---

To study and determine the educational needs of nurses after graduation in order to make them further capable, aims at promotion of their occupational standards and betterment of this profession. By means of this study we can identify their needs and make necessary planning to reduce the resultant shortcommings and problems. The present research is a descriptive and analytical study conducted to survey the educational needs of nurses regarding non-pharmacological methods of controlling chronic pans in patients at medical surgical wards of the hospitals of Tehran University Medical of Sciences. A total of 119 nurses working at one of these wards participated in this research. The tool for gathering the information was a three-part questionnaire. The first part deal with individual particulars, the second part was about questions regarding the feeling needs of nurses an the third part was about questions regarding the educational needs of nurses. The findings showed: As for the feeling needs, nurses needed training , as for the level of educational needs regarding the concept of pain (69.7%), characteristics of chronic pains (52.9%), guided imagery method (50.4%) of nurses were in need of a high level of training and regarding the progressive muscle relaxation (68.9%) of nurses were in need of a medium level of training. The results revealed the connection between some individual particulars with the level of educational need, to the extent the age, clinical work experience, work experience in medical and surgical ward and the type of ward affected the level of educational need, and by using the Pearson Coefficient a meaningful statistical difference appeared, in other words, as the years of service increases , the level of knowledge decrease and the educational needs rise up.

---

Introduction: Surgery is a stressful event and patients undergoing surgery experience anxiety. Any effort to reduce anxiety of surgical patients should be of priority in nursing care of preoperative patients. The purpose of this study was to compare the effect of Benson relaxation technique and Zekr (rosary) on anxiety level of patients awaiting abdominal surgery.

Materials and Methods: This research is a quasi-experimental study carried out on patients who were admitted for abdominal surgery in a affiliated hospital to Tehran University of Medical Sciences in the year 2004. A total of 70 patients were chosen and divided randomly into two groups. We used Benson’s relaxation technique in first and Zekr in the second group. The patients were assessed on the day before surgery and on the day of surgery by a questionnaire that included demographic information and Spielberger anxiety tool. Vital signs were also recorded. The data were analyzed by SPSS computer software. The differences between pre and post intervention values were analyzed using paired t test, and between groups using independent t test and 2.

Results: Although there was a significant difference between mean anxiety level before and after intervention in both Zekr (p<0.006) and relaxation group (p<0.02), there was no significant difference between two techniques in reduction of preoperative anxiety (p>0.05). There was also a significant reduction in systolic blood pressure and pulse rate in both groups (p<0.05).

Conclusion: It seems that Zekr is as effective as Benson’s relaxation technique in reducing anxiety level of patients and both can be used to reduce anxiety level of patients awaiting abdominal surgery.

---

Background & Aim: One of the cause of anxiety for most patients is hospitalization. Once the patients are hospitalized for cardiac catheterization, the anxiety would be augmented. The anxiety raises body physiological and psychological activities such as: heart rate and respiratory rate. This research, as clinical trial study, has the objective to determine the influence of applying two methods of relaxation and premeditation on respiratory rate and pulse rate in hospitalized patients, experiencing coronary angiography, in heart and postangio wards of Shahid Beheshti Hospital in Zanjan, at 2003.

Methods & Materials: 40 patients who were candidates for CA, has been studied, in regard to existing conditions and methods of sampling and random allocation to two groups of relaxation, and premedication. Data collection tool included demographic and disease related information sheet, as well as record sheets for respiratory rate and pulse rate at intervals of 8-12 and ½ hrs before, during and after the angiography. For relaxation group, the researcher would speak individually about the influence of relaxation, the day before angiography then with the aid of client himself/herself, performed relaxation instances in a single bout, and eventually asked client to perform relaxation technique 2-3 times before going for angiography. In premedication group, patients received regular preangiographic medications including diazepam, chlorpheniramine, metoclopramid, and hydrocortisone. Respiratory rate and pulse rate were measured in both groups 8-12 and ½ hrs, before during and after CA. Afterward, resulted data were analyzed statistically by (SPSS) software for windows.

Results: Pulse rate at 8-12 hours before, during and after the angiography showed no significant difference between two groups (p>0.05). Thus our research hypothesis that “alterations of respiratory rate and pulse rate in patients under coronary angiography, who get relaxation, are identical to those in premedicaton group”, would be confirmed

Conclusion: These results show that the premeditation method can be substituted by relaxation before practicing invasive procedures.

