<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE trials [
<!ELEMENT trials (trial+)>

<!ELEMENT trial (main,contacts,countries,criteria,health_condition_code,health_condition_keyword,intervention_code,
          intervention_keyword,primary_outcome,secondary_outcome,secondary_sponsor,secondary_ids,source_support,ethics_reviews)>

<!ELEMENT main (trial_id,utrn?,reg_name,date_registration,primary_sponsor,public_title,acronym?,scientific_title,scientific_acronym?,
          date_enrolment,type_enrolment,target_size,recruitment_status,url?,study_type,study_design,phase,hc_freetext?,i_freetext?,results_actual_enrolment,results_date_completed,results_url_link,results_summary,           results_date_posted,results_date_first_publication,results_baseline_char,results_participant_flow,results_adverse_events,results_outcome_measures,results_url_protocol,results_IPD_plan, results_IPD_description)>
<!ELEMENT trial_id (#PCDATA)>
<!ELEMENT utrn (#PCDATA)>
<!ELEMENT reg_name (#PCDATA)>
<!ELEMENT date_registration (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT primary_sponsor (#PCDATA)>
<!ELEMENT public_title (#PCDATA)>
<!ELEMENT acronym (#PCDATA)>
<!ELEMENT scientific_title (#PCDATA)>
<!ELEMENT scientific_acronym (#PCDATA)>
<!ELEMENT date_enrolment (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT type_enrolment (#PCDATA)>
<!ELEMENT target_size (#PCDATA)>
<!ELEMENT recruitment_status (#PCDATA)><!-- Pending,Recruiting,Suspended,Complete,Other -->
<!ELEMENT url (#PCDATA)>
<!ELEMENT study_type (#PCDATA)><!-- interventional,observational -->
<!ELEMENT study_design (#PCDATA)>
<!ELEMENT phase (#PCDATA)>
<!ELEMENT hc_freetext (#PCDATA)>
<!ELEMENT i_freetext (#PCDATA)>
<!ELEMENT results_actual_enrolment (#PCDATA)>
<!ELEMENT results_date_completed (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_url_link (#PCDATA)>
<!ELEMENT results_summary (#PCDATA)>
<!ELEMENT results_date_posted (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_date_first_publication (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_baseline_char (#PCDATA)>
<!ELEMENT results_participant_flow (#PCDATA)>
<!ELEMENT results_adverse_events (#PCDATA)>
<!ELEMENT results_outcome_measures (#PCDATA)>
<!ELEMENT results_url_protocol (#PCDATA)>
<!ELEMENT results_IPD_plan (#PCDATA)>
<!ELEMENT results_IPD_description (#PCDATA)>


<!ELEMENT contacts (contact+)>
<!ELEMENT contact (type,firstname,middlename,lastname,address,city,country1,zip,telephone,email,affiliation)>
<!ELEMENT type (#PCDATA)><!-- Public,Scientific -->
<!ELEMENT firstname (#PCDATA)>
<!ELEMENT middlename (#PCDATA)>
<!ELEMENT lastname (#PCDATA)>
<!ELEMENT address (#PCDATA)>
<!ELEMENT city (#PCDATA)>
<!ELEMENT country1 (#PCDATA)>
<!ELEMENT zip (#PCDATA)>
<!ELEMENT telephone (#PCDATA)>
<!ELEMENT email (#PCDATA)>
<!ELEMENT affiliation (#PCDATA)>

<!ELEMENT countries (country2+)>
<!ELEMENT country2 (#PCDATA)>

<!ELEMENT criteria (inclusion_criteria,agemin,agemax,gender,exclusion_criteria)>
<!ELEMENT inclusion_criteria (#PCDATA)>
<!ELEMENT agemin (#PCDATA)>
<!ELEMENT agemax (#PCDATA)>
<!ELEMENT gender (#PCDATA)>
<!ELEMENT exclusion_criteria (#PCDATA)>

<!ELEMENT health_condition_code (hc_code+)>
<!ELEMENT hc_code (#PCDATA)>

<!ELEMENT health_condition_keyword (hc_keyword+)>
<!ELEMENT hc_keyword (#PCDATA)>

