The Impact of Benson's Relaxation Technique on the Quality of Life of Operating Room Nurses in Hospitals Southwest Iran: A Randomized Controlled Trial

doi:10.21203/rs.3.rs-4359707/v1

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Research Article

The Impact of Benson's Relaxation Technique on the Quality of Life of Operating Room Nurses in Hospitals Southwest Iran: A Randomized Controlled Trial

https://doi.org/10.21203/rs.3.rs-4359707/v1

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Background

In clinical settings, continuous changes lead to increased professional stress, affecting the quality of life of nurses. Some complementary interventions may influence the improvement of the quality of life. This study aimed to determine the effect of Benson's relaxation technique on the operating room nurses’ quality of life.

Methods

In this clinical trial, 180 operating room nurses were randomly allocated to two groups: intervention (Benson's relaxation technique) and control (routine activity). The study was conducted from December 2021 to March 2022 in hospitals affiliated with Shiraz University of Medical Sciences. Benson's relaxation technique was performed twice daily by the intervention group for 8 weeks. Quality of life was measured before and after the intervention using the SF-36 questionnaire. Data were analyzed using SPSS version 21 software, with a significance level set at a P-value of < 0.05.

Results

After the intervention, the results showed that Benson's relaxation technique led to an increase in the quality of life in the intervention group (P-value < 0.0001). In terms of quality-of-life dimensions, significant improvements were observed in the intervention group in the domains of physical problems (P-value = 0.026), emotional problems (P-value = 0.010), general health (P-value < 0.038), pain (P-value = 0.0001), and social functioning (P-value = 0.001). However, no significant differences were found in the dimensions of physical functioning (P-value = 0.294), energy (P-value = 0.078), and emotional well-being (P-value = 0.087).

Conclusions

Benson's relaxation technique can serve as a complementary method to enhance various dimensions of the operating room nurses’ quality of life.

Trial Registration Number:

IRCT20211002052650N1 with the Clinical Trial Registry (26.10.2022)

operating room

quality of life

relaxation therapy

Quality of life, as a multidimensional, extensive, and complex concept, is widely discussed in various fields, including health and medicine (1, 2). This concept evaluates overall functioning, expectations, standards, concerns, and individual well-being and directly correlates with the sense of well-being in life (3, 4). Numerous factors influence the quality of life. Age, culture, gender, education, socioeconomic status, illness, and social environment, along with behavioral factors, job stress, and inadequate coping resources, can lead to physical and mental health problems in individuals, ultimately reducing their quality of life (5–8). The importance of health status and quality of life is such that some proponents consider improving quality of life the primary goal of therapeutic interventions (9). In constantly changing medical environments, professional stress has continuously increased, leading to an analysis of an individual's quality of life. Among all healthcare professions, nurses, due to the physical and mental stressors associated with patient care, are more exposed to occupational burnout, fatigue, decreased satisfaction, and reduced quality of life (10). Healthcare professionals face unpredictable challenges in a complex work environment due to factors such as high workload, shift work, low staff numbers, and high stress levels, which may affect their job satisfaction and professional quality of life (6, 11–14). Healthcare workers may experience psychiatric symptoms such as anxiety and sleep disturbances. These symptoms can negatively impact problem-solving skills and worsen their quality of life (15). In their study, Ying et al. stated that nurses experiencing depression had a lower quality of life (16). In the study by Caputo et al., stressors in clinical environments were identified as a risk factor for fatigue, reduced quality of life, and work motivation among nurses (5). Therefore, considering the conditions and determining factors in the relationship between health and work, it is impossible to separate an individual's physical and mental health from his/her professional activities and work environment (17). Among healthcare professionals, operating room nurses are susceptible to various occupational hazards, including prolonged standing, awkward positioning during surgery, continuous performance of repetitive and monotonous tasks, rapid movements in emergencies, direct contact with patients’ blood or body fluids, and lifting heavy objects, which may lead to increased occupational stress (18, 19). Indeed, the high volume of workload and long hours spent on complex procedures (20) and performing emergency procedures during night shifts place operating room nurses under high levels of physical and mental stress (18). The operating room is a high-risk, dynamic environment with high responsibilities, where multidisciplinary professional teams are responsible for providing safe and effective treatment to patients (20, 21). Operating room nursing, as defined by the Association of Perioperative Registered Nurses (AORN), encompasses nursing activities before, during, and after surgical procedures (22). In the surgical environment, nurses play a key role in delivering patient-centered care using best practices (23). Therefore, increased support for operating room nurses to employ safe surgical techniques and achieve better outcomes is essential (24). Despite the importance of the quality of life in improving nursing skills and social functioning, few non-pharmacological interventions, including psychological-behavioral interventions, mindfulness, and yoga, have been conducted at the national and international levels. Relaxation techniques are among the accessible treatment options for nursing, which have recently received considerable attention (25–28). Among these interventions is Benson's relaxation technique, introduced by Herbert Benson (29). Benson's relaxation technique is a non-pharmacological method that has been investigated for its effects on sleep quality (30, 31), pain reduction (32), depression, anxiety, and stress (33–35), fatigue (36), acceptance and understanding of hemophilic patients (37), and preoperative anxiety (38). This technique may also be effective in improving the quality of life of operating room nurses. However, in recent literature reviews, no published studies have been conducted in this area. Operating room nurses are under both physical and psychological stress (39). The present study was conducted to determine the effect of Benson's relaxation technique on the quality of life of operating room personnel.

