Ghazavi 2010.

Methods	RCT, Iran
Participants	45 male and female nurses with B. Sc. of nursing, who exclusively worked in emergency or acute, chronic, or specialised male and female wards of psychiatry, and who scored less than 150 on the Holms and Rahe stress scale. 66.7% were married, 73.3% were on rotating shifts, and 55.4% were in the age range of 25 ‐ 30.
Interventions	1) Experimental: Communication skills training for 6 hours over 3 weeks 2) Control: No intervention
Outcomes	A stress questionnaire designed by the researcher. The questionnaire was based on Tuft‐Anderson’s questionnaire, psychiatric nurses occupational stress scale (PNOSS), and an opinion poll of some nurses working in psychiatry wards about the sources of their stress. " To determine the validity of the questionnaire designed by the researcher, it was revised and approved by five faculty members of psychiatric nursing, one PhD of nursing, three psychiatric nurses, two psychiatrists, and six psychologists." (p. 397) "The questionnaire consisted of 34 questions, on a four point scale, ranging from 0 to 3, in which 0 implied no stress, 1 mild stress, 2 moderate stress, and 3 high stress. Thus, the highest and the lowest possible scores of the questionnaire were 102 and zero, respectively. The questionnaire covered six fields; nine items on coping with threatening cases, four items on shortage of resources, nine items on personnel conflicts, five items on planning issues, four items on working load, and three items on un‐preparedness for the occupational stress of psychiatric wards. Obtaining scores equal to or less than 30 was interpreted as low stress, while stress score of 40‐62, and 63 and above indicated moderate and high stress, respectively." (p. 397)
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	"the participants were randomly assigned to two groups; experiment and control. According to the random number table, of the 23 participants in the experiment group, four (17.4%) and 19 (82.6%) were from Noor and Farabi hospitals, respectively, while of the 22 participants in the control group, 10 (45.5%) and 12 (54.5%) were from Noor and Farabi hospitals, respectively." (p. 397)
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding (performance bias and detection bias) All outcomes	High risk	Not possible, self report
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	The authors do not report about participants dropping out.
Selective reporting (reporting bias)	Unclear risk	The authors report the results of their stress questionnaire only as group means and t‐test P values.
Other bias	High risk	The only outcome measure the authors used was of their own devising and it was validated only by revision and approval by colleagues.