<!ELEMENT intervention_code (i_code+)>
<!ELEMENT i_code (#PCDATA)>

<!ELEMENT intervention_keyword (i_keyword+)>
<!ELEMENT i_keyword (#PCDATA)>

<!ELEMENT primary_outcome (prim_outcome+)>
<!ELEMENT prim_outcome (#PCDATA)>

<!ELEMENT secondary_outcome (sec_outcome+)>
<!ELEMENT sec_outcome (#PCDATA)>

<!ELEMENT secondary_sponsor (sponsor_name+)>
<!ELEMENT sponsor_name (#PCDATA)>

<!ELEMENT secondary_ids (secondary_id+)>
<!ELEMENT secondary_id (sec_id,issuing_authority)>
<!ELEMENT sec_id (#PCDATA)>
<!ELEMENT issuing_authority (#PCDATA)>

<!ELEMENT source_support (source_name+)>
<!ELEMENT source_name (#PCDATA)>

<!ELEMENT ethics_reviews (ethics_review+)>
<!ELEMENT ethics_review (status,approval_date,contact_name,contact_address,contact_phone,contact_email)>
<!ELEMENT status (#PCDATA)><!-- Not approved,Approved,NA -->
<!ELEMENT approval_date (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT contact_name (#PCDATA)>
<!ELEMENT contact_address (#PCDATA)>
<!ELEMENT contact_phone (#PCDATA)>
<!ELEMENT contact_email (#PCDATA)>
]>
<trials>
  <trial>
    <main>
      <trial_id>IRCT20200918048750N1</trial_id>
      <utrn></utrn>
      <reg_name>IRCT</reg_name>
      <date_registration>2020-12-15</date_registration>
      <primary_sponsor>Zahedan University of Medical Sciences</primary_sponsor>
      <public_title>The effect of Benson relaxation technique on anxiety and aggression in patients with thalassemia major</public_title>
      <acronym></acronym>
      <scientific_title>Examining the Effect of Benson’s Relaxation Technique on Anxiety and Aggression Patients with Thalassemia Major</scientific_title>
      <scientific_acronym></scientific_acronym>
      <date_enrolment>2020-12-20</date_enrolment>
      <type_enrolment>anticipated</type_enrolment>
      <target_size>60</target_size>
      <recruitment_status>Complete</recruitment_status>
      <url>https://irct.ir/trial/51052</url>
      <study_type>interventional</study_type>
      <study_design>Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Other design features: After selection, in order to standardize the research conditions for both intervention and control groups, the random allocation method will be used. If the patient is in the intervention group, the Benson relaxation technique will be performed, but no intervention will be performed for the control group, Randomization description: Sampling will be done by available methods. Then the selected patients are randomly divided into two groups of intervention and control. In this way, first, an envelope containing the group name is prepared for the total number of people studied and randomly arranged, and with the gradual referral and selection of individuals, one of the cards will be assigned to them, respectively; Which will determine the individual group in the intervention or control group. Due to random sampling, the samples will have an equal chance of being selected in both intervention and control groups.</study_design>
      <phase>N/A</phase>
      <hc_freetext>The effect of Benson relaxation technique on anxiety and aggression in patients with thalassemia major.</hc_freetext>
      <i_freetext>Intervention 1: Intervention description:Prior to his intervention, the researcher will undergo theoretical and practical training in relaxation techniques in several stages under the full supervision of a psychologist. First, the researcher will provide patients with a questionnaire, which includes a questionnaire of demographic characteristics, anxiety and aggression, and after completing the questionnaire; Benson relaxation technique is taught individually by the researcher in 2 face-to-face sessions of 30 to 45 minutes with an interval of 2 to 3 days in Ali Asghar Clinic, the time of which is determined in coordination with the patient. The first session is training in the technique and the second session is training with questions from the patient and answers to questions that arise for him during the practice of the Benson technique at home. A CD containing Benson's step-by-step relaxation instruction is provided to the intervention group. The intervention group is asked to do relaxation exercises twice a day for 6 weeks according to the schedule set at home. Take about 15 to 20 minutes at a time. The technique is performed as follows: first before performing the relaxation technique; The patient removes all additional items such as watches, bracelets, rings and all items that can be detached and puts them next to him, and then Benson relaxation steps are taught to patients as follows: 1) Gently in position Comfortable. 2) Close your eyes slowly. 