Caesarean section is one of the most common surgical procedures in obstetric care worldwide. While medically necessary in many cases, the procedure is frequently perceived by mothers as frightening. Concerns about pain, anesthesia, surgical outcomes, and the safety of the baby often trigger intense worry. If not properly managed, this psychological burden can interfere with preoperative preparation, increase blood pressure and heart rate, and negatively affect healing.
The research from STIKes Maluku Husada adds strong evidence that SEFT, a short and non-pharmacological intervention, can serve as an effective complementary nursing strategy to address this widespread problem.
Anxiety Before Caesarean Surgery Remains a Persistent Challenge
Preoperative anxiety is a well-documented issue in maternal health. Many mothers experience fear, tension, and uncertainty when facing surgery, especially if it is their first caesarean section or if they have had previous negative birth experiences.
Pharmacological approaches, such as sedatives, are sometimes used to control anxiety. However, medication use in pregnant women must be approached cautiously due to potential side effects and interactions with anesthesia. As a result, healthcare professionals are increasingly seeking non-drug interventions that are safe, simple, and compatible with holistic nursing care.
SEFT fits this need. The technique combines spiritual affirmation, emotional awareness, and gentle tapping on specific points of the body. It is designed to release negative emotions and promote relaxation by balancing psychological and energetic responses.
How the Study Was Conducted
The study was carried out in 2025 in the obstetric ward of Bhayangkara Hospital Level III Ambon, Indonesia. The researchers used a one-group pretest–posttest design, meaning anxiety levels were measured before and after the SEFT intervention in the same group of participants.
Key features of the methodology included:
- Participants: 15 mothers scheduled for caesarean section
- Sampling method: Accidental sampling
- Measurement tool: Hamilton Anxiety Rating Scale (HARS)
- Intervention: SEFT administered for approximately 10 minutes
- Analysis: Wilcoxon signed-rank test
This straightforward design allowed the researchers to directly observe changes in anxiety levels following the intervention.
Who Participated in the Study
Most participants were within the healthy reproductive age range of 20–35 years (93.3%). More than half had completed senior high school education (53.3%), and the majority were housewives (93.3%). In terms of childbirth history:
- 33.3% were nulliparous (no previous births)
- 26.7% were primiparous (one previous birth)
- 40.0% were multiparous (more than one previous birth)
These characteristics suggest that preoperative anxiety affects mothers across different educational backgrounds and reproductive experiences.
Anxiety Levels Before and After SEFT
Before receiving SEFT:
- 60.0% of mothers had moderate anxiety
- 40.0% had severe anxiety
- No participant reported mild or no anxiety
After SEFT was administered:
- 86.7% of mothers reported mild anxiety
- 13.3% reported no anxiety
- No participants remained in the moderate or severe anxiety categories
Statistical analysis showed a significant difference (p = 0.001) between pre- and post-intervention anxiety levels. All participants experienced a reduction in anxiety.
These results clearly indicate that SEFT produced a meaningful calming effect in a very short time.
Why SEFT Works
SEFT operates through three integrated components:
- Set-up: acknowledging the emotional problem and expressing acceptance
- Tune-in: focusing attention on the uncomfortable feeling
- Tapping: stimulating specific points on the body
Together, these steps encourage emotional release and activate the body’s relaxation response.
Ethically paraphrasing the authors’ interpretation, Fany Sabban from STIKes Maluku Husada explains that SEFT helps individuals achieve emotional balance by combining spiritual surrender with psychological focus, which leads to reduced fear and increased inner calm.
This combination may be particularly effective in culturally and spiritually oriented communities, where spiritual coping strategies play an important role in dealing with stress.
Implications for Nursing Practice
The findings position SEFT as a practical tool that nurses can incorporate into routine preoperative care.
Potential benefits include:
- For nurses: an easy-to-learn intervention requiring no special equipment
- For hospitals: a low-cost method to improve patient comfort
- For mothers: a safe alternative to medication for anxiety relief
- For healthcare systems: stronger integration of holistic and patient-centered care
SEFT can be performed at the bedside, takes only a few minutes, and does not interfere with medical procedures.
Broader Impact on Maternal Health
Reducing anxiety before caesarean section is not only about emotional comfort. Lower anxiety levels are associated with:
- More stable vital signs
- Better cooperation during surgical preparation
- Potentially faster postoperative recovery
- More positive birth experiences
By addressing psychological needs alongside physical care, hospitals can improve overall quality of maternal services.
Study Limitations and Future Directions
The authors acknowledge that the study involved a small sample size and did not include a control group. Anxiety was also measured only shortly after the intervention, so long-term effects remain unknown.
Future research with larger samples, randomized controlled designs, and follow-up measurements would strengthen the evidence base. Comparing SEFT with other non-pharmacological interventions, such as music therapy or guided imagery, could also provide valuable insights.
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