Study Design:

This randomized controlled trial was conducted at Namazi, Faghihi, Khalili, Rajaei, and Chamran hospitals affiliated with Shiraz University of Medical Sciences (SUMS), Iran, from December 2021 to March 2022.

Participants:

Participants included operating room nurses who were willing to participate in the study, had obtained a quality-of-life score of less than 50% before the intervention, and had not participated in interventional studies such as therapeutic massage, relaxation therapy, and similar interventions during the past three months. The exclusion criteria included incomplete questionnaire responses and self-reported participants' exposure to known psychiatric illnesses such as depression, anxiety, and psychosis, as well as encountering crises such as mourning or divorce (as these factors could affect the participants' focus and proper execution of the Benson's relaxation technique).

Sample Size Calculation:

Based on a similar previous study using NCSS software, with α = 0.05, a power of 80% (37), and considering µ1-µ2 equal to 20.95 and δ equal to 12.31 and 13.63 in the control and intervention groups, respectively, the maximum sample size of 180 individuals (90 individuals in each group) was considered. The following formula was used to determine the sample size.

$$\varvec{n}=\frac{{({\varvec{Z}}_{1-\raisebox{1ex}{$\varvec{\alpha }$}\!\left/ \!\raisebox{-1ex}{$2$}\right.}+{\varvec{Z}}_{1-\varvec{\beta }})}^{2} ({\varvec{\sigma }}_{1}^{2}+{\varvec{\sigma }}_{2}^{2}) }{{({\varvec{\mu }}_{1}-{\varvec{\mu }}_{2})}^{2}}$$

$$\varvec{n}=\frac{{(1/96+0/84)}^{2} ({63/13}^{2}+{31/12}^{2}) }{{(52/95-32)}^{2}}$$

Sample Size:

At the beginning of the study, 198 individuals were assessed. However, 18 participants were excluded from the study due to failure to meet the inclusion criteria (n = 13), refusal to participate (n = 2), and other reasons (n = 3) (Fig. 1). Ultimately, 90 individuals were included in each of the control and intervention groups for analysis.

Data Collection and Ethical Considerations:

The present study commenced after obtaining ethical approval from the Ethics Committee of Shiraz University of Medical Sciences (IR.SUMS.REC.1398.1331). At the outset, the study objectives were explained to the operating room nurses who participated in the study, and written informed consent was obtained. Additionally, the participants were assured of the confidentiality of their information and the voluntary nature of their participation. Before the intervention, the Short Form Health Survey (SF-36) questionnaire was administered to assess the quality of life of the participants. Those who scored less than 50% were included in the study.

Intervention Procedure:

Initially, participants were randomly divided into two groups using block randomization with block sizes of four. This block was created using a sealed randomization list (https://www.sealedenvelope.com/simple-randomiser/v1/lists). Then, the questionnaire was given to both groups. Subsequently, the Benson relaxation technique program was implemented in the intervention group. It is noteworthy that those involved in data collection and analysis were blinded to the study groups.

To commence the intervention, we prepared an instructional pamphlet for the intervention group, defining and emphasizing the importance of the quality of life, explaining the implementation of the Benson relaxation technique, and highlighting the significance of regular practice. Participants were given two days to study the pamphlet and mentally prepare. Following the pamphlet study, a practical session was conducted collectively for male and female participants, where a consultant explained the technique and participants practiced it. Any queries or concerns raised by the participants were addressed during this session.

Participants were then positioned comfortably in a dark room, lying or sitting on a comfortable bed or sofa. Their bodies were kept warm with appropriate blankets or additional clothing, if necessary. Participants closed their eyes and focused away from any tension, concentrating on positive thoughts. A sound file containing instrumental music along with the Benson relaxation technique was played for 20 minutes. Participants were instructed to consciously control their breathing through their noses calmly and naturally while listening to the music. They were reassured that they should not worry about deeply relaxing and should allow relaxation to occur naturally.

The Benson relaxation technique was to be performed regularly twice a day for eight weeks, with a gap of 4–6 hours between each session (40). Participants recorded their practice in a daily log provided beforehand. The method of completing the log was explained during the practical training session. If a participant forgot to perform the intervention on any occasion, the log would remain blank. Recording the time and date of the relaxation sessions served three purposes: preventing forgetfulness during the eight weeks, ensuring better timing coordination for the participants, and allowing the researcher to verify the number of relaxation sessions conducted during the eight weeks, thereby ensuring a complete and reliable sample size in this regard.