3) Relax all the muscles of the body deeply. Start from the soles of your feet and gradually move towards the face. This will keep people calm. 4) At the same time, Breathe through the nose. Be aware of your breathing and while exhaling slowly, repeat soothing words such as (God, love, rain, rainbow and the like) under your lips and start breathing deeply and regularly and do it with your nose and tail. Then exhale with your mouth and repeat the word in your mind. 5) Continue this for 15 to 20 minutes and try to relax all your muscles from the tips of the toes to the upper body muscles so that all the muscles of the body reach full expansion. After 15-20 minutes, slowly open your eyes and do not get up for a few minutes. 6) Do not worry about reaching a deep level of relaxation or not; Let the relaxation happen with his own song. When annoying thoughts occur, try to ignore them. During 6 weeks, to ensure that the relaxation technique is performed on the prescribed days, a checklist is provided to the samples until the day , The time and duration of the technique and if not, record the cause. In addition, a technique training CD will be provided to the patient. Also, in order to solve possible problems in the field of technique implementation, during the research period, the researcher has made a phone call with the research samples two days a week to ensure the process of technique implementation and completion of the checklist. It will also hold a training session for patients' families and ask them to monitor the patient's performance of the technique at home and to notify the researcher in the event of a problem. Finally, after 8 weeks, the researcher completes a questionnaire, anxiety and aggression for patients in the intervention group. Intervention 2: Control group:If the patient is assigned to the control group, the demographic information questionnaire, anxiety and aggression questionnaire are completed by the researcher to start the pre-test, and this group does not receive any intervention except for routine care. After 8 weeks, the Anxiety and Aggression Questionnaire will be completed again by the researcher at the same time as the intervention group. Finally, the control group is given a CD of Benson relaxation technique.</i_freetext>
      <results_actual_enrolment></results_actual_enrolment>
      <results_date_completed></results_date_completed>
      <results_url_link></results_url_link>
      <results_summary></results_summary>
      <results_date_posted></results_date_posted>
      <results_date_first_publication></results_date_first_publication>
      <results_baseline_char></results_baseline_char>
      <results_participant_flow></results_participant_flow>
      <results_adverse_events></results_adverse_events>
      <results_outcome_measures></results_outcome_measures>
      <results_url_protocol></results_url_protocol>
      <results_IPD_plan>Undecided - It is not yet known if there will be a plan to make this available</results_IPD_plan>
      <results_IPD_description>Justification or reason for indecision in sharing IPD is There is no more information</results_IPD_description>
    </main>
    <contacts>
      <contact>
        <type>public</type>
        <firstname>Mahnaz Ghaljeh</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>No. 19, Alley 12, Shohada Lebanon, Tehran St.</address>
        <city>Shahroud</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>3619676483</zip>
        <telephone>+98 23 3237 3188</telephone>
        <email>ssn.shahroud@yahoo.com</email>
        <affiliation>Zahedan University of Medical Sciences</affiliation>
      </contact>
      <contact>
        <type>scientific</type>
        <firstname>Mahnaz Ghaljeh</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>No. 19, Alley 12, Shohada Lebanon, Tehran St.</address>
        <city>Shahroud</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>3619676483</zip>
        <telephone>+98 23 3237 3188</telephone>
        <email>ssn.shahroud@yahoo.com</email>
        <affiliation>Zahedan University of Medical Sciences</affiliation>
      </contact>
    </contacts>
    <countries>
      <country2>Iran (Islamic Republic of)</country2>
    </countries>
    <criteria>
      <inclusion_criteria>Age over 18 years
Ability to communicate in Persian
No hearing / heart or lung problems
Lack of known neurological problems such as multiple sclerosis and Parkinson's (due to lack of technical ability)
No substance abuse
No history of participating in training courses and not attending similar courses (before and during research)
No disorders of the musculoskeletal system
Do not take anti-anxiety drugs
Ability to access and control the patient during 6 weeks
Having a cell phone in person or in the family or having a landline at home
