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Aromatherapy for stress reduction in healthy adults: A systematic review and meta-analysis of randomized clinical trials
Abstract
The aim of this review was to systematically assess the effectiveness of aromatherapy for stress management. Seven databases were searched from their inception through April 2014. RCTs testing aromatherapy against any type of controls in healthy human person that assessed stress level and cortisol level were considered. Two reviewers independently performed the selection of the studies, data abstraction and validations. The risk of bias was assessed using Cochrane criteria. Five RCTs met our inclusion criteria, and most of them had high risk of bias. Four RCTs tested the effects of aroma inhalation compared with no treatment, no aroma, and no odour oil. The meta-analysis suggested that aroma inhalation has favourable effects on stress management (n = 80; standard mean difference (SMD), −0.96; 95% CI, −1.44 to −0.48; P < 0.0001; I2 = 0%). Three of included RCTs tested aroma inhalation on saliva or serum cortisol level compared with control and meta-analysis failed to show significant difference between two groups (n = 88, SMDs −0.62; 95% CIs −1.26 to 0.02, P = 0.06, I2 = 42%). In conclusion, there is limited evidence suggesting that aroma inhalation may be effective in controlling stress. However, the number, size and quality of the RCTs are too low to draw firm conclusions.
... It involves the use of volatile herbal oils like essences to improve the psychosomatic health. It is used to relieve pain, anxiety, depression, insomnia, fatigue and exhaustion, asthma, and even self-confidence, success, and creativity (Hur, Song, Lee, & Lee, 2014). These oils can be used through inhalation, bath, or massage. ...
... These oils can be used through inhalation, bath, or massage. The most common method used in aromatherapy is massage (Hur et al., 2014). ...
... It is believed that the aroma activates the olfactory neurons leading to stimulation of the limbic system; as a result, various neural transmitters are released depending on the type of aroma. These transmitters include enkephalin, endorphin, noradrenaline, and serotonin (Hur et al., 2014). One of the aromas with a tranquilizing effect is lavender with the scientific name Lavandula stoechas (Lavandula angustifolia) of the Labiatae family (mints). ...
To determine the effect of aromatherapy with rose and lavender on the patient outcomes after open‐heart surgery (OHS). In the clinical trial, patients were randomized to four groups. One group received routine care, the placebo group received a cotton swab soaked in water and the other two groups received either a cotton swab containing three drops of rose or lavender essence (0.2 ml). A total of 160 patients were randomized into four groups. Intergroup anxiety was not significantly different; however, the reciprocal time‐group effect was significant among the four groups. The extubation time was significant among the four groups which related to rose essence group compared with the control group (p < .001) and placebo group (p = .029). The surgical site pain was significant in the rose essence and lavender groups compared to the control group. Aromatherapy can reduce extubation time, surgical site pain severity, and anxiety in patients undergoing OHS
... Cerrahi uygulamalar dünya genelinde milyonlarca insanın ölüm ve sakatlık riskini azaltması nedeniyle kritik sağlık hizmetleri arasında yer almakta ve bu hizmetlere olan ihtiyaç gün geçtikçe artmaktadır (2). Cerrahi uygulamalar; hastanede yatış, anestezi, hastanın ameliyata ilişkin korkuları, bireyin daha önce yaşadığı olumsuz deneyimleri, bedeninin zarar göreceği algısı, ameliyat sonrası yeti yitimi ve belirsizlik, kullanılan ilaçlar, ameliyat kararı ve sürecini bekleme, cerraha olan güvensizlik, cerrahın tutumu ve postoperatif dönemde ağrı yaşama gibi durumlar hastalarda anksiyeteye neden olabilmektedir (3)(4)(5)(6). Cerrahi operasyonlar hayat kurtarıcı olsa da işlem sırasında ve sonrasında beklenen sonuçlardan birisinde hastanın ağrı hissetmesidir (2,7). Hastaların ağrı deneyimlerine ek olarak cerrahi prosedürün hastaya açıklanmasıyla başlayan ve süreç içinde artan anksiyete, bireyin günlük yaşam aktivitelerini gerçekleştirme, iyi olma, tedaviye uyum gibi süreçleri etkilemesinin yanında bireyin operasyon sonrası daha fazla ağrı yaşamasına neden olmaktadır (5). ...
... Preoperatif dönemde anksiyete yaşayan hastalarında yaklaşık %40-65'inin postoperatif dönemde orta derecede ağrı deneyimledikleri saptanmıştır (8). Ağrı ve anksiyetenin sempatik sinir sistemini aktive etmesiyle ortaya çıkan katekolamin salınımı, nabız artışı ve kan basıncının yükselmesine neden olur (6,7). Bu durum uykunun başlamasını ve uykunun sürdürülmesini engellemektedir (9). ...
Objective:A descriptive and correlational study was conducted to determine the effect of pain and anxiety on sleep quality in patients hospitalized in surgical clinics.Materials and Methods:The population of the study consisted of patients who were hospitalized in the surgical clinics of a university hospital in April-June 2019 and accepted to participate in the study. Two hundred-four patients who met the inclusion criteria of the study during these dates were included in the sample of the study. Ethics committee approval and permission from the institution where the study was conducted were obtained before starting the study. Data were collected using the patient identification form, the numerical pain rating scale (NPS), state anxiety scale (SAS) and Richard-Campbell sleep scale (RCSS). Number, percentage, mean, standard deviation, correlation and regression analysis were used in the evaluation of the data.Results:It was determined that 32.8% of the patients participating in the study were hospitalized in the general surgery service and 51.0% had surgery. It was found that 48.0% of the patients had sleep problems during their stay in the hospital and 54.1% of the patients having sleep problems had sleep problems due to pain. It was determined that the mean scores of NPS, SAS, and RCSS (3.77±2.52; 42.15±9.99; 49.61±25.34, respectively) were at a moderate level. A statistically significant negative correlation was found between the patients’ mean NPS and SAS scores and the mean RCSS scores (p
... Another nonpharmacological technique is aromatherapy. Aromatherapy is one of the Complementary Alternative Medicine techniques that use essential oils derived from plants that can be obtained efficacy through topical application or inhalation (Hur, Song, Lee, &Lee, 2014). The aroma of inhaled oil will react to the olfactory nerve that will be delivered to the central nerve and influence the mind to achieve relaxation, while the application of the skin allows the oil to be absorbed from the pores into the blood vessels and provides a muscle relaxation effect (Hur, Song, Lee, &Lee, 2014). ...
... Aromatherapy is one of the Complementary Alternative Medicine techniques that use essential oils derived from plants that can be obtained efficacy through topical application or inhalation (Hur, Song, Lee, &Lee, 2014). The aroma of inhaled oil will react to the olfactory nerve that will be delivered to the central nerve and influence the mind to achieve relaxation, while the application of the skin allows the oil to be absorbed from the pores into the blood vessels and provides a muscle relaxation effect (Hur, Song, Lee, &Lee, 2014). ...
Background: Primary dysmenorrhea is menstrual pain that occurs since menarche without the presence of pathology in the pelvis that causes disruption of daily activities and decreases the quality of life. Improved blood circulation and aromatic odors can reduce pain. in this study to find out the effectiveness of warm water compresses and lemon aromatherapy with lavender aromatherapy against the level of primary dysmenorrhea pain in young women.Methods: Pre-Experiment with One Group Pre - Post-test design approach. The sampling technique of this study is accidental Sampling. The subjects of this study were 37 young women who suffered from dysmenorrhea and met the criteria. Data analysis using the Wilcoxon test and the Whitney Mann test.Result: research shows Sig Value. (2-tailed) = 0.001. Then the value of Sig. (2-tailed) 0.05 (0.00 0.05) then Ho is rejected and Ha is accepted which can mean that warm water compress and lemon aromatherapy with warm water compress and lavender aromatherapy are effective against decreased dysmenorrhea pain.Conclusion: From the results of the study can be concluded warm water compress and aromatherapy lemon is more effective to reduce dysmenorrhea pain in young women
... Studies have reported predominantly anxiolytic and anti-stress effects, although some reports have produced conflicting findings. [1][2][3] Variations in the number of subjects, procedures, and evaluation methods among studies may contribute to such discrepancies. ...
... A meta-analysis of five RCTs 1 indicated that aroma inhalation is effective for relieving stress, although problems with the study protocols impeded the generation of definite conclusions. Inhalation of lavender, which is often used for aroma inhalation, has been reported to be effective in improving 1) anxiety and the quality of sleep in an intensive care unit, 4 2) sleep quality and fatigue in subjects undergoing hemodialysis in combination with sweet orange, 5 3) mood before menstruation, 6 4) conditions such as pain, depression, and anxiety in elderly people in combination with bergamot, 7 and 5) conditions such as pain, anxiety, and nausea in combination with ginger, sweet marjoram, and mandarin. 8 Inhalation of lavender has also been found to reduce stress in nurses, thereby improving the quality of treatment that patients receive. ...
In order to be able to use the aroma hand massage as a skill that can be done by a nurse who does not have a special aromatherapy technique, we examine anti-stress effects of simplified aroma hand massage for healthy subjects. We evaluated the anti-stress action of aroma hand massage and the different components of the procedure in 20 healthy women in their twenties. We used autonomic nervous function measured via electrocardiogram as an index of stress. After conducting a baseline electrocardiogram, we induced stress in the participants by asking them to spend 30 minutes completing Kraepelin's arithmetic test. We then administered various treatments and examined the anti-stress effects. Kraepelin's test significantly increased sympathetic nervous function and significantly reduced parasympathetic nervous function. Compared with massage without essential oil or aroma inhalation, aroma hand massage significantly increased parasympathetic nervous function and significantly decreased sympathetic nervous function. The effect of the aroma hand massage persisted when the procedure was simplified. The anti-stress action of the aroma hand massage indicates that it might have beneficial application as a nursing technique. There are several limitations in this study; ambiguities of low component/high component ratio of heart rate variability and bias by small subjects groups of the same women.
... In this work, we hypothesized that the use of essential oils obtained from lavender (Lavandula angustifolia Mill), French lavender (Lavandula dentata L.) and fennel (Foeniculum vulgare Mill.) would be effective for such conditions. dysfunction and psychological issues such as difficulty to concentrate, fatigue, irritability, neurosis and depression [6,7]. ...
... The hypothalamus releases the corticotropin releasing hormone (CRH), which stimulates the release of adrenocorticotrophic hormone (ACTH) from the pituitary. ACTH, in turn, activates the secretion of cortisol from the Adrenal glands [7,15]. Salivary cortisol has been extensively used as a biomarker of psychological stress and mental diseases, having considerable sources of variation though. ...
Introduction
Chronic stress and sleeping disorders have long been associated with anxiety. Pharmacological treatment includes benzodiazepines and selective serotonin reuptake inhibitors. The adverse effects associated with these medicines do, however, call for safer alternatives, including aromatherapy. The current study assesses the effect of intranasal administration of essential oils obtained from lavender, French lavender and fennel (Pinetonina™), on chronic stress.
Methods
Forty-five patients were divided in 3 groups: Group 1 (CTRL) received saline in nasal spray form; Group 2 (P30) received 30 % Pinetonina™ in buffered vehicle for intranasal spray; Group 3 (P50), 50 % Pinetonina™ in the same vehicle. All groups used the product for 3 months, once daily (before bedtime), using a spray-puff in each nostril. Salivary cortisol levels were measured in the beginning and at the end of the study. Quality of sleep, level of anxiety, perceived stress, and overall quality of life were measured through self-reported questionnaires.
Results
In P30 and P50, total salivary cortisol levels were significantly reduced by 37 % and 54 % respectively. Changes in perceived stress and overall quality of life showed no significant differences among the 3 groups, but P50 showed significant improvement in the quality of sleep index, as evaluated with the PSQI questionnaire. Salivary cortisol levels at time-zero and after 3 months of use were compared. Significant changes in the salivary cortisol levels for 30 % and 50 % of Pinetonina were seen after 3 months, unlike the control that showed no significant changes. Additionally, the Pittsburgh Sleep Quality Index when compared at baseline with the end of the study for the placebo and 30 % and 50 % Pinetonina. Significant changes in the quality of sleep were shown.