The control group did not receive any relaxation interventions. To prevent contamination, no information about the intervention was provided to the control group participants, and those in the intervention group were instructed not to share any information about the Benson relaxation technique with the control group. After eight weeks, the relevant questionnaire was again provided to participants in both the control and intervention groups for completion. Subsequently, the collected data were analyzed using SPSS version 21.

Data Collection Tools:

The research data were collected using a demographic information form covering age, gender, marital status, number of children, educational level, work field, shift type, employment status, work experience, history of specific diseases, genetic diseases, working hours per week, night shifts per month, and double shifts per day (long shift) per month, as well as the SF-36 questionnaire to assess the quality of life.

SF-36 Health Survey: The SF-36 questionnaire, consisting of 36 items, was designed by Ware and Sherbourne in 1992 in the United States, and its validity and reliability were assessed in various groups of patients (41). This questionnaire evaluates eight different domains of health (general health, physical functioning, role limitations due to physical health, role limitations due to emotional health, bodily pain, social functioning, vitality, and mental health). It assesses the quality of life of individuals, with the lowest score being zero and the highest 100. In the study carried out by Zhang et al., the correlation coefficients (r > 0.50) of the items in various domains were relatively high, indicating the good structural validity of this scale. Additionally, the reliability of this questionnaire was reported to be 0.79 according to Cronbach's alpha coefficient (42). The validity and reliability of the Persian version of this questionnaire have also been confirmed in Iran. Montazeri et al. reported the reliability of this questionnaire as 0.87, with internal consistency coefficients of the 8 sub-scales ranging from 0.70 to 0.85. Test-retest reliability with a one-week interval ranged from 0.43 to 0.79. Convergent validity results showed correlations between 0.58 and 0.95. Factor analysis identified two main components that together accounted for 65.9% of the variance (43). In the study by Beshiri Nezhadyan et al., the reliability of this questionnaire was also calculated using Cronbach's alpha method, yielding a value of 0.85 (44).

The mean age of the participants in the intervention group was 44.32 years, while it was 47.32 years in the control group. Half of the individuals in the control group were single, and more than half of those in the intervention group were married. Most participants in both control and intervention groups were employed in general surgery. Moreover, more than half of the participants in both groups had a bachelor's degree. The work experience of participants in the intervention group was 67.8, compared to 85.6 in the control group. Overall, the two groups were homogeneous in terms of demographic characteristics (P-value > 0.05) (Table 1).

Table 1

The participants’ Characteristics (n = 180)
Individual Characteristics		Control Group Number (percentage) / Mean ± Standard Deviation	Intervention Group Number (percentage) / Mean ± Standard Deviation	Significance Level
Gender	Male	41 (45.6)	43 (47.8)	0.765
Gender	Female	49 (54.4)	47 (52.2)	0.765
Marital Status	Single	45 (50)	43 (47.8)	0.766
Marital Status	Married	45 (50)	47 (52.2)	0.766
Hospital Name	Khalili Hospital	17 (18.9)	19 (21.1)	0.994
	Namazi Hospital	19 (21.1)	17 (18.9)
	Faghihi Hospital	18 (20)	18 (20)
	Rajaei Hospital	18 (20)	18 (20)
	Chamran Hospital	18 (20)	18 (20)
Education Level	Diploma	1 (1.1)	0 (0)	0.621
	Bachelor's	87 (96.7)	89 (98.9)
	Master's	2 (2.2)	1 (1.1)
Work Field	Orthopedics	33 (36.7)	41 (45.6)	0.266
	Urology	17 (18.9)	17 (18.9)
	Neurology	34 (37.8)	31 (34.4)
	General	45 (50)	45 (50)
	Women	7 (7.8)	5 (5.6)
	Eye	14 (15.6)	18 (20)
	Ear, Nose, and Throat	14 (15.6)	13 (14.4)
Work Shift Type	Fixed	13 (14.4)	14 (15.6)	0.835
Work Shift Type	Rotating	77 (85.6)	76 (84.4)	0.835
Employment Status	Formal Employment	54 (60)	62 (68.9)	0.539
	Contractual	5 (5.6)	6 (6.7)
	Semi-Contractual	2 (2.2)	2 (2.2)
	Company	1 (1.1)	0 (0)
	The Post-Graduation Obligatory Service in Nursing	28 (31.1)	20 (22.2)
Age		32.44 ± 7.1	32.7 ± 6.01	0.412
Work experience (years)		8.67 ± 7.58	9.18 ± 6.85	0.418
Weekly Working Hours		49.02 ± 9.97	49.15 ± 9	0.909
Number of Night Shifts per Month		2.65 ± 2.09	2.73 ± 2.26	0.876
Number of Double Shifts per Month		10.45 ± 3.83	10.28 ± 3.35	0.811
• p < 0.05 indicates significance.

