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Authors
Tian, Di
Xia, Rui
Li, Hui
Yang, Yao
Lin, Yuxia
He, Jinqiong
Lin, Weilin
Li, Jin
Yang, Yuan
Zhou, Ying
Ren, Yulan
Su, Xi
Li, Jiamei
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Funding
Funding for this research was provided by:
the 2024 Guangdong Province Undergraduate Universities Teaching Quality and Teaching Reform Project (2024-282)
the 2023 Guangdong Province Undergraduate Universities Teaching Quality and Teaching Reform Project (2023-919)
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Article History
Received: 14 October 2025
Accepted: 22 July 2026
First Online: 27 July 2026
Declarations
Ethics approval and consent to participate: This study was performed in accordance with the relevant guidelines and regulations (Declaration of Helsinki). The study was approved by the Ethics Committee of Guangzhou Medical University in January 2022 (Approval No. 202201005). Participants in both the quantitative and qualitative phases provided written informed consent before participation, and their responses were analyzed and reported anonymously. Participants were informed that they were free to decline to answer any question or withdraw from the study at any time without any negative consequences. Because the qualitative phase involved discussion of traumatic birth experiences, additional procedures were implemented to protect participants’ psychological safety and minimize the risk of re-traumatization. Before each interview, participants were reminded again of their right to decline any question, pause the interview, or withdraw at any time. Interviews were conducted in a private and quiet setting, and the interviewer monitored participants’ verbal and nonverbal signs of distress throughout the interview. If a participant showed strong emotional reactions, the interview could be temporarily suspended or terminated according to the participant’s preference. After each interview, a brief debriefing was conducted, during which participants were given the opportunity to discuss any discomfort caused by the interview and were reminded that they could seek support from available hospital-based psychological or occupational health resources if needed. The interviewers had received training in qualitative interviewing and were briefed on trauma-informed communication, including empathetic listening, nonjudgmental responses, avoidance of unnecessary probing into distressing details, and appropriate management of emotional responses during interviews.
Consent for publication: Not applicable.
Competing interests: The authors declare no competing interests.
