Abstract
BACKGROUND: Primigravidas of advanced maternal age (AMA) encounter distinct challenges throughout pregnancy and are particularly susceptible to heightened levels of anxiety. OBJECTIVE: To identify the influencing factors of pregnancy-related anxiety in AMA primigravidas and to develop, implement, and evaluate a personalized psychological nursing intervention. METHODS: Phase I involved a cross-sectional survey of 300 AMA primigravidas to identify anxiety-influencing factors. Phase II was a randomized controlled trial (RCT) with 160 AMA primigravidas assigned to either a personalized psychological nursing intervention group or a standard care control group. RESULTS: Phase I identified key factors influencing anxiety, including perceived pregnancy risks, social support, and self-efficacy. In Phase II, the intervention group showed significantly lower anxiety levels (p < 0.001), improved self-efficacy (p < 0.001), and higher satisfaction with prenatal care (p < 0.01) compared to the control group. CONCLUSION: Personalized psychological nursing interventions based on identified influencing factors effectively reduce anxiety and improve psychological well-being in AMA primigravidas. Implementation of such interventions in prenatal care could significantly enhance outcomes for this vulnerable population.