The comparison of the quality of life of operating room personnel between the two control and intervention groups before Benson relaxation was not significant (P-value = 0.165). Furthermore, the findings indicated that the quality of life of operating room personnel in both control and intervention groups became significant after Benson relaxation (P-value = 0.001). On the other hand, the comparison between the control and intervention groups showed that Benson relaxation resulted in increased quality of life in the intervention group (P < 0.0001). In terms of the dimensions of quality of life between the control and intervention groups after Benson relaxation, disorders related to physical problems (P = 0.026), emotional problems (P = 0.010), general health (P-value < 0.038), pain (P = 0.0001), and social functioning (P = 0.001) were significant. However, physical functioning (P = 0.294), energy (P = 0.078), and emotional well-being (P = 0.087) were not significant. On the other hand, the comparison between the two control and intervention groups showed that Benson relaxation led to improvement in disorders related to physical problems (P = 0.002), emotional problems (P < 0.0001), energy (P < 0.0001), emotional well-being (P < 0.0001), social functioning (P < 0.0001), pain (P < 0.0001), and general health (P = 0.001) in the intervention group (Table 2).

Table 2

Determination and Comparison of the Mean Scores for Dimensions and Total Quality of Life Questionnaire between and within the Intervention and Control Groups before and after the Intervention
Variable		Group		P-value between groups
Variable		Intervention	Control	P-value between groups
Physical Functioning	Before	75.05 ± 22.19	75.44 ± 20.52	0.904
Physical Functioning	After	83.61 ± 16.81	80.66 ± 18.90	0.294
P-value within the group		< 0.0001^**	0.045^*
Role Dysfunction Due to Physical Problems	Before	54.72 ± 36.12	55.83 ± 35.95	< 0.0001**
Role Dysfunction Due to Physical Problems	After	66.01 ± 30.73	53.88 ± 35.92	0.026*
P-value within the group		0.002^*	0.616
Role Dysfunction Due to Emotional Problems	Before	41.48 ± 36.14	53.70 ± 38.28	0.002*
Role Dysfunction Due to Emotional Problems	After	66.29 ± 34.07	51.48 ± 38.43	0.010*
P-value within the group		< 0.0001^**	0.597
Energy	Before	53.27 ± 18.77	56.66 ± 19.35	< 0.0001**
Energy	After	61.72 ± 13.63	57.11 ± 17.25	0.078
P-value within the group		< 0.0001^**	0.750
Emotional Well-being	Before	58.80 ± 19.05	62.57 ± 18.06	< 0.0001**
Emotional Well-being	After	67.60 ± 14.29	63.60 ± 15.49	0.087
P-value within the group		< 0.0001^**	0.923
Social Functioning	Before	55.97 ± 21.13	59.44 ± 21.39	< 0.0001**
Social Functioning	After	65.41 ± 16.01	55.97 ± 18.57	0.001**
P-value within the group		< 0.0001^**	0.098
Pain	Before	60.61 ± 20.33	22.68 ± 63.22	< 0.0001**
Pain	After	72.63 ± 19.14	58.86±	< 0.0001**
P-value within the group		< 0.0001^**	0.025^*
General Health	Before	57.55.18.10	60.05 ± 18.04	0.400
General Health	After	65.05 ± 14.49	60.27 ± 14.44	0.038^*
P-value within the group		0.001^**	0.962
*p < 0.05 is significant.
**p ≤ 0.001 is significant.

A comparison of the mean differences before and after the intervention between the groups showed that the mean quality of life score increased after the intervention (P_value < 0.0001). Furthermore, the comparison of mean differences before and after the intervention between the groups regarding dimensions of disorders related to physical problems (P = 0.001), emotional problems (P < 0.0001), energy (P < 0.0001), emotional well-being (P < 0.0001), social functioning (P < 0.0001), pain (P < 0.0001), and general health (P = 0.018) indicated improvement in each of these dimensions after the intervention (Table 3).

Table 3

Comparison of the Mean Differences before and after the Intervention between the Groups
Variable	Group		P-value
Variable	Control	Intervention	P-value
Physical Functioning	5.22 ± 15.91	8.55 ± 20.46	0.093
Physical Role Dysfunction Due to Physical Problems	-1.94 ± 37.33	11.29 ± 33.94	0.001**
Emotional Role Dysfunction Due to Emotional Problems	-2.22 ± 42.92	24.81 ± 37.58	< 0.0001**
Energy	0.44 ± 16.29	8.44 ± 14.85	< 0.0001**
Emotional Well-being	1.02 ± 15.43	8.80 ± 14.00	< 0.0001**
Social Functioning	-3.74 ± 21.20	9.44 ± 21.30	< 0.0001**
Pain	-4.36 ± 20.31	12.02 ± 21.67	< 0.0001**
General Health	0.22 ± 20.60	7.50 ± 21.04	0.018*
*p < 0.05 is significant.
**p ≤ 0.001 is significant.

