The study was proposed to evaluate co-morbid depression, anxiety and stress associated with tinnitus patients. The study was done on 196 subjects: 100 patients suffering from subjective tinnitus associated with hearing loss (tinnitus group), 45 patients suffering from hearing loss only (hearing loss group) and 50 healthy subjects not suffering from tinnitus or hearing loss (control group); the age ranges from 20 to 60 years old. The studied sample was subjected to full ear, nose and throat examinations and audiological evaluation. Depression, Anxiety and Stress Scale (DASS) was developed by Levibond H and Levibond F to assess three self-report scales designed to measure the negative emotional status of depression, anxiety and stress. All patients and control group were evaluated by DASS. (1) Depression: males were affected more than females. All patients over 60 years were affected by depression. The duration of tinnitus seems correlating with the severity of depression. Only 2 patients (4.3 %) of the hearing loss group suffer from depression. (2) Anxiety: 90 % of males suffer from anxiety as compared to 83.3 % females. The age group 20-29 years old suffers more than other age groups. Only 4 patients (8.7 %) of hearing loss group suffer from anxiety. (3) Stress: females seem to be affected by the stress (76.7 %) more than males (67.5). Patients in age group 30-39 suffer the most from the disease. There is a direct correlation between duration of tinnitus and severity of stress. No one of the hearing loss group suffers from stress. In conclusion, depression, anxiety and stress should be taken into consideration in the treatment of patients suffering from tinnitus.

Background: It is believed that, the greater nurses uncertainty is likely to negative attitude toward their organization and the quality of patient care. Staff nurses can be empowered at all levels of the organization, if management allows them the support, encouragement and rewards them. Empowerment is the process by which a leader shares power with others or enable them to act. Autonomy plays an important part in nurses' job satisfaction and retention. Autonomy is defined as authority and accountability for one's decision and activities.Aim: To study the relationship between psychological empowerment and perceived autonomy of nurses in University and Teaching Hospitals at Menofia Governorate. Design: a descriptive correlational design. Setting: This study was conducted in two selected hospitals namely Menofia University Hospital and Shebine EL-Kom Teaching Hospital. Sample: A convenint sample of 550 nurses was included in the study. Tool: Two tools wereused to collect the data: 1-Psychological Empowerment Instrument. 2-Nurses' autonomy questionnaire.Results: There was a highly statistical significant correlation between total psychological empowerment and perceived autonomy of nurses. A significant relation was founded between the levels of autonomy and nurses' work place. While, there was insignificant relation between both of nurses' psychological empowerment and autonomy according to their age, level of education and years of experiences. Recommendations: Staff development program for nurse managers to integrate staff nurses in decision-making and to deal effectively with new ideas to promote organizational climate and empowerment of nurses.

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