Individualized Grief Support With Swanson Model

Primary outcomes

1. Personal Information Form (Pre-Test)

   Time frame: At baseline (prior to intervention)

   This form will be administered to women during the initial interview after they are accepted into the service.

   It was developed by researchers to determine sociodemographic characteristics such as age, marital status, pregnancy history, and educational background. Women will also undergo pre-tests (PGS and DASS-21) during the initial interview.

2. Sociodemographic Characteristics Form

   Time frame: Baseline (pre-intervention)

   This form assesses participants' sociodemographic and obstetric characteristics, including age, marital status, educational level, and pregnancy history. The form is administered by the researcher during the initial interview after participants are accepted into the service.

3. Perinatal Grief Scale (PGS) Score

   Time frame: Baseline (pre-intervention)

   The Perinatal Grief Scale (PGS) is a self-report instrument used to assess grief intensity following pregnancy loss. The scale consists of 33 items rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Total scores range from 33 to 165, with higher scores indicating greater levels of perinatal grief.

4. Depression Anxiety Stress Scale-21 (DASS-21)

   Time frame: Baseline (pre-intervention)

   The Depression Anxiety Stress Scale-21 (DASS-21) is a self-report instrument used to assess symptoms of depression, anxiety, and stress. The scale consists of 21 items rated on a 4-point Likert scale ranging from 0 (did not apply to me at all) to 3 (applied to me very much or most of the time). The scale includes three subscales-Depression, Anxiety, and Stress-each comprising 7 items. Subscale scores are calculated by summing the relevant items and multiplying by two. Higher scores indicate greater symptom severity.

   Severity Classification:

   DASS-21 subscale scores are categorized as follows:

   Severity Level Depression Anxiety Stress Normal 0-4 0-3 0-7 Mild 5-6 4-5 8-9 Moderate 7-10 6-7 10-12 Severe 11-13 8-9 13-16 Extremely Severe ≥14 ≥10 ≥17

5. Bereavement Brochure

   Time frame: Immediately post-intervention

   A bereavement brochure, prepared with the contribution of experts, will be provided to women following pregnancy loss during the initial interview. The brochure contains information about emotional reactions, coping strategies, and available support resources.

6. Semi-Structured Interview

   Time frame: 1 week

   One week after the initial interview, semi-structured interviews will be conducted with women who have experienced pregnancy loss. In this interview, grief experiences and needs will be examined phenomenologically.

7. Swanson-Based Grief Counseling (First Session)

   Time frame: 3 weeks

   In the third interview, grief counseling will be provided based on findings from qualitative data. The counseling process will be structured using the Swanson Care Model.

8. Swanson-Based Bereavement Counseling (Second Session)

   Time frame: 2nd month

   In the fourth interview, bereavement counseling will again be conducted based on the Swanson Model, tailored to the woman's ongoing needs and responses.

9. Swanson-Based Bereavement Counseling (Third Session) + Post-Test Data Collection

   Time frame: 3rd month

   During the fifth interview, bereavement counseling will continue based on the Swanson Model. At this stage, post-test data collection forms (PGS and DASS-21) will also be administered.