<?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>IRCT20230724058904N1</trial_id>
      <utrn></utrn>
      <reg_name>IRCT</reg_name>
      <date_registration>2023-07-28</date_registration>
      <primary_sponsor>Ahvaz University of Medical Sciences</primary_sponsor>
      <public_title>The effect of emotional freedom technique (EFT) on pain intensity and fatigue in patients with rheumatoid arthritis</public_title>
      <acronym></acronym>
      <scientific_title>The effect of emotional freedom technique (EFT) on pain intensity and fatigue in patients with rheumatoid arthritis</scientific_title>
      <scientific_acronym></scientific_acronym>
      <date_enrolment>2023-08-23</date_enrolment>
      <type_enrolment>anticipated</type_enrolment>
      <target_size>82</target_size>
      <recruitment_status>Complete</recruitment_status>
      <url>https://irct.ir/trial/71573</url>
      <study_type>interventional</study_type>
      <study_design>Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Randomization description: In this research, based on the results of previous studies and according to the opinion of the esteemed consultant of statistics and methodology, the number of samples will be 82 people, and random block method will be used for randomization, and people will be randomly divided into two groups (intervention group) and (group control) are placed and blocks of 4 are used.
In this way, a card will be awarded to each person who has the conditions to enter the study ̨ in chronological order upon entering the study.
Then, by merging the cards together (hitting the cards), one card is removed and its assignment is recorded and a number is assigned to it. And after that card is taken out, it is returned to the pool of other cards.
  After assigning numbers to each card in the order of choosing the cards, each person and number will be placed in groups A and B respectively. In this way, the first person is placed in group A - the second person is placed in group B - the third person is placed in group A and .... and this process continues until 82 patients are included in a random list of people.
  In order to block the samples under the supervision of a statistical consultant and based on the random sequence of the cards and according to the number of permutations of 4 ̨ random selection process by placing these permutations (6 cards) ̨ in the form of cards (AABB), (ABAB), (BABA), (BBAA), (ABBA) and (BAAB)) are considered.
  In this way, by merging the cards together again (hitting the cards), a card is removed every time until a group of 4 cards is created, which must include two A cards and two B cards.
Then each card after being removed is returned to the pool of other cards.
Finally, each block is placed in the intervention group and the control group in the chronological order created. Block 1 is the intervention group, Block 2 is the control group, and Block 3 is the intervention group, and this process will continue until 82 patients are allocated treatment.
In this way, the samples eligible to enter the study were selected and randomly placed in two intervention groups (41 people) and control (41 people).</study_design>
      <phase>N/A</phase>
      <hc_freetext>Rheumatoid Arthritis.</hc_freetext>
      <i_freetext>Intervention 1: Intervention group: After coordinating the day and time of the session, the selected samples in the intervention group are gathered in a suitable classroom with communication facilities, and they are asked to maintain the peace of the educational environment as much as possible during the session. The EFT intervention will be done in a group in a quiet room with proper light and temperature, free from environmental stimuli. The participants will be asked to complete a brief pain questionnaire and a multidimensional fatigue measurement questionnaire as a pre-test. Then the researcher will start the emotional release technique session by showing images of the desired areas for stimulation to the people of the intervention group and they will be told how to gently pressurize the desired points using the index and middle fingers, and how to do this, he will show the steps of EFT tapping on the body (face and trunk) and ask the people to tap on their body. The practice continued until everyone learned how to perform EFT and each participant was taught individually. The duration of the training of the experimental group will be 35 minutes on average.This technique will be implemented based on the basic instructions of Gary EFT. In this technique, people are asked to think about their mental workload, fatigue and pain, check the severity of their problem and give them a score between 1 and 10. Then, using the 2 index and middle fingers of your dominant hand, hit the points around your face and upper body seven times and stimulate these points. At the same time, while hitting the points loudly, say the sentences that indicate his basic problems and the pain and fatigue that the person is experiencing, together with the sentences that indicate the acceptance of these problems. In this stage (adjustment stage), the patient says: 'Although I feel tired and in pain, I accept my body and myself completely and deeply.' He repeats this sentence three times and at the same time, massages the pain point (ST14 point in acupuncture) with a radius of 5 cm. In the recall stage, 13 acupuncture points including the head (DU20), eyebrow (BL2), near the eye (GB1), under the eye (ST1), under the nose (GV26), chin (CV24), below the border of the clavicle (KD27), armpit (SP21), the border between the thumb and the outer corner of the nail (LU11), the index finger (LI 1), the middle finger (PC9), the little finger (HT9) and using the tip of the index finger and the middle finger, hit the karate point (SI 3) hits At the same time, the patient repeats the phrase 'I'm tired and I feel pain', focusing on the fatigue and pain. At Gamut stage 9, tap the Gamut point (the TH3 acupuncture point on the back of the hand between the ring finger and little finger on the metacarpal bone). At