The effect of nursing care during pregnancy termination on women's prenatal grief, depression, anxiety, stress and coping levels: A randomized controlled study

Abstract

The termination of pregnancy is considered an emotionally devastating experience. Early intervention and counseling are essential to prevent adverse complications following pregnancy loss. This study aimed to determine the effect of nursing care based on Swanson's Theory of Caring on women's prenatal grief, depression, anxiety, stress, and coping levels during pregnancy termination. The training and counseling program, based on Swanson's Theory of Caring, included hospital care, a mobile application, and telephone follow-ups. We conducted this prospective randomized controlled experimental study in the gynecology and obstetrics clinic of a tertiary university hospital in Türkiye between September 2021 and May 2022. The study sample consisted of 50 women (intervention group: 25, control group: 25) whose pregnancy was terminated in the second trimester. The women were assigned to groups according to a randomization list created by a statistician. Data collection tools included a Personal Information Form, the Perinatal Grief Scale, the Depression, Anxiety, and Stress Scale, the Coping and Adaptation Process Scale, and the Numerical Rating Scale. We collected the data during hospitalization, between the 6^th and 8^thweeks after discharge, and at the 12^thweek. We performed a chi-square test, a paired samples t-test, and an independent samples t-test on the IBM Statistical Package for the Social Sciences Statistics 26. The intervention group had lower mean perinatal grief (54.76 ± 19.49), depression (2.56 ± 2.39), anxiety (2.08 ± 2.10), and stress (3.52 ± 1.78) scores and higher mean coping and adjustment scores (140.48 ± 11.47) than the control group(p < .05). The intervention group also had a lower perception of labor pain, shorter discharge time, and a higher level of readiness for a new pregnancy (p < .05). The program that we applied in the study was effective in managing the pregnancy termination and post-discharge period in the population we studied.

Trial registration: ClinicalTrials.gov NCT05326854.

Keywords: Coping; Swanson’s Theory of Caring; grief; nursing care; psychological changes; termination of pregnancy.