Conclusions
Daily intranasal use of Pinetonina™ before sleep was shown to significantly reduce salivary cortisol levels and improve quality of sleep based upon the significant differences found in the study.
... Aromatherapy is the therapeutic use of essential oils from plants. Essential oils can be absorbed into the body via the skin or the olfactory system [6]. Lavender is often mentioned as the "mother" of essential oils [3]. ...
... Hur and colleagues published another review of 5 RCTs investigating the effects of inhalation aromatherapy on stress in healthy people. They reported a SMD of À0.96 (CI; À1.44 to À0.48) for self reported stress including 4 trials and a SMD of À0.62 (CI; À1.26 to 0.02) for cortisol combining 5 trials [6]. The effect of inhalation on self-rated anxiety À0.71 of our review is smaller than À0.96 of Hur and collegues' report. ...
Purpose:
Although lavender is purported to possess anxiolytic and sedative properties and is often recommended for relieving anxiety, the efficacy of lavender has not been well established. Thus, this review aimed to evaluate the anxiolytic effects of lavender aromatherapy.
Methods:
Ten data bases were searched for studies published between 2000 and 2018. Randomized controlled trials investigating the anxiolytic effects of lavender aromatherapy with any type of application for persons with or without clinical anxiety were included. The outcome variables included self-rated anxiety, vital signs, and salivary cortisol and chromogranin A (CgA) levels. In the meta-analysis, standardized mean difference and 95% confidence interval were calculated as effect measures by applying the random effect model and inverse variance method.
Results:
Twenty-two trials met our inclusion criteria. Lavender aromatherapy was found to have favorable effects in relieving anxiety (Hedges' ĝ=-0.65; 95% CI, -0.84 to -0.46) and decreasing systolic blood pressure (ĝ=-0.22; 95% CI, -0.43 to -0.02), heart rate (ĝ=-0.53; 95% CI, -0.74 to -0.32), and salivary cortisol (ĝ=-1.29; 95% CI, -2.23 to -0.35) and CgA (ĝ=-2.29; 95% CI, -3.24 to -1.34) levels. However, the meta-analysis did not reveal any significant effects of lavender on diastolic blood pressure (effect size: -0.17; 95% CI, -0.37-0.04).
Conclusions:
Aromatherapy using lavender oil might have favorable effects on anxiety and its physiological manifestations. Future studies are recommended with an emphasis on methodological quality. In nursing practice, it is suggested that lavender aromatherapy be included in programs intended to manage anxiety in patients across diverse healthcare settings.
... In this study, when looking at the perceived stress of AG and CG after applying aromatherapy, there was no significant difference between the two groups. In a systematic literature review of the effect of aromatherapy on reducing stress in healthy adults, 24 it was found that aromatherapy had a stress-reducing effect, but there was no significant difference between AG and CG in the subjects of this study. However, seeing that the stress of both groups decreased significantly from the start of the experimental treatment to the fourth day of the experimental treatment, it appears that stress decreased relatively significantly after the covid-19 infection quarantine was lifted. ...
Background
Patients with coronavirus disease 2019 (COVID-19) usually complain of fever, cough, and sore throat. This study examined the effects of aromatherapy on sore throat, nasal symptoms, stress, fatigue, and sleep quality by administering it to adults with post-COVID-19 condition.
Methods
This study was conducted in a randomised controlled design. Its target population were adults who were released from COVID-19 quarantine treatment within 45 days from infection onset and capable of performing daily activities after isolation treatment. The participants were randomised into aromatherapy group (AG) and control group (CG). To test experimental treatment effects, the levels of sore throat, nasal symptoms, stress, fatigue and sleep quality were measured at the baseline (pre-test) and after the trial (post-test), using the numerical rating scale for sore throat, stress and fatigue, the Total Nasal Symptoms Score for nasal symptoms, and the Korean Version of Modified Leeds Sleep Evaluation Questionnaire for quality of sleep.
Results
After experimental treatment, there was a significant difference in sore throat in AG compared to CG on the 3rd day (t=-2.022 p=0.048) and 4th day (t=-2.450, p=0.017) of treatment. There was also a significant difference in fatigue between AG and CG on the 2nd day(t=-2.748, p=0.008), 3rd day (t=-2.948, p=0.005) and 4th day (t=-3.084, p=0.003) of treatment. There was no significant difference in TNSS, stress, and sleep quality between the two groups after the experimental treatment.
Conclusion
Inhaling aroma essential oils reduced sore throat and fatigue in adults with post-COVID-19 condition, demonstrating the feasibility of aromatherapy as an effective treatment.
Trial registration
The study was registered with Clinical Research Information Service (KCT0008029).
... Many uses and benefits are obtained from patchouli as a basic ingredient in perfume and as a medicinal plant for aroma therapy, namely controlling stress (Hur MH, Song JA, Lee J, 2014), eliminates labor pain (Jones L, Othman M, Dowswell T, Alfirevic Z, Gates S, Newburn M, 2012), controlling hypertension (Hur MH, Lee MS, Kim C, 2012), reduces postoperative nausea (Hines S, Steels E, Chang A, 2012) and improve symptoms of dimensia (Forrester LT, Maayan N, Orrell M, Spector AE, Buchan LD, 2014), However, empirical evidence lacks to support the way these treatments go into therapeutic treatment (Maddocks-Jennings W, 2004). Therefore, it can clearly be implemented well and in largescale randomized controlled trials to determine the level of efficacy of aroma therapy, so it is necessary to analyze the main article, author and explore research on the topical relationship of content in patchouli patchouli and can contribute to adding science in the scope of biodiversity. ...
This study is related to patchouli plants (Pogostemon Cablin) as the main published variable. The purpose of this study was to examine the profile of original scientific articles and reviews on patchouli topics using bibliometric analysis. Scientific articles related to patchouli (Pogostemon Cablin) published between 2013-2023 taken from Scopus. The notes analyzed and extracted for the following research citation characteristics, including the distribution of author names, year of publication, country or region, journals, publicators using Microsoft Excel 2016, VOSviewer v.1.61 are used to create bibliometric diagrams. A total of 303 original scientific articles and reviews, published in Scopus peer reviewed journals were written by 1732 identified authors. The number of articles that have been published continues to increase from 2013 to 2023. The majority of scientific articles written in English 283, Chinese 14, Portuguese 2, Germany 1, Indonesia 1, Russia 1 and the unidentified 1. China is the most superior country in the number of scientific articles published, namely (n = 116, 34%), the second country is Indonesia with (n = 76, 22%) articles, the third country is India with (n = 43, 13%). The article that receives the largest number of citations is published in Chinese Medicine (United Kingdom) with 1650 per year. Visualization analysis based on the accuracy of words connected in titles and abstracts has revealed several research groups, the research groups are patchouli, pogostemon cablin, bent, patchouli alcohol, essential oil. This research contributes to providing a systematic picture related to productivity and visibility of research work by focusing on patchouli plants (Pogostemon Cablin), it is hoped that this study and its findings can be used to organize and prioritize subsequent studies related to patchouli plants (Pogostemon Cablin).
... 6,7 It has been shown that pharmacologic agents such as benzodiazepines 8 as well as nonpharmacologic methods such as preoperative information, music, aromatherapy, and acupuncture can reduce preoperative anxiety. [9][10][11][12] Aromatherapy which uses essential oil derived from plants, is a complementary and alternative medicine. 13 There has been a lot of research on anxiolytic properties of Lavandula angustifolia, Rosa damascene, and Osmanthus fragrans. ...
Background:
Aromatherapy is a noninvasive method used for alleviating anxiety. Lemon verbena (Aloysia citriodora Paláu, LV) has been frequently used in traditional medicine as an anxiolytic agent due to its pharmacological ingredients.
Objective:
This randomized controlled trial aimed to assess the effects of inhaling essential oil of LV on the level of anxiety and subsequent hemodynamic changes before cesarean section.
Methods:
The recent study was a randomized single-blind trial. Participants (n = 84) were randomly divided into two groups: LV essential oil (group A) and placebo (group B). The intervention group underwent aromatherapy using three drops of LV essential oil at a distance of 10 cm for 30 min. The placebo group received aromatherapy in a similar fashion. The State-Trait Anxiety Inventory of Spielberger questionnaire was administered before and 5 min after aroma inhalation. Vital signs were recorded before and after aromatherapy. Likewise, pain severity was assessed using the Numeric Rating Scale and vital signs were recorded. Data were analyzed using t-test, χ 2, and the Kolmogrov-Smirnov test through SPSS21 software.
Results:
Anxiety level was significantly attenuated in group A after aromatherapy. Heart rate, respiratory rate, and blood pressure decreased after inhalation; but no significant variation of pain scores was observed after inhalation in both groups.
Conclusion:
We concluded that LV decreased preoperative anxiety in this recent study, therefore, aromatherapy with LV essential oil as a preemptive adjuvant to relieve anxiety before cesarean section is recommended by us; although more studies are required to endorse the results.
... Aromatherapy is a technique to reduce dysmenorrhea by using essential oils of lavender, cary sage, rose (Han et al., 2006) through topical applications or by inhalation (Han et al., 2006;Apay et al., 2012;Bakhtshrinin, Abedi, Yusefijoy, Razmjoee, 2015;Matsumoto, Asakura, & Hayashi, 2013;Rose, Ambika, & Williams, 2013) or a mixture of cinnamon oil, rose, clove, also lavender in almond oil (Marzouk, El Nemer, & Baraka, 2013). The aroma of the inhaled oil will react to the olfactory nerves which will be delivered to the central nerve and affect the mind to achieve relaxation, while application to the skin allows the oil to be absorbed from the pores into the blood vessels and gives a muscle relaxing effect (Hur, Song, Lee, & Lee, 2014). Another effect of aromatherapy can reduce both psychological and physical stress, namely reducing anxiety and reducing pain sensations and ...
Dismenorrhea is a medical condition characterized by severe uterine pain during menstruation that manifests as cyclical lower abdominal pain. Dismenorrhea is classified into primary dismenorrhea in the absence of pathology and secondary dismenorrhea in the event of an identifiable pathological condition. About 40-70% of women of childbearing age suffer from dismenorrhea accompanied by associated psychological, physical, behavioral, and social distress. This is the main cause of the decline in the quality of life of adolescents. The pathophysiological process due to increased myometrium activity caused by excessive production of prostaglandins that cause ischemia. Risk factors are very important in enforcing the diagnosis of dismenorrhea and also in distinguishing between primary and secondary dismenorrhea. Mainstay treatment is generally supportive by relieving symptoms in primary dismenorrhea and surgical treatment may be recommended for secondary dismenorrhea. Therefore, patients with primary dismenorrhea may only require simple non pharmacological and analgesic therapies, whereas patients with secondary menorrhea require treatment for major problems.
... Stres juga merupakan reaksi dalam dan luar tubuh manusia yang menyebabkan kesehatan menurun bahkan hingga menyebabkan suatu penyakit (Ansori dan Martiana, 2017). Stres yang berkepanjangan dapat menyebabkan penyakit fisik, sedangkan untuk stres akut dapat menyebabkan gangguan kecemasan (Hur et al., 2014). Menurut Arbi dan Ambarini (2018), Faktorfaktor yang menyebabkan stres diantaranya yaitu gangguan struktur dan fungsi jaringan organ maupun sistemik yang menimbulkan fungsi tubuh yang abnormal. ...
