Introduction
The coronavirus disease 2019 (COVID-19), in addition to physical health problems, caused psychological health problems such as anxiety, depression, insomnia, emotional changes, fear, stigma, and post-traumatic stress syndrome. The use of drugs such as benzodiazepines in infected patients can lead to the suppression of the respiratory system and exacerbation of the disease; hence, it is better to use non-pharmaceutical methods to control the anxiety of patients. In a study, it was shown that Benson’s relaxation technique significantly reduced the anxiety of patients with breast cancer. Another study showed that this method reduced nurses’ anxiety. Stress and anxiety can weaken the body’s immune system and make them vulnerable to diseases. Considering the high prevalence of anxiety in patients with COVID-19 and its negative effects on the body organs as well as the side effects of anti-anxiety drugs, the present study aims to evaluate the effect of Benson’s relaxation technique on the anxiety of patients with COVID-19.
Methods
This is a quasi-experimental study. The study population consists of all patients with COVID-19 admitted to Amir al-Momenin Hospital affiliated to Arak University of Medical Sciences in 2021. The sample size was calculated 22 per group based on previous studies and considering 95% confidence interval and the test power of 80%. Considering the possibility of dropout, the number of samples in each group increased to 32 per group. A convenience sampling method was used to select the samples. Then, they were randomly divided into two groups of control and intervention. First, a pre-test was conducted using a demographic form and the Spielberger State-Trait Anxiety Inventory (STAI). Then, Benson’s relaxation method was taught to the experimental group. Then, the recorded relaxation audio file was provided to the experimental group through a headphone. They were instructed to perform the technique for two days twice a day, each for 15 minutes in the morning and evening (4 sessions in total). The control group did not receive any intervention. After the fourth relaxation session, the STAI was completed again by both groups. The collected data were analyzed in SPSS v. 21 software using descriptive statistics (mean and standard deviation) and inferential statistics (paired t-test, independent t-test, and chi-square test).
Results
The two groups were homogeneous in terms of demographic variables and there was no statistically significant differences between them (P>0.05) (Table 1).


The mean anxiety score in the intervention group was 55.21±8.85 before relaxation and decreased to 40.43±9.97 after relaxation, and the difference was significant (P<0.001). The mean anxiety score in the control group was 54.75±6.62 before relaxation and 52.03±6.35 after relaxation, and the difference was significant (P<0.001). The independent t-test results showed a statistically significant difference in the post-test score of anxiety between the two groups (P<0.001) (Table 2).


Discussion
Benson’s relaxation technique can reduce the anxiety of patients with COVID-19. This method as a complementary treatment, can be used along with common treatments, due to its low cost and simplicity, to reduce the anxiety of patients with COVID-19.

Ethical Considerations
Compliance with ethical guidelines
All ethical principles were considered in this study and an ethical approval was obtained from Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1400.103).

Funding
This study was funded by Arak University of Medical Sciences.

Authors' contributions
The authors equally contributed to preparing this article.

Conflicts of interest
The authors declare no conflict of interest.

Acknowledgements
The authors would like to thank the Deputy for Research and Technology of Arak University of Medical Sciences, the personnel of Amir al-Momenin Hospital, and all patients for their support and cooperation in this research.



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