Have a minimum literacy level of reading and writing
Resident of Zahedan
Anxiety score above 43 and aggression score above 48</inclusion_criteria>
      <agemin>18 years</agemin>
      <agemax>no limit</agemax>
      <gender>Both</gender>
      <exclusion_criteria>Withdrawal from study during research for any reason
Incidence of severe physical complications from the disease</exclusion_criteria>
    </criteria>
    <health_condition_code>
      <hc_code>D56.1</hc_code>
    </health_condition_code>
    <health_condition_keyword>
      <hc_keyword>Beta thalassemia</hc_keyword>
    </health_condition_keyword>
    <intervention_code>
      <i_code>Rehabilitation</i_code>
      <i_code>Rehabilitation</i_code>
    </intervention_code>
    <intervention_keyword>
      <i_keyword>Intervention description:Prior to his intervention, the researcher will undergo theoretical and practical training in relaxation techniques in several stages under the full supervision of a psychologist. First, the researcher will provide patients with a questionnaire, which includes a questionnaire of demographic characteristics, anxiety and aggression, and after completing the questionnaire; Benson relaxation technique is taught individually by the researcher in 2 face-to-face sessions of 30 to 45 minutes with an interval of 2 to 3 days in Ali Asghar Clinic, the time of which is determined in coordination with the patient. The first session is training in the technique and the second session is training with questions from the patient and answers to questions that arise for him during the practice of the Benson technique at home. A CD containing Benson's step-by-step relaxation instruction is provided to the intervention group. The intervention group is asked to do relaxation exercises twice a day for 6 weeks according to the schedule set at home. Take about 15 to 20 minutes at a time. The technique is performed as follows: first before performing the relaxation technique; The patient removes all additional items such as watches, bracelets, rings and all items that can be detached and puts them next to him, and then Benson relaxation steps are taught to patients as follows: 1) Gently in position Comfortable. 2) Close your eyes slowly. 3) Relax all the muscles of the body deeply. Start from the soles of your feet and gradually move towards the face. This will keep people calm. 4) At the same time, Breathe through the nose. Be aware of your breathing and while exhaling slowly, repeat soothing words such as (God, love, rain, rainbow and the like) under your lips and start breathing deeply and regularly and do it with your nose and tail. Then exhale with your mouth and repeat the word in your mind. 5) Continue this for 15 to 20 minutes and try to relax all your muscles from the tips of the toes to the upper body muscles so that all the muscles of the body reach full expansion. After 15-20 minutes, slowly open your eyes and do not get up for a few minutes. 6) Do not worry about reaching a deep level of relaxation or not; Let the relaxation happen with his own song. When annoying thoughts occur, try to ignore them. During 6 weeks, to ensure that the relaxation technique is performed on the prescribed days, a checklist is provided to the samples until the day , The time and duration of the technique and if not, record the cause. In addition, a technique training CD will be provided to the patient. Also, in order to solve possible problems in the field of technique implementation, during the research period, the researcher has made a phone call with the research samples two days a week to ensure the process of technique implementation and completion of the checklist. It will also hold a training session for patients' families and ask them to monitor the patient's performance of the technique at home and to notify the researcher in the event of a problem. Finally, after 8 weeks, the researcher completes a questionnaire, anxiety and aggression for patients in the intervention group.</i_keyword>
      <i_keyword>Control group:If the patient is assigned to the control group, the demographic information questionnaire, anxiety and aggression questionnaire are completed by the researcher to start the pre-test, and this group does not receive any intervention except for routine care. After 8 weeks, the Anxiety and Aggression Questionnaire will be completed again by the researcher at the same time as the intervention group. Finally, the control group is given a CD of Benson relaxation technique</i_keyword>
    </intervention_keyword>
    <primary_outcome>