Stress and anxiety are one of the mental disorders that are still a problem in Indonesia. Stress and anxiety can be experienced by anyone that can be caused by certain conditions. Aromatherapy treatment is an alternative to reduce stress and anxiety levels. Aromatherapy is a therapy that uses essential oils as the main agent. The purpose of this study was to determine which essential oils can reduce stress and anxiety levels in various patient conditions. The method used in this research was a literature review study consist of 16 article from online search site . The results of the study showed that essential oils from lavender (Lavandula angustifolia), bergamot orange (Citrus bergamia Risso et Poiteau), lemon (Citrus limon (L.) Burm. F), peppermint (Mentha piperita L.), chamomile (Matricaria Chamomilla L), ylang flower (Cananga Odorata (ylang-ylang)), lemongrass (Cymbopogon ciratus (DC.), bitter orange (Citrus aurantium (L.), and rosemary (Rosemarinus officinalis L.) can be used to reduce stress and anxiety levels caused by certain conditions.
... Only a few studies have examined the effects of aroma on biomarkers for stress [22]. In the present study, salivary α-amylase level and cortisol concentration were measured as indices of stress response via the hypothalamic-sympathetic nervous system and hypothalamic-pituitary-adrenal (HPA) axes. ...
Background: The effect of nighttime aromatherapy on sleep has been explored. However, its effect on mood states has not been established. This study aimed to determine the effects of nighttime aromatherapy, using skin patches with lavender aroma, on mood states of young women.
Methods: Twenty-four young women slept as usual with a skin patch placed under their clothing for seven consecutive nights. One group of subjects (AROM group) used skin patches with lavender aroma, whereas the other group (CONT group) used skin patches without the aroma. The primary outcome measure was mood states assessed with the Profile of Mood States 2nd Edition (POMS 2). The secondary outcome measures were physiological indices of stress assessed by salivary α-amylase activity, cortisol concentration, and pulse rate measured immediately after waking up. Assessments were performed pre-intervention, the morning after the first intervention night, and post-intervention.
Results: Skin patches with lavender aroma improved total mood disturbance and two negative subscales scores of the POMS 2 in the AROM group over time. There was an interaction between time and treatment condition (with/without aromatherapy) for the fatigue-inertia subscale, although no interaction was detected between time and condition for total mood disturbance and the anger-hostility subscale. The positive subscales scores of POMS 2 did not change in both groups. In the AROM group, salivary α-amylase level measured the morning after the first intervention night was significantly higher than the pre-intervention level; however, there was no significant difference between pre- and post-intervention. Moreover, there were no significant changes in salivary cortisol concentration and pulse rate in both groups.
Conclusions: Unlike the AROM group, no improvement in mood states was observed in the CONT group. Low-cost and easily applicable aromatherapy using skin patches are potentially useful in stabilizing mood states in various populations.
Trial registration: UMIN-CTR, UMIN000035051. Registered 28 November 2018, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000039962
... Moreover, pleasantness negatively correlated with HR, indicating that HR increased as the pleasantness of the odor decreased. Lavender essential oil (and its main chemical components linalool and linalyl acetate) has probably been the most popular odorant when investigating the relaxing effects of odor on physiology (e.g., Chamine & Oken, 2015, 2016Cho et al., 2017;Diego et al., 1998;Field et al., 2005;Kuroda et al., 2005;Lin et al., 2021;Malcolm & Tallian, 2017;Motomura et al., 2001;Sayorwan et al., 2012;Toda & Morimoto, 2008; for reviews see Herz, 2009;Hur et al., 2014;Kang et al., 2019;Sayed et al., 2020). Several studies have reported a decrease of HR when exposed to lavender odor (Cho et al., 2017;Kuroda et al., 2005;Sayorwan et al., 2012), even though it has been claimed that participants' expectations might explain these effects (Campenni et al., 2004;Chamine & Oken, 2015;Howard & Hughes, 2008, but see Baccarani, Grondin, et al., 2021). ...
Several studies have described, often separately, the relaxing effects of music or odor on the autonomic nervous system (ANS) activity. Only a few studies compared the presentation of these stimuli and their interaction within a same experimental protocol. Here, we examined whether relaxing music (slow-paced classical pieces) and odor (lavender essential oil) either presented in isolation or in combination would facilitate physiological recovery after cognitive stress. We continuously recorded the electrocardiogram to assess the high-frequency component of heart rate variability (HF-HRV), an index of parasympathetic activity, and electrodermal activity (EDA), an index of sympathetic activity, 10 min before, during and 30 min after a cognitive stress (i.e., completing timely constrained cognitively demanding tasks) in 99 participants allocated to four recovery conditions (control N = 26, music N = 23, odor N = 24, music+odor N = 26). The stressing event triggered both a significant increase in EDA and decrease in HF-HRV (compared to baseline). During the recovery period, the odor elicited a greater decrease in EDA compared to an odorless silent control, whereas no difference in HRV was observed. Conversely, during this period, music elicited a greater increase in HF-HRV compared to control whereas no difference in EDA was observed. Strikingly, in the multimodal music+odor condition, no beneficial effect was observed on ANS indexes 30 min after stress. Overall, our study confirms that both olfactory and musical stimuli have relaxing effects after stress on ANS when presented separately only, which might rely on distinct neural mechanisms and autonomic pathways.
... Currently, common symptoms of stress can be managed through either drug therapy or psychotherapy. The latter includes music therapy [14,15], relaxation therapy [16,17], light or phototherapy [18], and aromatherapy [19]. Among these, aromatherapy is a form of complementary therapy. ...
This study aimed to evaluate the efficacy of aromatherapy in relieving the stress of nursing staff working in different departments during COVID-19. A total of 26 nursing staff from Taiwan were recruited for this study. Bergamot essential oil was diffused for over a four-week period in four different hospital departments. We assessed heart rate variability indicators, Nurse Stress Checklist, and Copenhagen Burnout Inventory before and after the intervention. The results of the analysis showed that during a high workload period, aromatherapy had no significant effect on regulating physical stress. Subjective measurements showed a significant impact on work concern and personal fatigue. Moreover, there were large differences among the four departments; the aromatherapy treatment had a weak effect on those with a heavy workload, whereas those with a lighter workload showed a stronger effect. Finally, this study provides practical results about aromatherapy stress reduction applied during the pandemic on first-line medical staff.
... While this meta-analysis included studies with combined aromatherapy, lavender was the most common herb included. 40 Lavender has also been studied for its use in anxiety and insomnia. Evidence from clinical trials shows its efficacy in treating General Anxiety Disorder when compared to placebo, 41 and a 2020 trial reported a reduction of anxiety on the Visual Anxiety Scale (VAS) in patients undergoing bone marrow biopsy. ...
Frontline healthcare workers have reported elevated levels of stress and increase prevalence of burnout symptoms since the onset of the COVID-19 pandemic. With these heightened levels of stress and burnout comes a need for more evidence-based interventions to address these symptoms earlier, in both a safe and effective way. Some common botanical medicines have a measurable effect on perceived stress, neurotransmitter levels, and circulating cortisol levels indicating their ability to modify the stress response. Botanical medicines are often relatively low cost, increasingly available in retail stores and online marketplaces, and show relatively low reports of adverse effects, making these medicinal herbs an important option for addressing work-related stress for healthcare workers.
... 12 Therefore, numerous strategies have been developed and studied to alleviate the possible adverse health effects of stress by effective management of stress through meditation, mindfulness, aromatherapy, and massage. [13][14][15][16] Among the traditional methods for stress management, hand massage reportedly has diverse effects on the human body. The known effects of hand massage include alleviation of depression and pain, 17 improvement of sleep quality, and heart rate stabilization. ...
Objective
Since the clinical benefits of a massage chair have not been fully elucidated, we aimed to assess the effects of the long-term use of a massage chair on stress measures in older adults.
Design
Randomized controlled trial
Setting
Community.
Interventions
In total, 80 adults aged 50–75 years were randomly assigned to the intervention group (n=41) and control group (n=39). The intervention group used the massage chair twice a day for 6 months. The control group was educated about lifestyle modification.
Main outcome measures
The primary outcome was the change in serum cortisol levels in the morning (8 a.m.) and afternoon (1 p.m.), and the secondary outcomes included changes in levels of dehydroepiandrosterone-sulfate (DHEA-S), serotonin, insulin-like growth factor, erythrocyte sedimentation rate, high sensitivity C-reactive protein, and natural killer cell activity, and results from a questionnaire on mood, cognition, and quality of life.
Results
The use of the massage chair was associated with a decreasing trend in serum cortisol levels at 1 p.m. (-2.68 ug/dL, p = 0.059). Serum DHEA-S levels significantly decreased with the intervention (-9.66 ug/dL, p = 0.003). In addition, the perceived rate of depression and health status considerably improved following the intervention.
Conclusions
Chronic stress in adults could be effectively managed using a massage chair.
... There are, however, many open questions regarding the underlying mechanisms of aromatherapeutic effects on serotonin release in humans. Although meta-analyses and systematic reviews report favorable effects of aromatherapeutic interventions for treating stress (Hur et al. 2014), sleep disorders (Hwang and Shin 2015), or depressive symptoms (Sanchez-Vidana et al. 2017), they do not account for neuroendocrine biomarkers like serotonin. ...
Background: The effectiveness of exogenously triggered serotonin increase (e.g. via dietary supplements, drugs) is varied. However, since urinary serotonin concentrations were found to correlate with those in the cerebrospinal fluid the olfactory system might be an efficient and testable pathway to quickly elevate serotonin levels due to its fast-acting central neurophysiological and peripheral pathways. However, little research has been devoted to investigate this assumption.
Objective: This paper extends previous findings of parasympathetic activation of a specially designed essential oil inhaler (AromaStick® Balance) by experimentally testing its impact on urine serotonin and saliva cortisol excretion.
Method: Two experiments involving healthy individuals were conducted to test the efficacy of essential oil application to the nose by employing different inhalation protocols and control conditions.
Results: In the pilot study (n = 8), serotonin urine excretion was increased after six inhalations (effect size Cohen’s d = 0.7). In the second experiment (n = 80), inhalations proved superior to both a natural control condition and a pseudo placebo condition after six and three inhalation cycles (0.6 < d < 1.8). In addition, there was a large reduction of cortisol saliva levels after three inhalations (d = 0.9).
Conclusion: Short and deep inhalations of essential oil scents directly delivered to the olfactory system appear to result in enhanced serotonin and reduced cortisol release in healthy individuals of both sexes.
... Therefore aroma inhalation could be a very effective stress management method in several contests ranging from medical care centers to school and studyrooms [18]. However, while more basic research is needed to fully understand the mechanisms underlying the effects of aromatherapy [6], the clinical trials seems to suggest that aromatherapy may decrease sympathetic nervous system activity and increase parasympathetic nervous system [5]. Finally, aromatherapy-enhanced mindfulness state has been studied in order to develop new therapeutic intervention against stress and anxiety in hospitalized people [16,17]. ...
Stress and anxiety are part of the human mental process which is often unavoidably yield by circumstances and situations such as waiting for a flight at the airport gate, hanging around before an exam, or while in an hospital waiting room. In this work we devise a decision system for a robotic aroma diffusion device designed to lessen stress and anxiety-related behaviors. The robot is intended as designed for deployments in closed environments that resembles the aspect and structure of a waiting room with different chairs where people sit and wait. The robot can be remotely driven by means of an artificial intelligence based on Radial Basis Function Neural Networks classifiers. The latter is responsible to recognize when stress or anxiety levels are arising so that the diffusion of specific aromas could relax the bystanders. We make use of thermal images to infer the level of stress by means of an ad hoc feature extraction approach. The system is prone to future improvements such as the refinement of the classification process also by means of accurate psychometric studies that could be based on standardized tests or derivatives.
... Therefore aroma inhalation could be a very effective stress management method in several contests ranging from medical care centers to school and studyrooms [18]. However, while more basic research is needed to fully understand the mechanisms underlying the effects of aromatherapy [6], the clinical trials seems to suggest that aromatherapy may decrease sympathetic nervous system activity and increase parasympathetic nervous system [5]. Finally, aromatherapy-enhanced mindfulness state has been studied in order to develop new therapeutic intervention against stress and anxiety in hospitalized people [16,17]. ...