Nurses are considered the largest group of healthcare providers. Therefore, the quality of life of nurses directly or indirectly affects the quality and safety of healthcare services and, consequently, the health of patients (45). Thus, identifying the influential elements in the quality of life of operating room nurses, considering all their physical, mental, cultural, and social dimensions, can play a significant role in improving healthcare services and ultimately enhancing the community health. The aim of the present study was to investigate the effect of Benson relaxation on the quality of life of operating room personnel.

According to the results of this study, the implementation of the Benson relaxation technique led to an improvement in the quality of life of the intervention group. Nurses who performed the Benson relaxation technique reported a higher quality of life. Additionally, in the present study, the Benson relaxation technique improved the scores of the quality-of-life questionnaire and its subscales related to physical problems, emotional problems, social functioning, pain, and general health in operating room nurses.

Similarly, it has been shown that the Benson relaxation technique enhances the quality of life in various dimensions in the healthcare domain (46–48). The results of multiple studies indicate the impact of the Benson relaxation technique on reducing patient pain (37, 49, 50). It seems that the Benson relaxation technique helps individuals reduce negative thoughts and feelings associated with pain by accepting illness and unchangeable life conditions, consequently reducing pain severity. Furthermore, the Benson relaxation technique has a significant effect on reducing disorders related to physical problems and emotional problems, including anxiety and depression, and improving general health (46, 51). Veiga et al. examined the effects of occupational stress and burnout on nurses and identified the influence of physical and mental health on these healthcare professionals. The results showed that occupational safety hazards and other workplace problems may affect the nurses' social functioning, job satisfaction, and general health. Moreover, the lack of essential resources such as equipment, medications, and laboratory facilities, as well as any sense of insecurity, can lead to increased job stress and poor outcomes for patients (52). It seems that Benson’s relaxation, by improving autonomic nervous system activity through muscle relaxation, improves individual and social performance and ultimately increases positive feelings in individuals (53). In this regard, Rambod et al. recommended educating the nurses and implementing this technique to improve the quality of sleep. They stated that using this technique can reduce physical discomfort, create muscle relaxation, and alleviate anxiety disorders, which can be effective in improving individuals' sleep quality (54). In summary, it seems that the Benson’s relaxation technique, as a complementary therapy, supports a comprehensive and extensive self-care program encompassing the physical, emotional, mental, and spiritual aspects of individuals.

Working in an environment with high-risk and critically ill patients, occupational stressors such as high workload, stress from infection risk, and many other factors can have many adverse effects and consequences that can affect the quality of life of nurses. Borzoui et al. showed that performing relaxation techniques reduces the nurses' anxiety levels after the intervention (55). Additionally, Hassanzadeh et al. found that the Benson relaxation technique improved attention, a wide range of physical and mental symptoms, pre-stress symptoms, anxiety, mood, and self-confidence (56). Based on the results of multiple studies, stress management strategies such as Benson’s relaxation technique can help reduce occupational stress and improve patient outcomes (46, 55–57). Therefore, different interventions for reducing occupational stress and improving quality of life, including psychological interventions among various groups of nurses, are needed (25, 26, 58, 59). Although the outcome variables in the mentioned studies and the present study are different, it can be concluded that the use of relaxation techniques in individuals can lead to improvement in various dimensions of their mental, physical, emotional, and social aspects. Our findings may provide some evidence to support the effects of psychological interventions and relaxation techniques on the quality of life, filling in some of the missing evidence. However, more studies are needed to expand the existing knowledge about the impact of employing the Benson’s relaxation technique on the quality of life of nurses, especially operating room nurses.

One of the strengths of this study was that the implementation of Benson’s relaxation technique resulted in an improvement in the quality of life in various dimensions among operating room nurses. Therefore, this technique can be recommended as a complementary method for improving the quality of life of operating room nurses. One limitation of this study was that the participants were limited to operating room nurses, so the results cannot be generalized to other nurses in different clinical settings. Another limitation of the study was the short intervention and follow-up periods. It is suggested that longer, longitudinal studies should be conducted on this topic. Furthermore, it is recommended that this intervention should be used for all nursing groups in various clinical settings.

The study results demonstrated that Benson's relaxation technique led to an improvement in the quality of life among operating room nurses across various dimensions. To enhance evidence-based practice, further studies on this subject are recommended. Moreover, the impact of Benson's relaxation technique on other occupational outcomes of operating room nurses, such as the levels of stress and anxiety, sleep quality, physical activity, and self-efficacy, is suggested for investigation in future studies.

Acknowledgments:

This project was conducted under approved grant of 20070 and ethics code of IR.SUMS.REC.1398.1331 at Shiraz University of Medical Sciences. The authors express their gratitude to the Vice Chancellor for Research and Technology of Shiraz University of Medical Sciences, the Clinical Research Development Center of Namazi Hospital and Dr Nasrin Shokrpour for editorial assistance, and the operating room personnel who participated in the study.