---

Background & Aim: Pain is one of the important complication of chronic diseases such as cancer. Purpose of this study is to investigation of two non-pharmacological methods, progressive muscle relaxation and music, on pain relief in patients suffer from cancer.

Methods & Materials: This research is a intervention clinical trial which was done in a hospital affiliated to Tehran University of Medical Sciences. In this study, 100 cancerous patients that have inclusion criteria were selected by simple sampling method. The participants into two groups allocated, 50 patients in progressive muscle relaxation, and 50 patients in music group. Data collection tools were questionnaire, pain level recorded sheet, taps with headphone (is produced by Sony company) and music box including light music consist of classical, mild and Iranian traditional music. Questionnaire was designed in two parts, demographically characteristics and disease characteristics. Data were collected by interview and patient self report. After adequate education to two groups, asked them to perform that method 30minet per day until 3 days. Then, pain level, at previous 24 hours until 3 days were assessed and recorded in related sheet. Analysis of data were analyzed by SPSS software, inferential and descriptive statistics such as Mann Whitney, chi Square, Fisher’s exact test, and Friedman.

Results: The finding of research showed in both relaxation and music groups there were significant differences in pain level before and after intervention (p<.001). Also there were significant differences between two groups in pain level (p=0.016). It means that pain relief in relaxation group was more significant.

Conclusion: According to the findings of this research, although both progressive muscle relaxation and music are effective and decreasing of pain level but progressive muscle relaxation is more effective than music.

---

Background & Aim: Anxiety is a common experience which is felt as uneasiness, non-specific threat, and activation of autonomic nervous system. The aim of this study was to assess the effect of muscular relaxation on anxiety level of patients underwent cardiac catheterization.

Methods & Materials: In this clinical trial, 118 patients who were expected to have a cardiac catheterization were recruited from an educational hospital at Tehran University of Medical Science. The participants were allocated to two groups, including muscular relaxation group (50 patients), and control group (68 patients). Data were collected using a questionnaire, and a self-report paper for recording anxiety level. Anxiety level was recorded one hour before cardiac catheterization in two groups. Then, the intervention group was asked to listen to the Benson muscle relaxation guide direction tape for 20 minutes through headphone. After using muscle relaxation in the intervention group and immediately before cardiac catheterization, the anxiety level of the respondents was recorded once more. Control group received standard nursing cares. Data were analyzed using χ², Fisher&aposs exact test, Kruscalwallis, Man-Whitney and Wilcoxon statistical tests in the SPSS.

Results: There were no significant difference between two groups in demographic characteristics and anxiety level before the intervention and one hour before cardiac catheterization. After the intervention, the anxiety level was significantly reduced in the intervention group (P<0.001) while it increased in the control group.

Conclusion: Based on the results of this study, Benson muscle relaxation significantly decreased anxiety level in patients who were expected to go for cardiac catheterization.

 

---

  Background & Aim: Reducing maternal anxiety has a critical role in maternal and fetal mental and physical health. This study aimed to assess the effect of two anxiety reducing techniques including relaxation and maternal-fetal attachment training on anxiety in third trimester and postpartum depression among primipara women.

  Methods & Materials: In this clinical trial, 126 pregnant women were randomly selected and divided into three groups including relaxation training, maternal-fetal attachment skills training, and control group. The participants completed a demographic questionnaire, the Spillberger and Beck questionnaires and written consents at baseline. The participants completed the questionnaires after the intervention too. The one way ANOVA and paired t-test were used to analyze the data. 

  Results: At baseline, the mean total anxiety, state and trait anxiety and depression scores were not significantly different between the groups. The ANOVA showed differences in the mean score of anxiety after the intervention (P=0.03) in the intervention groups. There were statistically significant differences between the attachment and control groups (P=0.01) and the relaxation and control groups (P<0.001) in terms of the mean score of state anxiety. The ANOVA showed a reduction in the mean score of state anxiety after intervention in the attachment (P=0.02) and relaxation groups (P=0.01). There was significant difference after the intervention in the mean score of maternal depression (P=0.002) between the attachment and relaxation groups with the control group (P=0.01, P=0.01 respectively). 

  Conclusion: A ttachment and relaxation trainings can reduce maternal anxiety and post-partum depression. Pregnancy visit is an important opportunity to screen maternal anxiety and prevent post-partum depression using simple and non-expensive training programs.