... 12 Aromaterapi üzerine yapılan birçok klinik çalışma, aromaterapinin endorfin üretimini uyararak anksiyeteyi, stresi ve ağrıyı azalttığını, uyanıklığı ve gevşeme hissini arttırdığını göstermiştir. [12][13][14][15][16] Aromaterapi genellikle kadın sağlığında da oldukça sık kullanılan TT yöntemlerinden biridir. Aromaterapi premestrual sendrom, vajinal enfeksiyonlar, menopoz semptomları, sistit ve infertilite gibi durumlarda da kullanılabilmektedir. 17 Ayrıca gebelikte aromaterapi uygulamasının bulantı-kusma, yorgunluk, anksiyete, stria gravidarum, kaşıntı ve bel ağrısı semptomlarını azalttığı gösterilmiştir. ...
Menopoz, tüm kadınların yaşamını etkileyen doğal biyolojik süreç olsa da, birçok kadın bu süreçte sıcak basması, depresyon, vajinal kuruluk, düşük libido, osteoporoz, yorgunluk, uyku bozuklukları, çarpıntı, duygusal dengesizlik gibi çeşitli semptomlar yaşayabilmektedir. Bu semptomlar kadınların yaşam kalitesini olumsuz etkilemektedir. Pek çok kadın menopoza bağlı yaşadıkları semptomları azaltmak için tamamlayıcı terapi yöntemlerini kullanmaktadır. Bu derleme ile menopoz semptomları için bir tedavi olarak aromaterapinin terapötik etkilerini değerlendiren girişimsel çalışmaların incelenmesi amaçlanmıştır. Ulaşılabilen literatürde menopoz dönemindeki kadınlarda aromaterapinin etkinliğini inceleyen 16 çalışmaya ulaşılmıştır. Çalışmaların on birinin İran, üçünün Kore, birinin Japonya ve birinin ülkemizde yapıldığı görülmektedir. Aromaterapi uygulaması çalışmaların altısında masaj, altısında inhalasyon, dördünde oral yol ile uygulanmıştır. Bu çalışmalarda aromaterapi uygulamasının menopoz semptomları azalttığı, psikolojik sağlığı, menopoza özgü yaşam kalitesi, uyku kalitesi, kan basıncı ve kan parametrelerini iyileştirdiği görülmüştür. Menopoz semptomlarının yaşam kalitesi üzerindeki istenmeyen etkileri göz önüne alındığında, basit, invaziv olmayan, güvenli ve etkili bir yöntem olan aromaterapi menopoz dönemindeki kadınlar tarafından kullanılabilir.
... 7 Many clinical studies have revealed the therapeutic benefits of aromatherapy in relieving anxiety and stress, reducing pain, enhancing alertness, and inducing relaxation, by stimulating endorphin production. [7][8][9][10][11] There are five systematic reviews of aromatherapy for menopausal symptoms. [12][13][14][15][16] All of the reviews concluded that aromatherapy may be effective for relieving menopausal symptoms. ...
Background: Aromatherapy is widely used in women's health as a complementary therapy. Objective: This review aimed to critically evaluate clinical evidence of the effectiveness of aromatherapy in managing menopausal symptoms. Design: A systematic review and meta-analysis. Methods: A total of 11 electronic databases were searched up to November 5, 2020. Randomized controlled trials (RCTs) evaluating any type of aromatherapy against placebo in menopausal individuals were eligible. Two authors independently assessed the study eligibility and risk of bias as well as extracted the data for each study. Cochrane risk of bias tool was used to evaluate the methodological quality of each included studies. No ethical approval was required for this manuscript as this study did not involve human subjects or laboratory animals. Results: Seven RCTs met our inclusion criteria and were analyzed. Most of the included RCTs had low risk of bias in most domains except for blinding. Four studies tested the efficacy of aromatherapy for menopausal symptoms. The results showed that aromatherapy (lavender or low dose of neroli) inhalation had superior effects on reducing the total menopausal symptom score compared with the placebo. One study presented that aromatherapy massage with mixed oils reduced menopausal symptoms. Three studies investigated the effects of aromatherapy inhalation on sexual desire, and all of the studies showed that aromatherapy inhalation (lavender or low dose of neroli or mixed oils) had superior effects compared with the placebo. Conclusion: This review indicates limited evidence of the benefit of aromatherapy (lavender or low dose of neroli) in improving total menopausal symptoms and sexual desire. Further studies are highly warranted to validate the findings.
... 9 Aromatherapy can be applied directly to the skin by massage, but it can also be applied by inhalation. 10 Although there are many different types of aromatherapy oils, lavender oil is one of the most common. 11 It is often used in aromatherapy to reduce anxiety, stress and improve sleep. ...
Background:
Burns are a source of pain, which cannot be fully treated with medications.
Objectives:
This study aims is to test the effectiveness of lavender oil inhalation aromatherapy applied before dressing change on vital signs and pain levels of children with burns.
Design:
This randomized controlled study was held between May 2018 and May 2019. A total of 108 children who met the inclusion criteria were studied in three groups: Lavender-15 Group inhaled lavender oil for 15 minutes before dressing (n:36), Lavender-60 Group inhaled lavender oil for 60 minutes before dressing (n:36), and Control Group inhaled jojoba (placebo) oil for 15 minutes before dressing (n:36). Baseline pain levels and vital signs of the children were measured before inhalation. Pain levels and vital signs of the children were re-measured at the 1st and 30th minutes after dressing.
Results:
There was no significant difference between the groups in terms of pain levels (p = 0.750) and vital signs before dressing. In post-dressing measurements, the number of respiration (after 1 min p = 0.000, after 30 min p = 0.000), heart rate (after 1 min p = 0.000, after 30 min p = 0.000), mean arterial blood pressure (after 1 min p = 0.010, after 30 min p = 0.000) and pain levels (after 1 min p = 0.000, after 30 min p = 0.000) were lower in the Lavender groups compared to the placebo group.
Discussion:
The result of this research reveals that inhalation aromatherapy which applied before dressing in children with burns affects the reduction of pain levels and stabilization of vital signs.
... Aromatherapy is a beneficial effect on anxiety (Bagheri-Nesami (Tayebi et al., 2015), the pain of arteriovenous fistula puncture (Aliasgharpour et al., 2016;Bagheri-Nesami et al., 2014), headache (Biçer et al., 2015) and sleep quality (Mohamed & Hafez, 2019;Muz & Tasci, 2017) in adults receiving haemodialysis. Moreover, in metaanalyses that investigate the effect of aromatherapy in different disease groups, it was found that aromatherapy had a significant and positive effect on pain (Lakhan et al., 2016), sleep quality (Hwang & Shin, 2015;Lin et al., 2019), labour pain , stress (Hur et al., 2014), dysmenorrhea Sut & Kahyaoglu-Sut, 2017), anxiety (Gong et al., 2020) and preoperative anxiety (Guo et al., 2020;Huang et al., 2021). ...
Aim
To synthesise the effect of aromatherapy on fatigue in adults receiving haemodialysis treatment in randomised controlled trials.
Design
A systematic review and meta-analysis of randomised controlled trials following the Cochrane methods.
Data resources
Systematic search was carried out using the Cochrane Library, CINAHL, Council of Higher Education National Thesis Center, Networked Digital Library of Theses & Dissertations, Science Direct, Springer Link, Scopus, PubMed, ProQuest, Ovid, ULAKBIM Turkish National Databases and Web of Science without year limitation for studies published in the English language. The review covered the period between 1960 and April 2020.
Review methods
Three authors reviewed the risk of bias independently and systematically using the Cochrane Collaboration tool.
Results
Eight studies with 606 participants were included in this systematic review and meta-analysis. Aromatherapy was applied through inhalation and massage methods and performed from 2 to 30 min and in 3 to 30 sessions. There was no significant publication bias. Aromatherapy had a large effect on fatigue in adults receiving haemodialysis treatment and high heterogeneity.
Conclusion
Aromatherapy has a high and positive effect on fatigue in the adults receiving haemodialysis and can be used as an effective intervention in the management of fatigue.
Impact
Aromatherapy may help to reduce the severity of fatigue in adults receiving haemodialysis. The findings of this systematic review and meta-analysis will contribute to the use of aromatherapy in the management of fatigue and conduction of randomised controlled trials related to aromatherapy.
... As described above, stress-suppressing smells are well recognized, and essential oils are actually used for aromatherapy for stress reduction in humans [87]. Thus, the development of effective essential oil inhalers is underway [124]. ...
The stress response in the brain is not fully understood, although stress is one of the risk factors for developing mental disorders. On the other hand, the stimulation of the olfactory system can influence stress levels, and a certain smell has been empirically known to have a stress-suppressing effect, indeed. In this review, we first outline what stress is and previous studies on stress-responsive biomarkers (stress markers) in the brain. Subsequently, we confirm the olfactory system and review previous studies on the relationship between smell and stress response by species, such as humans, rats, and mice. Numerous studies demonstrated the stress-suppressing effects of aroma. There are also investigations showing the effects of odor that induce stress in experimental animals. In addition, we introduce recent studies on the effects of aroma of coffee beans and essential oils, such as lavender, cypress, α-pinene, and thyme linalool on the behavior and the expression of stress marker candidates in the brain. The transfer of volatile components into the brain is also discussed while using the results of thyme linalool as an example. These studies may provide a good opportunity to connect chemical research at the molecular level with neuropharmacological approaches in the future.
... There has been strong evidence of the impact of aromatherapy use on reducing stress, burnout, and anxiety of health care staff. Hur et al. (2014) in South Korea conducted a systematic review and metaanalysis of randomized controlled trials (RCTs) to determine the effectiveness of aromatherapy for stress management. Out of 629 relevant studies, five RCTs met the inclusion criteria, and used aromatherapy as inhalation, except for one study which used aromatherapy with massage. ...
Purpose: In response to the coronavirus disease 2019 (COVID-19) global human caring crisis, this article describes an innovative, theory-guided, holistic practice project at a major academic medical center in Northern California. The purpose of this theory-guided COVID-19 project was to address the self-care needs of caregivers so they could better care for patients/families who are confronting daily pandemic demands. Study design: The organization's professional practices are guided by Watson's theory of human caring and Caritas Processes. This setting has 16 Caritas Coaches® who have acquired expertise in human caring from an accredited program of the Watson Caring Science Institute ( www.watsoncaringscience.org ). Methods: Caritas Coaches® were mobilized to implement holistic caring–healing modalities such as aromatherapy and mindfulness meditation throughout the organization. Findings: By addressing the self-care needs of caregivers, the organizational culture shifted from fear, fatigue, stress, and burnout, to more intentional conscious, mindful, caring presence, gratitude, and purpose. Conclusion: This study has implications for other institutions regarding theory-guided practice and system responses to self-care needs of staff. This study provides an overview of the project from its origin to implementation and outcomes.
... Not all methods of relaxation must be so formal. Informal methods of relaxation, such as an act as simple as spending time in nature (Ingulli & Lindbloom, 2013), taking relaxing baths or aromatherapy (Hur et al., 2014), or any type of exercise ( Jackson, 2013), can eventually promote parasympathetic responses. ...
The COVID-19 pandemic is enacting a heavy mental health toll on people around the world. This article provides evidence-based information and techniques to promote and foster mental and physical health for our patients and health care providers. The article 1) reviews common emotional reactions faced by patients during the COVID-19 pandemic, 2) reviews how health care providers can help patients make sense of their experiences, and 3) teaches evidence-based skills that health care providers can use to support patients during the COVID-19 pandemic and care for themselves. The article provides tips and strategies that can be helpful in interacting with patients and supporting the well-being of health care providers. These strategies are based on empirically supported knowledge and skills drawn from literature on stress, coping, emotional management, chronic disease management, and behavior changes, and provides ways to discuss these tips with patients in applicable, understandable ways.
... Aromatherapy decreased the elderly anxiety after the intervention. These findings were in accordance with those of the previous studies (9)(10)(11). ...