the same time, the patient must perform 9 brain stimulation movements. These movements include: closing the eyes, opening the eyes, looking down and right, looking down and left, rotating the eyes clockwise, rotating the eyes counterclockwise, humming the desired song for 2 seconds, counting numbers from 1 to 5 and again humming the desired song for 2 seconds. In the last step, the second step is repeated. This intervention is repeated for 30 minutes. After hitting again, he will check the severity of his problems (fatigue and pain) and give them a score from 1 to 10. This technique will be repeated until the severity of the problems reaches zero. After a visual presentation about the technique, people's questions about EFT will be answered. This training will continue until all patients learn how to apply EFT. Also, each participant will be taught individually how to implement the technique. Practice will continue until all participants learn how to perform the technique. The training of each intervention group lasts an average of 30 minutes. Then the researcher asks the patients to do this technique individually at home or in the hospital twice a week, 30 minutes each time, for 4 weeks and a total of 8 sessions, and explains that to ensure the correct implementation of the technique by the person ̨ reminding them to do EFT twice a week and do their homework ̜ he calls them twice a week and answers them if there are any questions. Also, patients are asked to meet the researcher in person once a week, if possible, so that the correct way of performing the technique can be checked more closely.  Then (at the end of 8 sessions), the brief pain questionnaire and the multidimensional fatigue measurement questionnaire will be given to the members of the intervention group in writing and in the presence of the researcher or as an alternative method in the form of an electronic questionnaire, and the post-test will be taken. Intervention 2: Control group: Control group: In the control group, no special action will be taken and to prevent these people from contacting the intervention group in order to prevent the effect of the emotional release technique on the patients of the control group, if the patients of the two groups are in the same room, they will be excluded from the study. After the end of the 8 sessions of technique implementation in the intervention group, the people of the control group will also be contacted to complete the brief pain questionnaire and the multi-dimensional fatigue measurement questionnaire as a post-test. And at the end of the study, each of the people in the control group will be taught how to perform EFT.</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 further information</results_IPD_description>
    </main>
    <contacts>
      <contact>
        <type>public</type>
        <firstname>Dr. Shaiste Haghighi</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Ahvaz, Golestan, Jundishapur University of Medical Sciences, Faculty of Nursing and Midwifery</address>
        <city>AHVAZ</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>1579 61357</zip>
        <telephone>+98 61 3311 0000</telephone>
        <email>info@ajums.ac.ir</email>
        <affiliation>Ahvaz University of Medical Sciences</affiliation>
      </contact>
      <contact>
        <type>scientific</type>
        <firstname>Dr. Shaiste Haghighi</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Ahvaz, Golestan, Jundishapur University of Medical Sciences, Faculty of Nursing and Midwifery</address>
        <city>AHVAZ</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>15794 - 61357</zip>
        <telephone>+98 61 3311 0000</telephone>
        <email>info@ajums.ac.ir</email>
        <affiliation>Ahvaz University of Medical Sciences</affiliation>
      </contact>
    </contacts>
    <countries>
      <country2>Iran (Islamic Republic of)</country2>
    </countries>
    <criteria>
      <inclusion_criteria>Not having speech, hearing, and movement disorders
Not experiencing severe stress such as the death of relatives and loved ones or divorce in the last 6 months
Not having obstructive airway disorders such as apnea and chronic obstructive pulmonary disease
Absence of injuries and wounds in the desired points of acupuncture</inclusion_criteria>
      <agemin>18 years</agemin>
      <agemax>65 years</agemax>
      <gender>Both</gender>
      <exclusion_criteria>Having mental problems, blindness, deafness or a history of psychological problems
Incomplete completion of the demographic information questionnaire
Unwillingness and lack of cooperation to participate in the study
Alcohol and drug addiction
Participation in pain and fatigue coping courses and other complementary courses before entering the study
Age less than 18 years or more than 65 years
Lack of literacy
Musculoskeletal and neurological problems
Existence of wound - injury and dressing in the place of the desired points to implement the technique
Lack of proficiency in Persian language</exclusion_criteria>
    </criteria>
    <health_condition_code>
      <hc_code>M13.0</hc_code>
    </health_condition_code>
    <health_condition_keyword>
      <hc_keyword>Polyarthritis, unspecified</hc_keyword>
    </health_condition_keyword>
    <intervention_code>
      <i_code>Rehabilitation</i_code>
      <i_code>Rehabilitation</i_code>
    </intervention_code>
    <intervention_keyword>
