The Effect of Emotional Freedom Technique on Parents' Anxiety Level: Newborn Hearing Screening

Study Design and Randomization: This prospective, controlled experimental study utilized a pretest-posttest design to evaluate the effects of the Emotional Freedom Technique (EFT) on maternal anxiety. A total of 72 eligible mothers were recruited from the Newborn Hearing Screening (NHS) Units of two public hospitals. Participants were assigned to either the EFT intervention group (n=36) or a non-intervention control group (n=34) using stratified block randomization based on hospital site and baseline state anxiety levels.

Procedural Standardization and Participant Management: To maintain internal validity and ensure the stability of pre-procedural anxiety measurements, specific situational controls were implemented. Participants were excluded if acute situational triggers-such as neonatal crying or breastfeeding-occurred immediately before or during the intervention period. In accordance with this criterion, two participants were excluded from the study due to persistent neonatal crying during the session. To minimize external distractions and allow the participant to focus entirely on the protocol, relatives provided care for the neonates during the 30-35 minute study duration.

Intervention Protocols:

• EFT Group: Participants received a 15-minute guided session led by a certified practitioner. The session began with the "Karate Chop" point setup, where the participant repeated a specific acceptance sentence three times. This was followed by sequential tapping (approximately seven times per point) on twelve designated acupoints: the beginning of the eyebrow, side of the eye, under the eye, under the nose, the chin, collarbone, under the armpit, thumb, index finger, middle finger, little finger, and the Karate Chop point. Multiple tapping rounds were completed within the 15-minute timeframe.
• Control Group: Participants underwent identical pre-test assessments but remained in a designated waiting area for 15 minutes without any active intervention, guidance, or therapeutic contact.

Data Collection and Measurement: Baseline assessments (Pre-tests) included a Parental Information Form, the Subjective Units of Distress Scale (SUDS), and the State-Trait Anxiety Inventory (STAI). Post-test assessments (SUDS and STAI) were administered to both groups immediately following the 15-minute intervention or waiting period. The STAI evaluated both situational (state) and general (trait) anxiety on a scale ranging from 20 to 80, while the SUDS provided a subjective distress rating from 0 to 10.

Inclusion criteria

• Mothers of neonates who are undergoing the newborn hearing screening (NHS) for the first time.
• Ability to communicate effectively in the native language without language barriers.
• No prior experience or training in applying the Emotional Freedom Technique (EFT).
• Voluntary agreement to participate in the study and completion of the informed consent form.

Exclusion criteria

• Known history of diagnosed psychiatric disorders or epilepsy.
• Situations where the neonate is crying or being breastfed immediately prior to the intervention or during the assessment.
• The scheduled hearing screening procedure is initiated before the 30-35-minute study protocol is completed.
• Occurrence of any acute situational triggers or environmental distractions that may interfere with the stability of anxiety measurements.