Background: Anxiety in orthopedic surgeries, especially knee replacement, is one of the most common complaints of the elderly. Aromatherapy with Damask Rose (Rosa damascena Mill.) can be one of the non-pharmacological methods in complementary medicine to control anxiety. Objectives: The present study aimed to determine the effect of aromatherapy with R. damascena on elderly anxiety after knee replacement surgery. Methods: In this quasi-experimental study, 80 elderly patients (60 to 90 years old) undergoing knee replacement surgery according to inclusion criteria were selected by convenience sampling method randomly from Moheb Mehr and Shafa Yahyaian hospitals of Tehran, Iran, and were divided into two groups of case and control. The case group was exposed to aromatherapy intervention at four intervals of 30 minutes. The instrument for measuring anxiety was the Visual Analogue scale for anxiety (VAS-A). Results: The results showed that the study elderly were homogeneous in terms of demographic variables in both case and control groups, except for two variables of education level and consumption of analgesics, which were also determined by two-way ANOVA. These parameters (education level, P = 0.54, and consumption of analgesics, P = 0.661) were not confounding variables. Significant differences were observed in the anxiety of the case group before and after the intervention (P < 0.001), while this difference was not significant in the control group (P = 0.304). Moreover, the difference in anxiety scores was significantly decreased after the intervention compared to before intervention in both case and control groups (P < 0.001). Probably Damask Rose aroma molecules produce and secrete neurotransmitters such as endorphins and encephalin, thereby reducing pain and anxiety. Conclusions: According to the findings of the study, the aromatherapy with R. damascena seems to be effective in reducing postoperative anxiety in these elderly patients.
... Among the various interventions reducing occupational stress, evidences of antistress effects produced by complementary and alternative medicine (CAM) therapies have been adequately established by a systematic review and metaanalysis [8]. Aromatherapy, as one of CAM, is a simple, convenient and noninvasive method of stress relief. ...
Background:
Occupational stress is a common issue faced by workers in every discipline. Complementary and alternative medicine (CAM) therapies, such as aromatherapy massage or massage, have antistress effects in the literature. The purpose of this randomized clinical trial with triple blinds is to evaluate the immediate effects of lavender aromatherapy massage for improving work stress, burnout, and HRV parameters of female employees in a university.
Methods:
A total of 53 subjects in experimental group whereas 57 subjects in control group completed interventions and measurement and led to power of 0.98. Inferential statistics, as independent t-test, paired t-test, and Chi-Square test, were performed to verify the expected relationships.
Results:
The present study found that subjects in experimental group reported a lower role stress and less inclined to type A personality trait after aromatherapy massage with lavender. For control group, only less inclined to type A personality trait was reported after receiving massage. For burnout, a significant lower personal burnout and work-related burnout were reported after aromatherapy massage whereas only increased client-related burnout was reported in control group. For HRV, both the experimental and control groups reported higher SDNN and RMSSD in time domain after intervention. Contradictory HRT and PSI in time domain were significantly lower after intervention. In frequency domain of HRV, both groups reported significantly higher value in VLF and HF. In addition, the experimental group reported significantly higher value in TP and LF after intervention.
Conclusions:
Both the lavender aromatherapy massage and massage did show immediate effect on different dimensions of work stress, burnout, and HRV. These two interventions can be applied as routine leisure activities by personal preference to reduce stresses occurring in work environment.
... 17 In a metaanalysis of randomized controlled trials on stress reduction, aroma inhalation yielded favorable effects compared with no treatment, but this effect mainly showed in subjective self-reports. 18 Aromatherapy via massage, inhalation therapies, baths with herbal essential oil and mineral substances is used extensively. Aromatherapy is one of the potential methods of reducing perioperative pain. ...
Objective
Pain management is one of the methods used in the health sector. Nursing care focuses on non-pharmacological measures, including the provision of aromatherapy using lavender and rose aromatherapy, which aims to understand the effectiveness of lavender and rose aromatherapy on pain intensity of postoperative patients in Laparatomi Hospital in Aisyiyah General Hospital in the surgical inpatient room, Padang in 2019.
Method
The design of this study is a Quasi Experiment with pre-test and post-test designs with two groups. The sample of this study was Post Laparatomi in RSU with the technique of Accidental Sampling. The sample of this study consisted of 30 people for lavender and rose aromatherapy. Statistical tests used the Independent Test T-test.
Result
Based on the results of the study it was found that lavender and rose aromatherapy can reduce pain scale in postoperative patients. But compared to the two intervention groups, the aroma group of lavender therapy is more effective with mean pain scale before lavender aromatherapy being 5.20 and pre-test is 3.40 with p-value 0.000.
Conclusion
The nurses could provide nursing care in dealing with pain management in postoperative patients in addition to deep breathing techniques. It is recommended to apply aroma lavender therapy, which reduces pain and makes patients more relaxed.
... Natural products are receiving more and more attention due to their harmless properties and wide application in fragrance, spices, food, medicine, and other fields [1]. Rose essential oil has not only delicate and elegant, sweet, and soft faint aroma but also anti-inflammatory, calming, and relaxing effect and the ability of cells to regenerate [2]. ...
Twelve ionic liquids were synthesized and used as solvents to extract rose essential oil from rose slag. Tetrabutylammonium bromide propionic acid ionic liquid was selected as the best solvent. Five factors (feed to liquid ratio, extraction temperature, reflux time, stripping agent amount, and repeated extraction times) were considered in the reaction. The results showed that the optimum process conditions were 1:4 mass ratio of material to liquid, the temperature 75 °C, reflux time 4 h, and the amount of stripping agent 100 g; the highest yield of essential oil is 1.6095%. The yield did not show an obvious decline after repeating extraction three times. Comparing the yield, solvent consumption, and extraction time with other organic solvents, using tetrabutylammonium bromide propionic acid ionic liquid can effectively reduce energy and reduce environmental burden, which proves that the technology is sustainable.
... Notably, lavender oil is also absorbed in minutes after inhalation, achieving a peak plasma level in 60 to 90 min [14]. Our finding of a quick response to lavender aromatherapy is consistent with a meta-analysis on the stress alleviation effect of aromatherapy in healthy adults [52]. Notably, our analysis showed no significant difference between treatment arms and control at study endpoints. ...
Background
There is preliminary evidence for lavender as an anxiolytic agent through various routes of administration. Our goal is to elucidate the best route of administration for lavender as a treatment for anxiety.
Methods
Thirteen electronic search engines were systematically scanned for relevant publications. The relevant articles were included after the title and abstract screening followed by the full-text screening. This study included randomized control trials reporting lavender for the treatment of anxiety. The protocol was registered in PROSPERO (CRD42017076711). Frequentist network meta-analysis and Bayesian meta-regression were conducted to report the best treatment modality and the effect of covariates on the effectiveness as an anxiolytic. Treatment arms were ordered according P-scores, where higher P-score indicates better treatment choice.
Results
Forty studies were eligible for qualitative analysis, and 32 were included in quantitative analysis. Lavender aromatherapy was the best approach for the treatment of anxiety among other lavender modalities at the first week recording [Standardized Mean Difference (SMD) = −0.57, 95% CI (−1.14–0.01), P-score = 0.72], in addition to achieve at the first time points [SMD = −0, 95% CI (−0.97 ̶ -0.16), P-score = 0.69], compared to placebo; however, lavender massage along with foot bath were found to be the most efficacious for anxiety treatment at the study endpoint [SMD = −1.10, 95% CI = (−7.41 ̶ 5.21), P-score = 0.65]. Furthermore, network meta-regression revealed that the duration of therapy influenced treatment, suggesting Silexan (oral lavender) 80 mg (first rank probability = .116) as the favorable option for anxiety in long-term treatment.
Conclusions
Lavender aromatherapy is, clinically, superior in short-duration, while Silexan (oral lavender) 80 mg is preferable for long-term treatment of anxie
... Instead, it reduced subjective vicarious stress and state anxiety in response to observing a stressful situation. This indicates a stress-buffering effect of Hedione as it has been reported for odorants that are used in aromatherapy (Herz, 2009;Hur et al., 2014). The effects of aromatherapy are best accounted for by a psychological explanation. ...
Observing another person in a stressful situation can cause a full-blown physiological stress response in the observer, which is referred to as empathic stress. One under through which stress-related information might be transmitted between individuals in conditions of empathic stress is chemosensory communication. In the present study, we investigated whether the odorant Hedione, as a potential chemosignal, affects the empathic stress response at a physiological and psychological level. For this purpose, two experiments were designed, each testing one group of participants in an odor-free room and a second group in a room scented with Hedione. In Experiment 1, 60 participants (25 males) watched a video of an unknown female participant in the Trier Social Stress Test (TSST). In Experiment 2, 37 free-cycling females watched a live video of a male participant in the TSST. Observers’ psychological and physiological stress response was captured via repeated measurements of salivary cortisol, alpha-amylase, and self-report ratings. Empathy with the stressed participants was assessed on the dimensions of personal distress and empathic concern of the Emotional Response Scale (ERS). Our results show no substantial physiological stress response in the observers and no effect of Hedione on physiological stress measures. Further, in Experiment 1, there was no subjective stress elicited by the video and no effect of Hedione. In Experiment 2, the observation was perceived as stressful and Hedione reduced subjective vicarious stress. The subjective stress response was associated with the Observers’ direct personal distress, but not with their empathic concern for the target in both experiments. Based on the findings presented above, we conclude that under conditions of empathic stress, Hedione alleviates subjectively perceived stress felt when observing another person being stressed, while leaving empathic concern for the target unaffected. In this regard, future research is warranted to clarify the underlying mechanisms of this effect.
... Relieving the acute symptoms of patients suffering from AMI should be a priority of nurses in intensive care units. A reduction in anxiety in patients admitted to Cardiac Care Units (CCUs) requires independent interventions on the part of nurses with the goal of enhancing the patients' quality of life (Haeng Hura et al., 2014;Yeon Cho et al., 2013). ...
... The influence of EOs on emotions has extensively been described among humans [2][3][4][5][6] . Several studies have investigated the effects and the physiological pathways of EOs on behaviour, emotions and perception [7] . ...
The influence of essential oils (EOs) on emotions has been widely described among humans and animals. Several studies have investigated the effects and the actions of EOs on behaviour, mood and perception. In this study, shelter dogs (n=23) were exposed to olfactory stimulation through diffusion of 9 anxiolytic essential oils in one blend (olfactory enrichment) for 8 weeks in order to check long-term effects on behaviour. First, dog's postures have been evaluated in both groups before and after exposure. Secondly, in order to collect the preliminary results on the distance necessary to obtain an effect of EOs, dogs were divided in 2 groups according to the distance from the diffuser. Our results indicate that olfactory enrichment with this blend of EOs is related to less time spent by dogs in high posture. More research is needed to investigate a potential gradual effect of distance and concentration of EOs on dog's welfare.
... The effects of fragrances on the body and mind have been studied extensively in recent years; indeed, fragrances can have various biological and psychological properties, resulting in reduced stress and enrichment of people's lives. 18,19 Thus, an FE may result in reduced stress and inhibition of tumor growth. We previously demonstrated that inhalation of αpinene, a major volatile organic compound found in the forest, inhibits tumor growth in mice. ...
The environment is thought to affect outcomes in patients with cancer; however, this relationship has not been proven directly. Recently, an enriched environment, as a model of a positive environment, has been shown to suppress tumor growth by lowering leptin production through a pathway involving the hypothalamus/sympathetic nerve/leptin axis. We previously reported that a fragrant environment (FE) containing α-pinene suppressed tumor growth in mice; however, the underlying mechanism has not been elucidated. Accordingly, in this study, we investigated changes in the neuroendocrine and immune systems following exposure to an FE. Mice were exposed to α-pinene (5 h/day) for 4 weeks prior to tumor implantation with murine melanoma cells and 3 weeks after transplantation. In addition to the evaluation of tumor growth, the blood, spleen, and hypothalamus were collected 3 weeks after transplantation, and neuroendocrinological and immunological parameters were measured. Tumor size was ~40% smaller in mice exposed to FE. Moreover, plasma noradrenaline concentrations, which reflected sympathetic nervous activity, tended to increase, and leptin levels were significantly decreased in FE-exposed mice. Levels of stress hormones, such as plasma corticosterone and adrenaline, did not change in the 2 groups. In the hypothalamus, brain-derived neurotrophic factor protein levels and glucose-1-phosphate concentrations were decreased in the FE group. Additionally, numbers of B cells, CD4⁺ T cells, CD8⁺ T cells, and natural killer cells increased in the FE-exposed mice. These neurohormonal and immunological changes in the FE-exposed mice suggested that the FE may activate the hypothalamus/sympathetic nerve/leptin axis and immune system, thereby retarding tumor growth.