      <i_keyword>Intervention group: After coordinating the day and time of the session, the selected samples in the intervention group are gathered in a suitable classroom with communication facilities, and they are asked to maintain the peace of the educational environment as much as possible during the session. The EFT intervention will be done in a group in a quiet room with proper light and temperature, free from environmental stimuli. The participants will be asked to complete a brief pain questionnaire and a multidimensional fatigue measurement questionnaire as a pre-test. Then the researcher will start the emotional release technique session by showing images of the desired areas for stimulation to the people of the intervention group and they will be told how to gently pressurize the desired points using the index and middle fingers, and how to do this, he will show the steps of EFT tapping on the body (face and trunk) and ask the people to tap on their body. The practice continued until everyone learned how to perform EFT and each participant was taught individually. The duration of the training of the experimental group will be 35 minutes on average.This technique will be implemented based on the basic instructions of Gary EFT. In this technique, people are asked to think about their mental workload, fatigue and pain, check the severity of their problem and give them a score between 1 and 10. Then, using the 2 index and middle fingers of your dominant hand, hit the points around your face and upper body seven times and stimulate these points. At the same time, while hitting the points loudly, say the sentences that indicate his basic problems and the pain and fatigue that the person is experiencing, together with the sentences that indicate the acceptance of these problems. In this stage (adjustment stage), the patient says: 'Although I feel tired and in pain, I accept my body and myself completely and deeply.' He repeats this sentence three times and at the same time, massages the pain point (ST14 point in acupuncture) with a radius of 5 cm. In the recall stage, 13 acupuncture points including the head (DU20), eyebrow (BL2), near the eye (GB1), under the eye (ST1), under the nose (GV26), chin (CV24), below the border of the clavicle (KD27), armpit (SP21), the border between the thumb and the outer corner of the nail (LU11), the index finger (LI 1), the middle finger (PC9), the little finger (HT9) and using the tip of the index finger and the middle finger, hit the karate point (SI 3) hits At the same time, the patient repeats the phrase 'I'm tired and I feel pain', focusing on the fatigue and pain. At Gamut stage 9, tap the Gamut point (the TH3 acupuncture point on the back of the hand between the ring finger and little finger on the metacarpal bone). At the same time, the patient must perform 9 brain stimulation movements. These movements include: closing the eyes, opening the eyes, looking down and right, looking down and left, rotating the eyes clockwise, rotating the eyes counterclockwise, humming the desired song for 2 seconds, counting numbers from 1 to 5 and again humming the desired song for 2 seconds. In the last step, the second step is repeated. This intervention is repeated for 30 minutes. After hitting again, he will check the severity of his problems (fatigue and pain) and give them a score from 1 to 10. This technique will be repeated until the severity of the problems reaches zero. After a visual presentation about the technique, people's questions about EFT will be answered. This training will continue until all patients learn how to apply EFT. Also, each participant will be taught individually how to implement the technique. Practice will continue until all participants learn how to perform the technique. The training of each intervention group lasts an average of 30 minutes. Then the researcher asks the patients to do this technique individually at home or in the hospital twice a week, 30 minutes each time, for 4 weeks and a total of 8 sessions, and explains that to ensure the correct implementation of the technique by the person ̨ reminding them to do EFT twice a week and do their homework ̜ he calls them twice a week and answers them if there are any questions. Also, patients are asked to meet the researcher in person once a week, if possible, so that the correct way of performing the technique can be checked more closely.  Then (at the end of 8 sessions), the brief pain questionnaire and the multidimensional fatigue measurement questionnaire will be given to the members of the intervention group in writing and in the presence of the researcher or as an alternative method in the form of an electronic questionnaire, and the post-test will be taken.</i_keyword>
      <i_keyword>Control group: Control group: In the control group, no special action will be taken and to prevent these people from contacting the intervention group in order to prevent the effect of the emotional release technique on the patients of the control group, if the patients of the two groups are in the same room, they will be excluded from the study. After the end of the 8 sessions of technique implementation in the intervention group, the people of the control group will also be contacted to complete the brief pain questionnaire and the multi-dimensional fatigue measurement questionnaire as a post-test. And at the end of the study, each of the people in the control group will be taught how to perform EFT.</i_keyword>
    </intervention_keyword>
    <primary_outcome>
      <prim_outcome>Pain intensity. Timepoint: 4 weeks after the intervention. Method of measurement: Brief Pain Questionnaire.</prim_outcome>
      <prim_outcome>Fatigue intensity. Timepoint: 4 weeks after the intervention. Method of measurement: Multidimensional fatigue measurement questionnaire.</prim_outcome>
    </primary_outcome>
    <secondary_outcome>
      <sec_outcome>Pain interference in daily activities. Timepoint: 4 weeks after the intervention. Method of measurement: Brief Pain Questionnaire.</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>Ahvaz University of Medical Sciences</source_name>
    </source_support>
    <ethics_reviews>
      <ethics_review>
        <status>Approved</status>
        <approval_date>2023-07-24</approval_date>
        <contact_name>Ethics Committee of Jundi Shapur Ahvaz University of Medical Sciences</contact_name>
        <contact_address>: Ahvaz - Golestan Boulevard, University City, Esfand St., Jundishapur University of Medical Sciences, Ahvaz َAHVAZ Khouzestan Iran (Islamic Republic of)</contact_address>
        <contact_phone></contact_phone>
        <contact_email></contact_email>
      </ethics_review>
    </ethics_reviews>
  </trial>
</trials>
