Effect of Emotional Freedom Techniques on Fatigue, Hopelessness, and Perceived Stigma in Women With Unsuccessful IVF Experience

The Effect of Emotional Freedom Techniques Based on Levine's Conservation Model on Fatigue, Hopelessness, and Perceived Stigma in Women With Unsuccessful IVF Experience: A Randomized Controlled Trial

In this study, it is planned to provide nursing care to women with an experience of unsuccessful IVF treatment by combining Emotional Freedom Technique (EFT) with the principles developed in line with the philosophy of Levine's Conservation Model. Women with an experience of unsuccessful IVF treatment will be evaluated according to the three conservation principles, and these principles will form the basis of the setup statements used in the EFT sessions. When evaluated within the scope of the model, infertility disrupts the individual's energy conservation, leading to increased fatigue; impairs personal integrity, causing feelings of hopelessness; and threatens social integrity, resulting in feelings of stigma and isolation. In line with the integrity principles emphasized in Levine's model, it is considered that EFT may reduce fatigue by regulating the disrupted energy balance, alleviate levels of hopelessness by supporting personal integrity, and reduce the effects of infertility-related stigma by strengthening social integrity.

In this context, this study will be conducted to examine the effects of Emotional Freedom Techniques (EFT), structured in accordance with Levine's Conservation Model, on levels of fatigue, hopelessness, and perceived stigma in women with an experience of unsuccessful IVF treatment. This study will be conducted with 80 women who have experienced unsuccessful IVF treatment and meet the inclusion criteria of the study, including 40 women in the experimental group and 40 women in the control group, at Atatürk University Research Hospital In Vitro Fertilization Center. In the study, pre-test data of women in the experimental and control groups assigned through randomization will be collected using the Participant Information Form, the Visual Analog Scale for Fatigue, the Beck Hopelessness Scale, and the Infertility Stigma Scale. EFT structured in line with Levine's Conservation Model will be applied to the women in the experimental group, while no intervention will be applied to the control group. Post-test data will be collected from women in both the experimental and control groups after the completion of the 4-week EFT sessions. In order to test the effectiveness of EFT over time, repeated measurements will be conducted one month after the last application for each participant, and women in the experimental and control groups will complete the Visual Analog Scale for Fatigue, the Beck Hopelessness Scale, and the Infertility Stigma Scale again. The data of the experimental and control groups, coded as X and Y, will be transferred to a computer environment by an independent statistician, and the data will be analyzed and the findings will be reported.

Study Overview

• Status: Not yet recruiting
• Conditions: Emotional Freedom Technique
• Intervention / Treatment: Behavioral: Emotional Freedom Technique

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Women aged between 18 and 45 years,
• Having experienced at least one unsuccessful IVF treatment,
• Able to read and write in Turkish,
• Having no hearing or visual impairment,
• Having no diagnosis of a psychiatric disorder,
• Not using any complementary and alternative therapy methods (such as Reiki, hypnofertility, or acupressure),
• Scoring 4 or higher on the Beck Hopelessness Scale,
• Residing in the province of Erzurum,
• Willing to participate in the study voluntarily.

Exclusion Criteria:

• Receiving any assisted reproductive treatment during the study period,
• Developing a healthy pregnancy after enrollment in the study,
• Being diagnosed with a psychiatric disorder after the start of the study,
• Initiating the use of any complementary and alternative therapy methods during the study period,
• Women who request to withdraw from the study will be excluded from the sample.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental Group; Participants in the experimental group will receive Emotional Freedom Techniques (EFT) structured in line with Levine's Conservation Model. The intervention will be delivered over a 4-week period through EFT sessions developed according to the three conservation principles of the model.	Behavioral: Emotional Freedom Technique; Emotional Freedom Techniques (EFT) is a behavioral mind-body intervention that combines cognitive and somatic components. In this study, EFT will be structured in line with Levine's Conservation Model and tailored according to the three conservation principles (energy, personal integrity, and social integrity). The intervention will be delivered by a trained nurse through standardized EFT sessions conducted over a 4-week period. Each session will include setup statements developed based on the participant's experiences related to unsuccessful IVF treatment and the corresponding conservation principles.
No Intervention: Control; Participants in the control group will not receive any intervention during the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analog Scale for Fatigue	The scale consists of 18 items. Items 1, 2, 3, 4, 5, and 11 through 18 constitute the fatigue subscale, while items 6, 7, 8, 9, and 10 constitute the energy subscale. The scale is presented in the form of a 10-cm visual ruler, with the most positive expression at one end and the most negative expression at the other. For the fatigue subscale, the most positive expression is scored as 0 and the most negative expression as 10, whereas for the energy subscale, the most negative expression is scored as 0 and the most positive expression as 10. Items in the fatigue subscale are ordered from the most positive to the most negative, while items in the energy subscale are ordered from the most negative to the most positive. A higher score on the fatigue subscale and a lower score on the energy subscale indicate greater severity of fatigue.	This form will be administered at baseline. The experimental group will receive EFT for 4 weeks. The form will be re-administered as a post-test after the intervention and as a follow-up test one month later.
Beck Hopelessness Scale	The scale consists of three subscales: Loss of Motivation, comprising 8 items (2, 4, 9, 12, 14, 16, 17, and 20); Feelings and Expectations About the Future, comprising 5 items (1, 3, 7, 11, and 18); and Hope, comprising 7 items (5, 6, 8, 10, 13, 15, and 19). The total score obtainable from the scale ranges from 0 to 20. Scoring is based on binary responses, with a score of 1 assigned for a "No" response on items 1, 3, 5, 6, 8, 10, 12, 13, 15, and 19, and for a "Yes" response on items 2, 4, 7, 9, 11, 14, 16, 17, 18, and 20. The total score constitutes the participant's hopelessness score, with higher scores indicating greater levels of hopelessness. Scores of 0-3 indicate no hopelessness, 4-8 indicate low hopelessness, 9-14 indicate moderate hopelessness, and 15-20 indicate high levels of hopelessness.	This form will be administered at baseline. The experimental group will receive EFT for 4 weeks. The form will be re-administered as a post-test after the intervention and as a follow-up test one month later.
Infertility Stigma Scale	The Infertility Stigma Scale consists of 27 items rated on a 5-point Likert scale. It includes four subscales: self-devaluation (7 items), social withdrawal (5 items), public stigma (9 items), and family stigma (6 items). Total scores range from 27 to 135, with higher scores indicating greater perceived stigma.	This form will be administered at baseline. The experimental group will receive EFT for 4 weeks. The form will be re-administered as a post-test after the intervention and as a follow-up test one month later.

Collaborators and Investigators

• Sponsor: Ataturk University

Study record dates

Study Major Dates

• Study Start (Estimated): February 1, 2026
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: March 13, 2026
• First Submitted That Met QC Criteria: March 13, 2026
• First Posted (Actual): March 17, 2026

Study Record Updates

• Last Update Posted (Actual): March 18, 2026
• Last Update Submitted That Met QC Criteria: March 17, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: B.30.2.ATA.0.01.00/802

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No