... (Kugelmann, 1992, p. XVI) Dealing with stress involves a whole industry, an armada of health professionals and self-help gurus. Many strategies are regarded as potentially helpful and offered to the stressed individual: yoga classes (Parshad, 2004), meditation (Astin, 1997), relaxation techniques (Rausch, Gramling, & Auerbach, 2006), journal writing (Smyth & Helm, 2003), cognitive reappraisal (Jamieson, Mendes, & Nock, 2013), coaching (Gyllensten & Palmer, 2005), massages (Cady & Jones, 1997;Zeitlin, Keller, Shiflett, Schleifer, & Bartlett, 2000), walking in the forest (Hansmann, Hug, & Seeland, 2007;Morita et al., 2007), humor (Abel, 2002;Martin, Kuiper, Olinger, & Dance, 1993), spirituality (Delgado, 2007;Kim & Seidlitz, 2002), physical exercise (Salmon, 2001), mindfulness-based stress reduction (Grossman, Niemann, Schmidt, & Walach, 2004), aromatherapy (Hur, Song, Lee, & Lee, 2014), and so on. ...
Stress is a relatively new concept that has evolved during the second half of the 20th century. Besides being a theoretical construct that is used extensively in research, the stress concept has permeated into our daily lives. The question is: Why? Why has it become so normal to describe our daily hassles by referring to the concept of stress? This article investigates the societal functions of stress and argues that the concept of stress is deeply intertwined with the constituents of modern identity: It fits well into the discourse about the fundamental changes that the modern age imposes on individuals as well as on society as a whole. Following this line of thought, stress may be viewed as the result of an ongoing trend toward acceleration and flexibilization in the past decades. As acceleration and flexibilization are not inevitable, their existence itself needs an explanation, though. To provide such an explanation, one has to apply a broader understanding of the terms modern life and modern identity, incorporating developments of the past centuries rather than decades. This is done by using Taylor's (1989) philosophical framework, which proposes three constituents of modern identity: inwardness, the affirmation of ordinary life, and expressivism. A detailed analysis of the relation between these constituents of modern identity and the concept of stress reveals that stress is paradoxically used for both criticizing the constituents of modern identity and perpetuating their influence. Stress is a Janus-faced concept mirroring the Janus-facedness of modern life.
... (Linnemann, Ditzen, Strahler, Doerr, & Nater, 2015). Music therapy and lavender aromatherapy give effects on the stress management by decreasing the alpha-amylase activity (Hur, Song, Lee, & Soo, 2014). Muscle relaxation combined with music can increase the focus of participant attention and reduce mental tension; music encourages the body becomes more relaxed and able to motivate participants to follow a relaxation program (Robb, 2000). ...
Background: Stress among teachers has a significant relationship with the psychosomatic and depressive symptoms. Progressive muscle relaxation with music and aromatherapy is an intervention which can be implemented to reduce the level of stress among teachers.
Purpose: This study aimed to investigate the effects of progressive muscle relaxation with music and aromatherapy on decreasing the level of stress among teachers.
Methods: This study employed a pre-posttest quasi-experimental design with a control group. The samples were 46 teachers recruited by purposive sampling and were evenly assigned to the intervention group and the control group. Progressive muscle relaxation with music and aromatherapy was given to the intervention group for four sessions in four days; each lasted for 20 minutes. The data were collected using the Teacher Stress Inventory and analyzed using the t-test to know the effects of the intervention.
Results: The results showed that the mean of stress level among the teachers in the intervention group decreased from 50.65±3.761 to 32.78±8.426 after the intervention. Meanwhile, in the control group, the mean of stress level slightly decreased from 49.87±3.348 to 49.17±4.868. The t-test obtained a p-value of 0.000, indicating that there were significant differences in the stress levels between the intervention and the control group.
Conclusion: Progressive muscle relaxation with music and aromatherapy reduced the level of stress among teachers. Based on the findings, it is recommended that community nurses promote this relaxation therapy to decrease the stress level among school teachers.
Background: Family-centered empowerment model (FCEM) greatly values the motivational, psychological, and functional roles of children and their family members in health promotion. Its main goal is to strengthen the family system to promote children and family health. Aim: To investigate the effect of FCEM on knowledge and stress level among mothers of children with glucose-6-phosphate dehydrogenase enzyme deficiency(G6PD). Study design: A quasi-experimental design was performed. Setting: The study was conducted in hematology outpatient clinic at Mansoura University Children’s Hospital. Subjects: a purposive sample composed of 60 mothers and their children who are suffering from G6PD deficiency. Tools: Two tools were used for data collection: Glucose-6-Phosphate Dehydrogenase Enzyme Deficiency Knowledge Questionnaire and Arabic version of Perceived Stress Scale. Results: There were an improvement in the mean score of mothers' total knowledge with statistically significant difference (P<0.001) in the post intervention phase compared to pre intervention phase. Mean score of mothers' stress level was 26.90 ± 6.26 pre the FCEM implementation and decrease to17.36 ± 2.73 post FCEM with a statistically significant difference. Conclusion: Applying FCEM on mothers of children with G6PD deficiency leading to improvement of their knowledge regarding G6PD and reduce their level of stress Recommendations: researchers recommended implementing FCEM for all mothers and their children with chronic diseases as a strategy for education and management.
Ürodinami, mesanenin dolumu ve boşaltımı esnasında alt üriner sistemin işlevi hakkında fizyolojik veriler elde etmek için çoklu testlerden oluşan tanısal bir değerlendirme yöntemidir. Ürodinami, idrarda yanma, kanama, ağrı gibi sorunlara neden olabilmektedir. Bu sorunlar dışında hastanın mesanesine, rektum veya vajinasına kateter yerleştirilmesi, işlemin invaziv ve travmatize edici bir yöntem olması, işlem esnasında idrarını yabancı bir kişinin yanında yapma, test boyunca idrar yapma durumunun gözlenmesi gibi nedenlerden dolayı hastalar utanma, rahatsızlık, gerginlik, anksiyete ve stres yaşayabilmektedir. Ürodinami sırasında hastanın stres düzeyindeki artış, sempatik sinir sistemini uyararak mesane kapasitesini düşürebilmekte ve hastanın ürodinami sonuçlarını etkileyebilmektedir. Ürodinami işlemi sırasında hastanın ağrı ve anksiyetesini azaltmaya yönelik birçok farmakolojik ve farmakolojik olmayan girişimler uygulanmaktadır. Aromaterapi, invaziv girişim öncesi anksiyetesi olan hastalarda tercih edilen farmakolojik olmayan bir uygulamadır. Aromaterapi, farmasötik yöntemlerle kıyaslandığında; basit, ucuz, invaziv olmayan ve uygulaması kolay bir yöntemdir. Hemşirelik biliminde esansiyel yağların kullanılması, hemşirelik felsefesini, teorilerini ve etiğini yansıtmaktadır. Bu bağlamda konforu sağlamada, stresle başa çıkmada, ağrı ve anksiyeteyi azaltmada aromaterapinin holistik bir hemşirelik girişimi olarak kullanılabileceği belirtilmiştir. Klinik aromaterapi, hemşirelik bilimine olduğu kadar, sanatına da katkı verdiği için hemşireliği güçlendirmektedir. Ancak aromaterapinin hemşirelik uygulamalarındaki önemli eksikliği bu alandaki bilimsel çalışmaların kanıt düzeyi yüksek çalışmalara henüz dönüşememiş olmasıdır. Bu derlemenin amacı, ürodinami işlemi sırasında hastaların yaşadıkları olumsuz duyguların azaltılmasında aromaterapinin kullanımı ve hemşirelerin sorumluluklarını güncel literatür eşliğinde aktarmaktır.
Amaç: Bu çalışma, esansiyel hipertansiyonu olan kadınlara uygulanan inhaler aromaterapinin yaşam bulguları ve kaygı düzeyine etkisini saptamak amacıyla yapılmıştır. Yöntem: Çapraz desenli tek kör nitelikteki bu çalışma esansiyel hipertansiyonu olan 40 kadın ile yürütülmüştür. Veriler tam otomatik tansiyon aleti, Durumluk Kaygı Ölçeği ve BIOPAC MP 35 Veri Edinim Sistemi (Version 3.7.3, Santa Barbara, ABD) cihazı ile yapılan kayıtlar kullanılarak iki dönemde toplanmıştır. Çalışmanın birinci döneminde kadınlara iki hafta süresince günde bir kez, beşer dakika, 5:3:2 oranında lavanta, bergamot ve ylang-ylang aromatik yağ karışımıyla inhaler aromaterapi uygulanmıştır. Plasebo uygulanan kadınlara ise günde bir kez, beş dakika olmak üzere iki hafta süresince ayçiçek yağı inhalasyonu yaptırılmıştır. Bir haftalık arınma süresinin ardından gruplar yer değiştirmiş ve çalışmanın ikinci dönemine geçilerek uygulamalar iki hafta daha sürdürülmüştür. Etkinliği saptamak için haftada bir kez kan basıncı ve nabız hızı ölçülmüş; ayrıca dönemlerin başında ve sonunda birer kez Durumluk Kaygı Ölçeği ve Veri Edinim Sistemi kayıtları alınmıştır. Bulgular: İnhaler aromaterapinin ilk haftasında esansiyel hipertansiyonu olan kadınlarda sistolik (p
Objective:
Gather scientific evidence on the application of inhalation aromatherapy for pain relief and estimate the effect measure of this practice on pain reduction.
Methods:
Searches were performed in 2021 in the Pubmed, Scopus, Web of Science, Cochrane, Science direct, Lilacs, Scielo databases. We selected 44 articles demonstrating the effect of aromatherapy on different painful conditions, of which 17 were inserted in the meta-analysis. The risk of bias was assessed according to Cochrane methodology.
Results:
In 35 (79.55%) studies was observed a significant reduction in pain, especially pain labor and postoperative pain. Through the meta-analysis, it was found that inhalation aromatherapy reduces by up to -1.73 points of the visual analog scale (VAS), indicating that this practice contributes to the reduction of pain perception in different painful conditions. In addition, the meta-analysis indicated that the time after inhalation, the type of oil used and the type of pain treated are important variables that interfere with the magnitude of the effect. These effects are attributed to the ability of essential oils to modulate nerve control centers and neurotransmission systems involved in pain control.
Conclusion:
From the gathering of articles on aromatherapy, it can be noted that aromatherapy appears to be helpful in alleviating acute pain, however there is an imminent need to improve aromatherapy studies to reduce the risk of bias and increase the power of its clinical evidence.
Prospero:
CRD42019121665.
Background: Since the 1990's aromatherapy has been a popular adjunct to nursing and midwifery care in a variety of health care settings. Objective: The scoping review seeks to identify and confirm the benefits of incorporating aromatherapy into holistic nursing and midwifery practice Design: A scoping review using PRISMA-ScR of experimental studies where care is provided to the patient by a registered nurse or midwife. Settings and participants: Any health care setting where nurses or midwives provide care. Review Methods: A multi- engine search using a range of MeSH and non-MeSH terms with the Boolean search [AND]. Inclusion criteria were; publication date from 2005–2021, study involved aromatherapy as an intervention, conducted in a clinical nursing or midwifery environment and the published article is available in full in English. Excluded were; single patient cases, animal studies, in vitro studies, use of essential oils internally or a whole plant extract was used or use was non-nursing/midwifery related. Results: 124 studies met the inclusion criteria (n = 19188), classified into seven themes. Conclusion: The evidence supports the use of aromatherapy within a range of nursing and midwifery practices enhancing a holistic model of care. Impact: This scoping review contributes evidence to support the inclusion of aromatherapy into holistic nursing and midwifery practice.
