Virtual Reality-Based and Face-to-Face Relaxation Programs in Pregnant Women With Preeclampsia

Primary outcomes

1. Descriptive Information Form

   Time frame: Day 1 (Baseline, Pre-Intervention)

   A researcher-developed questionnaire designed to collect sociodemographic and obstetric data based on the literature.

2. Maternal-Fetal Outcomes Follow-up Form

   Time frame: Day 1 (Baseline, Pre-Intervention), Day 2 and 3 (Post-Intervention for intervention groups, routine monitoring for the control group)

   Tracked using a researcher-developed follow-up form, including maternal vital signs and Non-Stress Test (NST) parameters.

3. Beck Anxiety Inventory (BAI)

   Time frame: Day 1 (Baseline, before intervention for intervention groups, before routine assessment for control group) and Day 3 (Post-intervention for intervention groups, after routine assessment for control group).

   Developed by Beck, Steer, Epstein, and Brown in 1988 and adapted into Turkish by Ulusoy et al. in 1998, this 21-item Likert-type scale measures anxiety levels. Each item is scored between 0 and 3, with total scores ranging from 0 to 63. Higher scores indicate higher levels of anxiety. The Turkish version has a Cronbach's alpha of 0.93, indicating high internal consistency. Factor analysis suggests two subscales: Subjective Symptoms and Somatic Symptoms.

4. Prenatal Comfort Scale (PCS)

   Time frame: Day 1 (Baseline, before intervention for intervention groups, before routine assessment for control group) and Day 3 (Post-intervention for intervention groups, after routine assessment for control group).

   Originally developed by Takeishi et al. in 2011 in Japan and later revised by Nakamura et al. in 2015 to a 15-item version, this scale measures prenatal comfort across five subscales: Partner's Role in Fatherhood, Fetal Interaction, Social Support, Maternal Role Adaptation, and Awareness of Pregnancy Changes. The 6-point Likert-type scale ranges from 0 (strongly disagree) to 5 (strongly agree), with higher scores indicating higher comfort levels. The scale has a Cronbach's alpha of 0.95 in the original study and 0.82 in the Turkish adaptation.

5. Heart Rate Variability (HRV) Measurement via Photoplethysmography (PPG)

   Time frame: Day 1 (Baseline, before the relaxation intervention) and Day 3 (Post-intervention, after the relaxation session).

   A non-invasive test used to assess physiological stress levels by measuring heart rate variability (HRV) through a photoplethysmography (PPG) sensor placed on the fingertip.

6. Satisfaction Evaluation Form (VAS)

   Time frame: Day 3 (Post-Intervention)

   A researcher-developed form assessing participants' overall satisfaction with the intervention, perceived anxiety and stress reduction, and general experience. (only for intervention groups)

7. Edinburgh Postpartum Depression Scale (EPDS)

   Time frame: Up to 4-6 weeks postpartum (via phone follow-up)

   eveloped by Cox et al. in 1987 and adapted into Turkish by Engindeniz et al. in 1996, this 10-item, 4-point Likert-type self-report scale assesses postpartum depression risk. Scores range from 0 to 30, with a cut-off point of 13. Internal consistency in the Turkish adaptation is 0.79, with a sensitivity of 0.84 and specificity of 0.88.

8. Postpartum Evaluation Form

   Time frame: Up to 4-6 weeks postpartum (via phone follow-up)

   A researcher-developed form assessing delivery type, maternal and neonatal health parameters, and newborn evaluations based on literature