A Swanson's Caring Theory-Informed Supportive Care Intervention for Reducing Infertility-related Stress and Improving Coping Strategies in Couples Undergoing Assisted Reproductive Treatment

Infertility is a significant life event that can affect individuals and couples at multiple levels, including emotional well-being, relationship dynamics, and future life planning. The World Health Organization defines infertility as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility-related stress often increases throughout the diagnostic and treatment process, and individuals undergoing ART frequently report elevated stress levels and difficulties in coping. Although infertility is experienced by both partners, supportive care interventions have largely focused on individuals, and structured approaches that include both partners remain limited.

Healthcare professionals, including midwives and nurses, are well positioned to provide continuous support during infertility treatment. Structured supportive care interventions may help reduce infertility-related stress and enhance coping; however, theory-informed and couple-inclusive care models are still limited in infertility treatment settings. Therefore, this single-blind randomized controlled trial was designed to evaluate the effects of a supportive care program based on Swanson's Caring Theory on infertility-related stress and coping in couples undergoing ART.

Swanson's Caring Theory was originally developed in the context of pregnancy loss and focuses on how caring processes support individuals in coping with loss, uncertainty, and emotional distress. The theory has since been applied across various clinical settings requiring supportive care. Unsuccessful assisted reproductive treatment may be perceived as a significant loss and can evoke grief-like responses. Therefore, this framework provides a relevant approach for supporting individuals undergoing infertility treatment.

Couples were randomly assigned to either an intervention group receiving structured education and counseling throughout the treatment process or a control group receiving routine care.

The sample size was determined based on the primary outcome, assuming 95% confidence, 95% statistical power, and an effect size of 0.60, resulting in a required sample size of 42 participants per group. To account for potential attrition, additional participants were included, leading to a total sample of 100 individuals (50 couples).