Olfactory cues can affect subjective and autonomic manifestations of the human stress response, but evidence of altered endocrine stress reactivity is inconclusive. In the present study, we investigated effects of the odorant Hedione on the human stress response. We exposed 56 women in their follicular phases to a stressor in a room scented with Hedione or no odor. Subjective stress was captured via repeated self-report measurements and the assessment of anticipatory appraisal. As physiological markers of stress, we assessed blood pressure, salivary cortisol and alpha-amylase. The odorant enhanced the cortisol and cardiovascular stress response while leaving subjective stress unaffected. Our results provide evidence for a modulation of the human response to acute psychosocial stress by Hedione. A potential mechanism underlying this effect is Hedione targeting the hypothalamus via binding to the VN1R1 receptor, which is expressed on the human nasal mucosa.
Objective
To explore potential clinical applications, based on evidence and a nurse-driven test of change, of using lavender aromatherapy for preoperative anxiety as an intervention complementary to standard preoperative care.
Design
A pre- versus postaromatherapy comparison using a visual analog scale (VAS).
Setting
The preoperative department at a level 2 trauma hospital witsth 544 beds.
Participants
Forty-four surgical patients, including 29 female participants and 15 male participants.
Intervention/Measurements
Participants reported their anxiety on a VAS before receiving a lavender aromatherapy inhaler. Anxiety scores were measured again after receiving the lavender aromatherapy and shortly before participants left the preoperative area for surgery. A pre–post comparison of the two VAS anxiety measurements before and after receiving the lavender aromatherapy was completed, analyzed, and is discussed.
Results
Mean anxiety scores were calculated for the pre- and postaromatherapy groups. More than 48% (n = 29) of participants reported a decrease in their anxiety after receiving preoperative lavender aromatherapy. Female participants reported higher preoperative anxiety scores and a larger decrease in their mean anxiety scores after receiving lavender aromatherapy when compared to male participants.
Conclusion
The use of a nurse-driven complementary intervention in the preoperative area was associated with a decrease in mean anxiety scores among female patients about to undergo elective surgery. However, cause and effect cannot be determined because of a lack of a control group and randomization. Opportunities exist with support from seasoned staff for nurses to incorporate safe, evidence-based complementary interventions into the current standard of care for preoperative anxiety.
Coffee beverage consumption is well-known to exert various health benefits; however, the effects of coffee aroma are rarely explored. This study aimed to investigate the calming effect of inhaling coffee aroma while the patients underwent dental procedures (probing and scaling). Salivary α-amylase (sAA) and cortisol (sCort) levels were measured as proxies of sympathetic nervous system and hypothalamic–pituitary–adrenal axis responses to stress respectively. Blood pressures and pulse rates were recorded. The results showed that undergoing dental procedures could increase sAA and sCort levels of the patients inhaling sham aroma while those inhaling coffee aroma had significantly decreased sAA and sCort levels (40% and 25% differences, respectively). The pulse rates of those inhaling coffee aroma were also lower. Subjective assessment using visual analog scale was in line with objective measures as well. The preference for coffee aroma or the frequency of coffee drinking had no effect on the sAA and sCort responses. This is the first study to provide evidence on the effect of coffee aroma on sAA and sCort levels in patients undergoing dental procedures.
Background
and purpose: Preoperative anxiety is an important factor for postoperative complications, and many patients are using aromatherapy to relieve preoperative anxiety. This study aimed to evaluate the effect of aromatherapy on preoperative anxiety in adult patients.
Methods
An electronic search of six databases (Cochrane Library, PubMed, Embase, CINAHL, CNKI, and WanFang Data) was conducted for full-text publications of trials published from the inception of the databases to February 20, 2020. All randomized controlled trials (RCTs) where aromatherapy was used for treatment of preoperative anxiety were included. Interventions included all types of aromatherapy compared to standard care or placebo. The primary outcome was self-rated anxiety and the secondary outcome was adverse effect. Two researchers independently screened and extracted relevant data. A random-effects model was utilized to calculate the effect size as mean difference (MD).
Results
Our search retrieved 347 records. Thirteen trials were included for qualitative analysis, of which ten RCTs with 750 patients were included for meta-analysis. Most studies had a high or unclear selection and performance bias. Overall, aromatherapy was found to decrease preoperative anxiety significantly compared to the control group (MD=-3.95, 95%CI [-6.36, -1.53], P=0.001). According to subgroup analysis, most subgroups showed a significant effect of aromatherapy on preoperative anxiety, except for the no treatment subgroup (MD: -5.40, 95%CI: -7.76 to 0.71) and female subgroup (MD: -3.96, 95%CI: -9.19 to 1.27).
Conclusion
Aromatherapy may be an effective complementary treatment for preoperative anxiety. Nevertheless, due to methodological limitations of the included trials, further studies with strict control of the research design are required for firm recommendations.
Background:
Aromatherapy as an alternative and complementary medicine is a well-known method for reducing the symptoms of various physiological processes such as labor experience. The aim of this study was to systematically review the currently available evidences evaluating the use of aromatherapy for management of labor pain and anxiety.
Methods:
In a systematic review, 5 databases (PubMed, SCOPUS, Web of Science, Google Scholar and Scientific Information Database [SID]) were searched, from database inception up to December 2019. Keywords used included (aromatherapy OR "essential oil" OR "aroma*") AND (pain OR anxiety) AND (labor OR delivery). Using the Cochrane Collaboration's 'Risk of bias' method; the risk of bias in the included studies was evaluated.
Results:
A total of 33 studies were verified to meet our inclusion criteria. Most of the included studies were conducted in Iran. Aromatherapy was applied using inhalation, massage, footbath, birthing pool, acupressure, and compress. The most popularly used essential oil in the studies was lavender (13 studies), either as a single essential oil or in a combination with other essential oils. Most of included studies confirmed the positive effect of aromatherapy in reducing labor pain and anxiety.
Conclusion:
The evidences from this study suggest that aromatherapy, as a complementary and alternative modality, can help in relieving maternal anxiety and pain during labor.
Introduction: Coronary artery angiography is a common diagnostic procedure in cardiovascular diseases which could cause fear, stress, anxiety and probably some instability at hemodynamic parameters in the patients before this diagnostic procedure. This study aimed to assess impact of inhalation aromatherapy with damask rose on anxiety of patients undergoing coronary angiography.
Methods: A single-blinded randomized controlled trial was conducted with 98 patients at aromatherapy and control group undergoing coronary angiography in the Besat educational hospital of Hamadan, Iran, in 2017. Patients inhaled 5 drops of 40% Rosa Damask essential oil for 20 minutes before the angiography at aromatherapy group and inhaled 5 drops of distilled water for 20 min before the angiography at the control group. Anxiety was measured before and 2 minutes after intervention by state section of state-trait anxiety inventory (STAI) questionnaire. Data were analyzed by SPSS 16 using independent t-test and paired t-test.
Results: There was no significant difference between mean of patient’s anxiety at aromatherapy and control group before intervention. There was significant difference between mean of patient’s anxiety before and after intervention at the aromatherapy group (P
Background:
Burn injuries are often accompanied by painful and distressing consequences, which can lead to long-term psychological issues. The most common form of anxiety in burn patients is pain anxiety. It is described as the feeling of fear and pain prediction caused by painful procedures.
Aim:
To compare the effects of inhalation aromatherapy using damask rose aroma and the Benson relaxation technique on pain anxiety in burn patients.
Methods:
This randomized clinical trial was conducted on 132 patients hospitalized in Motahari Burn Hospital from October 2017 to March 2018. The subjects were selected using a sequential sampling method. Next, they were randomly allocated by the Permuted block randomization method into four groups of rose aroma (5 drops of 40% rose aroma), the Benson relaxation technique, combined rose aroma-Benson relaxation and control. The interventions were performed for three consecutive days and once a day for 20 min, and each session lasted from 45 to 30 min before the daily dressing change. Data was collected using the Persian version of burn specific pain anxiety scale (BSPAS). Data was analyzed using descriptive and inferential statistics via the SPSS software version 16.
Results:
Immediately after the intervention, on the first, second and third days, significant differences in pain anxiety among four groups were reported. On the first day, the Scheffé ad hoc test indicated statistically significant differences in pain anxiety between all groups (p < 0.001), except rose aroma-plus-Benson relaxation and rose aroma groups (p = 0.15). On the second and third days, there were significant differences between the groups in pain anxiety (p < 0.001). Furthermore, after wound dressing, on the first, second and third days, statistically significant differences in pain anxiety among four groups were reported. On the first day, the Scheffé ad hoc test revealed statistically significant differences in pain anxiety between all groups (p < 0.001). On the second and third days, there were statistically significant differences in pain anxiety between the groups (p < 0.001), except the rose aroma and Benson relaxation groups. Immediately after the intervention, the maximum effect size was on the first day in the group of rose aroma-plus-Benson relaxation and the lowest effect size was on the first day in the Benson relaxation group. However, after wound dressing, the maximum effect size was on the third day in the rose aroma-pus-Benson relaxation group and the lowest effect size was on the first day in the Benson relaxation group.
Conclusion:
The combination of the rose aroma and Benson relaxation has a synergistic effect and has more effects in the reduction of pain anxiety in burn patients than a single intervention. Health care providers can provide these interventions simultaneously and help reduce pain anxiety in burn patients before conducting painful interventions.
This systematic review was aimed at critically evaluating the evidence regarding the adverse effects associated with aromatherapy.
Five electronic databases were searched to identify all relevant case reports and case series.
Forty two primary reports met our inclusion criteria. In total, 71 patients experienced adverse effects of aromatherapy. Adverse effects ranged from mild to severe and included one fatality. The most common adverse effect was dermatitis. Lavender, peppermint, tea tree oil and ylang-ylang were the most common essential oils responsible for adverse effects.
Aromatherapy has the potential to cause adverse effects some of which are serious. Their frequency remains unknown. Lack of sufficiently convincing evidence regarding the effectiveness of aromatherapy combined with its potential to cause adverse effects questions the usefulness of this modality in any condition.
Stressful life events are associated with the onset of episodes of major depression. However, exposure to stressful life events is influenced by genetic factors, and these factors are correlated with those that predispose to major depression. The aim of this study was to clarify the degree to which stressful life events cause major depression.
The authors assessed the occurrence of 15 classes of stressful life events and the onset of DSM-III-R major depression over a 1-year period in female twins ascertained from a population-based registry. The sample contained 24,648 person-months and 316 onsets of major depression. Stressful life events were individually rated on contextual threat and dependence (the degree to which the stressful life event could have resulted from the respondent's behavior). The nature of the relationship between stressful life events and major depression was tested by 1) discrete-time survival analysis examining the relationship between dependence and the depressogenic effect of stressful life events and 2) a co-twin control analysis.
While independent stressful life events were significantly associated with onsets of depression, when level of threat was controlled, the association was significantly stronger for dependent events. The odds ratio for onset of major depression in the month of a stressful life event was 5.64 in all subjects, 4.52 within dizygotic pairs, and 3.58 within monozygotic pairs.
Stressful life events have a substantial causal relationship with the onset of episodes of major depression. However, about one-third of the association between stressful life events and onsets of depression is noncausal, since individuals predisposed to major depression select themselves into high-risk environments.
Cochrane Reviews have recently started including the quantity I 2 to help readers assess the consistency of the results of studies in meta-analyses. What does this new quantity mean, and why is assessment of heterogeneity so important to clinical practice?
Systematic reviews and meta-analyses can provide convincing and reliable evidence relevant to many aspects of medicine and health care.1 Their value is especially clear when the results of the studies they include show clinically important effects of similar magnitude. However, the conclusions are less clear when the included studies have differing results. In an attempt to establish whether studies are consistent, reports of meta-analyses commonly present a statistical test of heterogeneity. The test seeks to determine whether there are genuine differences underlying the results of the studies (heterogeneity), or whether the variation in findings is compatible with chance alone (homogeneity). However, the test is susceptible to the number of trials included in the meta-analysis. We have developed a new quantity, I 2, which we believe gives a better measure of the consistency between trials in a meta-analysis.