Authors' contributions

Study concept and design (Z.M, Sina Ghanbarzadeh, A.E, FA.H); Data collection (A.E, Somaye Gheisari); Acquisition of subjects and/or data analysis and interpretation (Z.M, FA.H); Preparation, reading and approving the manuscript (all authors).

Ethics approval and consent to participate

This study was conducted in accordance with the Declaration of Helsinki. The protocol was approved by Institutional Review Board (IRB) of Committee on Ethics at Shiraz University of Medical Sciences with code number: " IR.SUMS.REC.1398.1331". The participants delivered their written informed consent ahead of conducting the study. Furthermore, the participation in the study was voluntary and the participants could be excluded at any stage of the study.

Consent for publication

Not applicable.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on request.

Competing interests

The authors declare that they have no competing interests.

Funding

This study was supported by the Shiraz University of Medical Sciences.

Haraldstad K, Wahl A, Andenæs R, Andersen JR, Andersen MH, Beisland E, et al. A systematic review of quality of life research in medicine and health sciences. Qual Life Res. 2019;28:2641–50.
Aggarwal AN. Quality of life with tuberculosis. J Clin tuberculosis other Mycobact Dis. 2019;17:100121.
Group W. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403–9.
Sitlinger A, Zafar SY. Health-related quality of life: the impact on morbidity and mortality. Surg Oncol Clin. 2018;27(4):675–84.
Caponnetto P, Magro R, Inguscio L, Cannella MC. Quality of life, work motivation, burn-out and stress perceptions benefits of a stress management program by autogenic training for emergency room staff: A pilot study. Mental Illn. 2018;10(2):67–70.
Ruiz-Fernández MD, Pérez-García E, Ortega-Galán ÁM. Quality of life in nursing professionals: Burnout, fatigue, and compassion satisfaction. Int J Environ Res Public Health. 2020;17(4):1253.
Nazir A, Smalbrugge M, Moser A, Karuza J, Crecelius C, Hertogh C, et al. The prevalence of burnout among nursing home physicians: an international perspective. J Am Med Dir Assoc. 2018;19(1):86–8.
Nogueira LS, RMCd S, Santos GES, MAd, Turrini RNT. Cruz DdALMd. Burnout and nursing work environment in public health institutions. Revista brasileira de enfermagem. 2018;71:336–42.
Edwards D, Burnard P, Coyle D, Fothergill A, Hannigan B. Stress and burnout in community mental health nursing: a review of the literature. J Psychiatr Ment Health Nurs. 2000;7(1):7–14.
Vieira NF, Nogueira DA, de Souza Terra F. Avaliação do estresse entre os enfermeiros hospitalares [Stress assement among hospital nurses][Evaluacíon del estrés entre enfermeras del hospital]. Revista Enfermagem UERJ. 2017;25:14053.
Ramirez-Baena L, Ortega-Campos E, Gomez-Urquiza JL, Cañadas-De la Fuente GR, De la Fuente-Solana EI. Cañadas-De la Fuente GA. A multicentre study of burnout prevalence and related psychological variables in medical area hospital nurses. J Clin Med. 2019;8(1):92.
Oshodi TO, Bruneau B, Crockett R, Kinchington F, Nayar S, West E. The nursing work environment and quality of care: Content analysis of comments made by registered nurses responding to the Essentials of Magnetism II scale. Nurs Open. 2019;6(3):878–88.
Al Sabei SD, Labrague LJ, Miner Ross A, Karkada S, Albashayreh A, Al Masroori F, et al. Nursing work environment, turnover intention, job burnout, and quality of care: The moderating role of job satisfaction. J Nurs Scholarsh. 2020;52(1):95–104.
Bautista JR, Lauria PAS, Contreras MCS, Maranion MMG, Villanueva HH, Sumaguingsing RC, et al. Specific stressors relate to nurses' job satisfaction, perceived quality of care, and turnover intention. Int J Nurs Pract. 2020;26(1):e12774.
Korkmaz S, Kazgan A, Çekiç S, Tartar AS, Balcı HN, Atmaca M. The anxiety levels, quality of sleep and life and problem-solving skills in healthcare workers employed in COVID-19 services. J Clin Neurosci. 2020;80:131–6.
An Y, Yang Y, Wang A, Li Y, Zhang Q, Cheung T, et al. Prevalence of depression and its impact on quality of life among frontline nurses in emergency departments during the COVID-19 outbreak. J Affect Disord. 2020;276:312–5.
de Freitas FMB, Vannuchi MTO, Haddad MCL, de Carvalho Silva LG, Rossaneis MA, HARDINESS AND OCCUPATIONAL STRESS IN NURSES MANAGERS OF HOSPITAL INSTITUTIONS. J Nurs UFPE/Revista de Enfermagem UFPE. 2017;11(10).
