T2）使用普通话版本的W-DEQ-A、SAS和SDS评估分娩恐惧、焦虑和抑郁。纵向变化分析采用线性混合效应模型，包括组、时间和组×时间相互作用项。采用T1 W-DEQ-A评分作为潜在中介，T2 SAS或SDS评分作为结果，对5000个bootstrap样本进行探索性单中介分析。结果：W-DEQ-A、SAS和SDS评分存在显著的组×时间交互作用（p≤0.005）。与常规护理相比，叙事性护理在T1和T2时调整后的W-DEQ-A评分较低，在T1和T2时SAS评分较低，在T2时SDS评分较低。T2时，调整后的组间差异为W-DEQ-A为-5.7分，SAS为-3.3分，SDS为-2.6分。探索性中介分析发现，T1对分娩的恐惧与T2焦虑（估计间接关联，-0.54；95%自举CI， -0.93至-0.23）和T2抑郁（估计间接关联，-0.45；95%自举CI， -0.81至-0.18）存在显著的间接关联。在两个模型中，直接关联仍然具有统计学意义。结论：记叙式护理与宫颈环切术妇女对分娩的恐惧、焦虑和抑郁的短期减少有关。探索性发现与分娩恐惧的潜在部分间接作用一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.