---

  Background & Aim: Patients with multiple sclerosis suffer from permanent pain. It is being increased to apply relaxation therapy to decrease patients' pain. The progressive muscle relaxation make the muscles feel more relaxed. The aim of this study was to assess the effect of progressive muscle relaxation on pain among patients with multiple sclerosis .

  Methods & Materials: A randomized controlled trial was carried out among 70 patients with multiple sclerosis selected from Hamadan Multiple Sclerosis Society patients. Inclusion criteria involved diagnosed with multiple sclerosis, 20-65 year old patients, having ability to do daily 20-minute exercises, feeling pain, having an EDSS score equal or less than 4.5. Patients were randomly divided into two groups of control and intervention. Patients' pain was measured using the VAS scale in the two groups at baseline. The relaxation training was implemented among intervention group patients and was repeated three times a week for four weeks. Each session lasted 40 minutes and the patients continued doing exercise at home for the other eight weeks. The control group patients were observed routinely. Patients' pain was measured eight weeks later in both groups. Data were analyzed using the paired independent t-test in the SPSS-16 .

  Results: Muscle relaxation had significant effect on pain among patients with multiple sclerosis (P<0.05). The mean of pain severity decreased from 4.60 ± 1.75 to 3.26±1.88 in the intervention group after the intervention. The mean of pain severity remained constant .

  Conclusion: This progressive muscle relaxation can be used for decreasing pain among patients with multiple sclerosis as a non-expensive, safe and simple method .

  

---

Background & Aim: Restless leg syndrome (RLS) is one of the common complications in patients under treatment with hemodialysis. Progressive muscle relaxation is a method which has been designed for reducing patients’ stress, pain and anxiety. The present study aimed to determine the effect of progressive muscle relaxation on the severity of RLS in hemodialysis patients.

Methods & Materials: In this quasi-experimental study (IRCT2015102824769N1), 74 hemodialysis patients were selected by convenience sampling method and divided into intervention and control groups based on records numbers. The intervention group was trained in progressive muscle relaxation technique in two half-hour sessions and they were asked to practice it twice a day for one month. RLS severity was measured using the standardized RLS questionnaire. Data were analyzed by descriptive and inferential statistical tests (independent and paired t-test, analysis of co-variance) using SPSS software version 23.

Results: There was no significant difference in the distribution of variables in the intervention and control group before intervention (P>0.05). Before the intervention, RLS severity score was 28.24±7.33 in the intervention group and 25.57±9.85 in the control group (P=0.189). After the intervention, the score for the intervention group was reduced to 10.67±5.66 (P>0.001) while there was no significant change in the control group after the intervention (26.16±9.69). Also, a significant difference was observed between the two groups in the mean score of RLS severity after removing the effect of RLS severity on pretest (P>0.0001).

Conclusion: The use of progressive muscle relaxation technique reduces RLS severity in patients under treatment with hemodialysis. Therefore, this technique is recommended to be used as one of the non-pharmacological methods to improve RLS in these patients.

---

Background & Aim: Breast cancer is one of the most prevalent cancers in women and is regarded as a chronic disease with various psychological complications including death anxiety. This study aimed to examine the effect of Benson’s relaxation technique on death anxiety among women with breast cancer.
Methods & Materials: In this randomized clinical trial, 100 patients with breast cancer referred to Velayat Hospital in Qazvin in 2017 were selected using the consecutive sampling and randomly assigned into groups of experimental and control. A questionnaire on demographic information and the Templer Death Anxiety Scale were used. Benson’s relaxation technique was taught to the patients in the experimental group. Afterward, they were asked to perform the technique for three months and were monthly followed up using checklists. The Templer Death Anxiety Scale was completed again by both groups. Data were analyzed via the SPSS software version 23 using descriptive and analytical statistics.
Results: There was no significant difference in demographic variables between the two groups (P>0.05). Before the intervention, no statistically significant difference was observed between the mean scores of death anxiety in the patients of the experimental group (46.4±10.3) and the control group (49.6±10.07) (P>0.05). However, after the intervention, a statistically significant difference was observed between the mean scores of death anxiety in the experimental group (44.5±10.2) and the control group (48.9±11.2) (P<0.05).
Conclusion: According to the results of the study, it can be concluded that Benson’s relaxation technique is effective in reducing death anxiety among patients with breast cancer.
Clinical trial registry: IRCT20170610034435N8