Kasatpibal N, Whitney JD, Katechanok S, Ngamsakulrat S, Malairungsakul B, Sirikulsathean P, et al. Practices and impacts post-exposure to blood and body fluid in operating room nurses: A cross-sectional study. Int J Nurs Stud. 2016;57:39–47.
Asghari E, Dianat I, Abdollahzadeh F, Mohammadi F, Asghari P, Jafarabadi MA, et al. Musculoskeletal pain in operating room nurses: Associations with quality of work life, working posture, socio-demographic and job characteristics. Int J Ind Ergon. 2019;72:330–7.
Zhou J, Yang Y, Qiu X, Yang X, Pan H, Ban B, et al. Serial multiple mediation of organizational commitment and job burnout in the relationship between psychological capital and anxiety in Chinese female nurses: A cross-sectional questionnaire survey. Int J Nurs Stud. 2018;83:75–82.
Bharathan R, Aggarwal R, Darzi A. Operating room of the future. Best Pract Res Clin Obstet Gynecol. 2013;27(3):311–22.
Committee AS. House of delegates–Implications and directions. AORN J. 1978;27(6):1153–78.
Gutierres LS, Santos JLGd, Peiter CC, Menegon FHA, Sebold LF, Erdmann AL. Good practices for patient safety in the operating room: nurses' recommendations. Revista brasileira de enfermagem. 2018;71:2775–82.
Sonoda Y, Onozuka D, Hagihara A. Factors related to teamwork performance and stress of operating room nurses. J Nurs Adm Manag. 2018;26(1):66–73.
Kowitlawkul Y, Yap S, Makabe S, Chan S, Takagai J, Tam W, et al. Investigating nurses’ quality of life and work-life balance statuses in Singapore. Int Nurs Rev. 2019;66(1):61–9.
Kent W, Hochard KD, Hulbert-Williams NJ. Perceived stress and professional quality of life in nursing staff: How important is psychological flexibility? J Context Behav Sci. 2019;14:11–9.
Love MF, Sharrief A, Chaoul A, Savitz S, Beauchamp JES. Mind-body interventions, psychological stressors, and quality of life in stroke survivors: A systematic review. Stroke. 2019;50(2):434–40.
Senchak JJ, Fang CY, Bauman JR. Interventions to improve quality of life (QOL) and/or mood in patients with head and neck cancer (HNC): A review of the evidence. Cancers head neck. 2019;4(1):1–11.
Benson H, Klipper MZ. The relaxation response: Morrow New York; 1975.
Habibollahpour M, Ranjkesh F, Motalebi SA, Mohammadi F. The Impact of Benson's relaxation technique on the quality of sleep in the elderly. Top Geriatric Rehabilitation. 2019;35(1):88–94.
Moradi Mohammadi F, Bagheri H, Khosravi A, Ameri M, Khajeh MM. The effect of Benson relaxation technique on sleep quality after coronary artery bypass graft surgery. Avicenna J Nurs Midwifery Care. 2020;27(6):371–80.
Solehati T, Rustina Y. Benson relaxation technique in reducing pain intensity in women after cesarean section. Anesthesiology pain Med. 2015;5(3).
Elsayed EBM, Radwan EHM, Elashri NIEA, El-Gilany A-H. The effect of Benson's relaxation technique on anxiety, depression and sleep quality of elderly patients undergoing hemodialysis. Int J Nurs didactics. 2019;9(02):23–31.
Akbari A, Ahmadi F, Jalili E, Khazaei S. The effect of relaxation technique (Jacobsen and Benson) on depression, anxiety, and stress in patients with multiple sclerosis. Curr Psychiatry Res Reviews Formerly: Curr Psychiatry Reviews. 2020;16(3):213–9.
Abu Maloh HIA, Soh KL, AbuRuz ME, Chong SC, Ismail SIF, Soh KG, et al. Efficacy of Benson’s relaxation technique on anxiety and depression among patients undergoing hemodialysis: A systematic review. Clin Nurs Res. 2022;31(1):122–35.
Mirhosseini S, Mohammadi A, Rezaei M, Mirbagher Ajorpaz N. The effect of Benson relaxation technique on the fatigue severity of patients with MS. J Client-Centered Nurs Care. 2019;5(3):175–82.
Molazem Z, Alizadeh M, Rambod M. The Effect of Benson’s Relaxation Technique on Pain Intensity, Belief, Perception, and Acceptance in adult Hemophilia Patients: A Randomized Controlled Trial. Int J community based Nurs midwifery. 2021;9(3):187.
Barabady A, Baghdassarians A, Memary E, Yazdani A, Barabady A, Sayadi S. Effect of Benson’s relaxation technique on propofol consumption and preoperative anxiety of patients undergoing cataract surgery. Anesthesiology Pain Med. 2020;10(3).
Paige J, Garbee D, Bonanno L, Kerdolff K. Qualitative analysis of effective teamwork in the operating room (OR). J Surg Educ. 2021;78(3):967–79.