      <prim_outcome>The patient scores on the Spielberger Anxiety Inventory in the range of 160-40. Timepoint: It is before the intervention and two months after the end of the intervention. Method of measurement: The questionnaire has 40 items with the lowest and highest scores equal to 40 and 160, respectively. At the Anxiety Scale, the main goal is to measure anxiety from low to high. That is, low scores indicate calmness, moderate scores indicate moderate levels of stress and anxiety, and high scores reflect intense fear, close to panic. In response to these substances, subjects show the intensity of their emotion on a 4-point scale (basically, somewhat, moderately, and very much) at a specific time. In response to the anxiety trait, subjects on a 4-point scale (never, sometimes, often, and always) show how they generally feel.</prim_outcome>
      <prim_outcome>The patient scores the Bass and Perry Aggression Questionnaire in the range of 145-29. Timepoint: It is before the intervention and two months after the end of the intervention. Method of measurement: This questionnaire has 29 questions and evaluates four aspects of aggression. Questions 1,5,9,13,17,21,24,26,28 related to physical aggression and questions 6,2,10,14,18 related to verbal aggression, questions 3, 7,11,15,19,22, 29 related They show hostility to anger and questions 4,8,12,16,20,23,25,27. Scoring: For each question, there are five options to answer as follows: It is completely contrary to my characteristics (score 1); Is somewhat contrary to my characteristics (score 2); Only slightly expresses my characteristics (score 3); It is somewhat indicative of my characteristics (score 4); It is quite telling of my characteristics (score 5) that the score of questions 24 and 29 is inverse. The scores of the subscales are obtained by summing the scores of the questions of that subscale. The total score is the sum of the total scores of the questions and its range is from 29 to 145. Higher scores are a sign of more aggression.</prim_outcome>
      <prim_outcome>Physical aggression score that is measured by Bass and Perry aggression questionnaire and its score range is 9-45. Timepoint: It is before the intervention and two months after the end of the. Method of measurement: The Bass and Perry Aggression Questionnaire is a 29-item questionnaire that includes 4 domains. The domain of physical aggression includes questions (1-5-9-13-17-21-24-26-28) and its score range is 9-45.</prim_outcome>
      <prim_outcome>Verbal aggression score that is measured by the Bass and Perry Aggression Questionnaire and its score range is 5-25. Timepoint: It is before the intervention and two months after the end of the. Method of measurement: The Bass and Perry Aggression Questionnaire is a 29-item questionnaire that includes 4 areas. The area of verbal aggression includes questions (2-6-10-14-18) and its score range is 5-25.</prim_outcome>
      <prim_outcome>Anger score that is measured by Bass and Perry Aggression Questionnaire and its score range is 7-35. Timepoint: It is before the intervention and two months after the end of the. Method of measurement: The Bass and Perry Aggression Questionnaire is a 29-item questionnaire that includes 4 areas, the anger area includes questions (3-7-11-15-19-22-29) and its score range is 7-35.</prim_outcome>
      <prim_outcome>The hostility score is measured by the Bass and Perry Aggression Questionnaire and its score range is 8-40. Timepoint: It is before the intervention and two months after the end of the. Method of measurement: Bass and Perry Aggression Questionnaire is a 29-item questionnaire that includes 4 areas, the area of hostility includes questions (4-8-12-16-20-23-25-27) and its score range is 8-40.</prim_outcome>
    </primary_outcome>
    <secondary_outcome>
      <sec_outcome></sec_outcome>
    </secondary_outcome>
    <secondary_sponsor>
      <sponsor_name></sponsor_name>
    </secondary_sponsor>
    <secondary_ids>
      <secondary_id>
        <sec_id></sec_id>
        <issuing_authority></issuing_authority>
      </secondary_id>
    </secondary_ids>
    <source_support>
      <source_name>Zahedan University of Medical Sciences</source_name>
    </source_support>
    <ethics_reviews>
      <ethics_review>
        <status>Approved</status>
        <approval_date>2020-10-11</approval_date>
        <contact_name>Ethics Committee of Zahedan University of Medical Sciences</contact_name>
        <contact_address>Zahedan University of Medical Sciences-Baluchistan Blvd- Dr. Hesabi Square Zahedan Sistan-va-Balouchestan Iran (Islamic Republic of)</contact_address>
        <contact_phone></contact_phone>
        <contact_email></contact_email>
      </ethics_review>
    </ethics_reviews>
  </trial>
</trials>