Sajadi M, Goudarzi K, Khosravi S, Farmahini-Farahani M, Mohammadbeig A. Benson’s relaxation effect in comparing to systematic desensitization on anxiety of female nurses: A randomized clinical trial. Indian J Med Pediatr Oncol. 2017;38(02):111–5.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical care. 1992:473 – 83.
Zhang Y, Bo Q, Lun S-s, Guo Y, Liu J. The 36-item short form health survey: reliability and validity in Chinese medical students. Int J Med Sci. 2012;9(7):521.
Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual Life Res. 2005;14:875–82.
Bashiri Nejadian A, Bayazi MH, Johari Fard R, Rajaei A. The Relationship between Ambivalence over Emotional Expression and Health-Related Quality of Life and Adherence to Treatment in Cancer Patients: The Mediating Role of Depression and Social Support: A Descriptive Study. J Rafsanjan Univ Med Sci. 2021;20(2):163–86.
Abbasi M, Ayadi N, Pirani Z, Montazeri Z. The effect of cognitive rehabilitation on social well-being, quality of life and marital satisfaction of nurses. Iran J Health Educ Health Promot. 2017;5(3):231–9.
Jasour A, Afrasiabifar A, Zoladl M, Hosseini N. A comparative study on the effects of Mitchell and Benson relaxation techniques on quality of life of the old people in nursing homes: a quasi-experimental study. BMC Geriatr. 2023;23(1):692.
Pangaribuan SM, Purborini N, Chang H-J. Effect of Benson’s Relaxation Technique on Mental Health and Quality of Life in Hemodialysis Patients: A Literature Review. Indian J Public Health Res Dev. 2020;11(5).
Ghaljeh M, Salarzehi FK, Salehipour S. The effect of benson relaxation technique on anxiety and quality of life in patients with thalassemia major: a clinical trial. Indian J Hematol Blood Transfus. 2023:1–8.
Gaber Zaghloul M, Saied Hassan S, Saraya AAE-fA, Elmasieh MNA. Fawzy El Sayed Ali H. Effect of Benson Relaxation Technique on Pain Intensity, Anxiety Level and Sleep Quality among Post Caesarean Women. Egypt J Health Care. 2022;13(3):1002–13.
Mohamady SH, Abd Elmoniem SO, Araby OA-WA, Elrefaeys SR, Nageeb SM. Effect Of Benson Relaxation Technique On Reducing Pain And Stress Among Post Cesarean Section Mothers. J Posit School Psychol. 2022;6(8):6820–48.
Khajeh Hosseini S, Sayadi A, Mobini Lotfabad M, Heidari S. The effect of Benson’s relaxation technique on sleep quality among shift-working nurses in hospitals. Hayat. 2020;25(4):415–28.
Veiga G, Rodrigues AD, Lamy E, Guiose M, Pereira C, Marmeleira J. The effects of a relaxation intervention on nurses' psychological and physiological stress indicators: a pilot study. Complement Ther Clin Pract. 2019;35:265–71.
Reisi S, Heidari H, Sedehi M, Frouzandeh N, Masoudi R. The effect of Benson relaxation program and progressive muscle relaxation on emotional intelligence of nurses in intensive care units: A randomized clinical trial. J Clin Nurs Midwifery. 2019;8(3):414–22.
Rambod M, Pourali-Mohammadi N, Pasyar N, Rafii F, Sharif F. The effect of Benson's relaxation technique on the quality of sleep of Iranian hemodialysis patients: a randomized trial. Complement Ther Med. 2013;21(6):577–84.
Borzoee F, Quchan ADM, Tabrizi ZM, Rastaghi S, Hesari MH, Heshmatifar N. The Effect of Benson's Relaxation Technique on Occupational Stress Among Nurses Caring for Covid-19 Patients in Sabzevar, Iran. 2020.
Hassanzadeh M, Kiani F, Bouya S, Zarei M. Comparing the effects of relaxation technique and inhalation aromatherapy on fatigue in patients undergoing hemodialysis. Complement Ther Clin Pract. 2018;31:210–4.
Jourabchi Z, Satari E, Mafi M, Ranjkesh F. Effects of Benson's relaxation technique on occupational stress in midwives. Nursing2022. 2020;50(9):64–8.
Li N, Zhang L, Li X, Lu Q. The influence of operating room nurses’ job stress on burnout and organizational commitment: The moderating effect of over-commitment. J Adv Nurs. 2021;77(4):1772–82.
McFadden P, Ross J, Moriarty J, Mallett J, Schroder H, Ravalier J, et al. The role of coping in the wellbeing and work-related quality of life of UK health and social care workers during COVID-19. Int J Environ Res Public Health. 2021;18(2):815.

No competing interests reported.

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The Impact of Benson's Relaxation Technique on the Quality of Life of Operating Room Nurses in Hospitals Southwest Iran: A Randomized Controlled Trial

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