Assessment of the consistency of effects across studies is an essential part of meta-analysis. Unless we know how consistent the results of studies are, we cannot determine the generalisability of the findings of the meta-analysis. Indeed, several hierarchical systems for grading evidence state that the results of studies must be consistent or homogeneous to obtain the highest grading.2–4
Tests for heterogeneity are commonly used to decide on methods for combining studies and for concluding consistency or inconsistency of findings.5 6 But what does the test achieve in practice, and how should the resulting P values be interpreted?
A test for heterogeneity examines the null hypothesis that all studies are evaluating the same effect. The usual test statistic …
Changes in the autonomic nervous activity can be induced by various sensory and emotional stimuli. The authors examined whether the power spectral analysis of heart rate variability (HRV) could detect changes in autonomic tone following a lavender aroma treatment or not. Healthy young women (n=10, 23+/-3 years old) underwent continuous electrocardiographic (ECG) monitoring before and after (10, 20, 30 minutes) the lavender fragrance stimuli. HRV was expressed by three indices: low (0.04-0.15 Hz) and high (0.15-0.40 Hz) frequency components (nLF and nHF, respectively) as well as LF/HF ratio. Increases in the parasympathetic tone were observed after the lavender fragrance stimulus as seen as increases in the HF component and decreases in the LF/HF. Additional measurement with positron emission tomography (PET) demonstrated the regional metabolic activation in the orbitofrontal, posterior cingulate gyrus, brainstem, thalamus and cerebellum, as well as the reductions in the pre/post-central gyrus and frontal eye field. These results suggested that lavender aromatic treatment induced not only relaxation but also increased arousal level in these subjects.
Stressors have a major influence upon mood, our sense of well-being, behavior, and health. Acute stress responses in young, healthy individuals may be adaptive and typically do not impose a health burden. However, if the threat is unremitting, particularly in older or unhealthy individuals, the long-term effects of stressors can damage health. The relationship between psychosocial stressors and disease is affected by the nature, number, and persistence of the stressors as well as by the individual's biological vulnerability (i.e., genetics, constitutional factors), psychosocial resources, and learned patterns of coping. Psychosocial interventions have proven useful for treating stress-related disorders and may influence the course of chronic diseases.
Objective. —To determine if inadequate approaches to randomized controlled trial design and execution are associated with evidence of bias in estimating treatment effects. Design. —An observational study in which we assessed the methodological quality of 250 controlled trials from 33 meta-analyses and then analyzed, using multiple logistic regression models, the associations between those assessments and estimated treatment effects. Data Sources. —Meta-analyses from the Cochrane Pregnancy and Childbirth Database. Main Outcome Measures. —The associations between estimates of treatment effects and inadequate allocation concealment, exclusions after randomization, and lack of double-blinding. Results. —Compared with trials in which authors reported adequately concealed treatment allocation, trials in which concealment was either inadequate or unclear (did not report or incompletely reported a concealment approach) yielded larger estimates of treatment effects ( P P =.01), with odds ratios being exaggerated by 17%. Conclusions. —This study provides empirical evidence that inadequate methodological approaches in controlled trials, particularly those representing poor allocation concealment, are associated with bias. Readers of trial reports should be wary of these pitfalls, and investigators must improve their design, execution, and reporting of trials. ( JAMA . 1995;273:408-412)
By measuring the sensitive salivary endocrinological stress markers cortisol and chromogranin A (CgA), we investigated effects on stress of lavender and peppermint aromas. Groups of volunteers were each exposed to an airborne organic essential oil: either lavender or peppermint or, for control, odourless jojoba. Saliva samples were collected immediately before and after the 10-min exposure and 5 and 10 min later. Salivary cortisol and CgA levels were evaluated by enzyme-linked immunosorbent assay. After exposure, in the peppermint aroma group, salivary cortisol statistically significantly decreased and salivary CgA statistically significantly increased. No similar changes were found in either the lavender aroma or the control group. These findings suggest that peppermint aroma may be useful for relieving stress. Copyright © 2011 John Wiley & Sons, Ltd.
This systematic review aimed to estimate the prevalence of use of complementary and alternative medicine (CAM) in the UK. Five databases were searched for English language, peer-reviewed surveys published between 1 January 2000 and 7 October 2011. In addition, relevant book chapters and files from our own departmental records were searched by hand. Eighty-nine surveys were included, with a total of 97,222 participants. Most studies were of poor methodological quality. Across surveys on CAM in general, the average one-year prevalence of use of CAM was 41.1% and the average lifetime prevalence was 51.8%. In methodologically sound surveys, the equivalent rates were 26.3% and 44%, respectively. In surveys with response rates >70%, average one-year prevalence was nearly threefold lower than in surveys with response rates between 21% and 50%. Herbal medicine was the most popular CAM, followed by homeopathy, aromatherapy, massage and reflexology. Many patients and consumers in the UK use CAM; healthcare professionals should therefore responsibly advise their patients about the use of CAM.
This systematic review is aimed at estimating the prevalence of complementary and alternative medicine (CAM)-use by paediatric populations in the United Kingdom (UK).
AMED, CINAHL, COCHRANE, EMBASE and MEDLINE were searched for English language peer-reviewed surveys published between 01 January 2000 and September 2011. Additionally, relevant book chapters and our own departmental files were searched manually.
Eleven surveys were included with a total of 17,631 paediatric patients. The majority were of poor methodological quality. Due to significant heterogeneity of the data, a formal meta-analysis was deemed inappropriate. Ten surveys related to CAM in general, while one was specifically on homeopathy. Across all surveys on CAM in general, the average one-year prevalence rate was 34% and the average lifetime prevalence was 42%. In surveys with a sample size of more than 500, the prevalence rates were considerably lower than in surveys with the sample size of lower than 500. Herbal medicine was the most popular CAM modality, followed by homeopathy and aromatherapy.
Many paediatric patients in the UK seem to use CAM. Paediatricians should therefore have sufficient knowledge about CAM to issue responsible advice.
Objective.
—To determine if inadequate approaches to randomized controlled trial design and execution are associated with evidence of bias in estimating treatment effects.Design.
—An observational study in which we assessed the methodological quality of 250 controlled trials from 33 meta-analyses and then analyzed, using multiple logistic regression models, the associations between those assessments and estimated treatment effects.Data Sources.
—Meta-analyses from the Cochrane Pregnancy and Childbirth Database.Main Outcome Measures.
—The associations between estimates of treatment effects and inadequate allocation concealment, exclusions after randomization, and lack of double-blinding.Results.
—Compared with trials in which authors reported adequately concealed treatment allocation, trials in which concealment was either inadequate or unclear (did not report or incompletely reported a concealment approach) yielded larger estimates of treatment effects (P<.001). Odds ratios were exaggerated by 41% for inadequately concealed trials and by 30% for unclearly concealed trials (adjusted for other aspects of quality). Trials in which participants had been excluded after randomization did not yield larger estimates of effects, but that lack of association may be due to incomplete reporting. Trials that were not double-blind also yielded larger estimates of effects (P=.01), with odds ratios being exaggerated by 17%.Conclusions.
—This study provides empirical evidence that inadequate methodological approaches in controlled trials, particularly those representing poor allocation concealment, are associated with bias. Readers of trial reports should be wary of these pitfalls, and investigators must improve their design, execution, and reporting of trials.(JAMA. 1995;273:408-412)
Two experiments examined the relationship between time domain patterns of EEG activity and self-reports for individuals exposed to different odorants. In Exp 1, 3 odorants produced different patterns of EEG theta activity and self reports from 9 adults, suggesting that odor administration is a reliable variable in manipulating neurophysiological response systems and may influence performance and mood. In Exp 2, EEG activity was recorded while 10 adults smelled 5 similar commercial odorous chemicals and an unscented base. Ss also completed questionnaires on odor character and mood. Results indicate that few perceptual or mood differences were produced by the odors. EEG alpha and theta activity in the left and right hemispheres, however, differed depending upon the odor presented and was dissociated from self-reports. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Aromatherapy is the therapeutic use of essential oil from herbs, flowers, and other plants. The aim of this overview was to provide an overview of systematic reviews evaluating the effectiveness of aromatherapy. We searched 12 electronic databases and our departmental files without restrictions of time or language. The methodological quality of all systematic reviews was evaluated independently by two authors. Of 201 potentially relevant publications, 10 met our inclusion criteria. Most of the systematic reviews were of poor methodological quality. The clinical subject areas were hypertension, depression, anxiety, pain relief, and dementia. For none of the conditions was the evidence convincing. Several SRs of aromatherapy have recently been published. Due to a number of caveats, the evidence is not sufficiently convincing that aromatherapy is an effective therapy for any condition.
The purpose of this study was to investigate whether lavender oil aromatherapy can reduce the bispectral index (BIS) values and stress and decrease the pain of needle insertion in 30 volunteers.
Thirty (30) healthy volunteers were randomly allocated to 2 groups: the experimental group received oxygen with a face mask coated with lavender oil for 5 minutes, and the control group received oxygen through a face mask with no lavender oil for 5 minutes. The stress level (0=no stress, 10=maximum stress), BIS value, and pain intensity of needle insertion (0=no pain, 10=worst pain imaginable) were measured.
There were no significant differences in age, sex, height, and weight between the two groups. Stress level, BIS value, and pain intensity of needle insertion before aromatherapy were similar between the two groups. However, the stress values (p<0.001) and BIS value (p<0.001) after aromatherapy were significantly reduced compared with the control. In addition, the pain intensity of needle insertion was significantly decreased after aromatherapy compared with the control (p<0.001).
Lavender aromatherapy in volunteers provided a significant decrease in the stress levels and in the BIS values. In addition, it significantly reduced the pain intensity of needle insertion.
We evaluated the stress relief effect of lavender aroma by measuring sensitive salivary endocrinological stress markers, cortisol and chromogranin A (CgA).
Thirty healthy students performed a serial arithmetic task for 10min and then rested for 10min. During the resting period, 16 students (aroma group) were exposed to airborne organic essential oil of lavender. Saliva samples were collected immediately before and after the arithmetic task, and at 5 and 10min after that. Salivary cortisol and CgA levels were determined by enzyme-linked immunosorbent assay.
In the aroma group, levels of CgA that had been elevated at the end of the arithmetic task were statistically significantly lower 10min later. The control group showed no such change. During the protocol, no statistically significant changes in levels of cortisol were detected in either the aroma group or the control group.
These findings suggest that lavender aroma has a stress relief effect.
To determine whether clinical trials originating in certain countries always have positive results.
Abstracts of trials from Medline (January 1966-June 1995).
Two separate studies were conducted. The first included trials in which the clinical outcome of a group of subjects receiving acupuncture was compared to that of a group receiving placebo, no treatment, or a nonacupuncture intervention. In the second study, randomized or controlled trials of interventions other than acupuncture that were published in China, Japan, Russia/USSR, or Taiwan were compared to those published in England.
Blinded reviewers determined inclusion and outcome and separately classified each trial by country of origin.
In the study of acupuncture trials, 252 of 1085 abstracts met the inclusion criteria. Research conducted in certain countries was uniformly favorable to acupuncture; all trials originating in China, Japan, Hong Kong, and Taiwan were positive, as were 10 out of 11 of those published in Russia/USSR. In studies that examined interventions other than acupuncture, 405 of 1100 abstracts met the inclusion criteria. Of trials published in England, 75% gave the test treatment as superior to control. The results for China, Japan, Russia/USSR, and Taiwan were 99%, 89%, 97%, and 95%, respectively. No trial published in China or Russia/USSR found a test treatment to be ineffective.
Some countries publish unusually high proportions of positive results. Publication bias is a possible explanation. Researchers undertaking systematic reviews should consider carefully how to manage data from these countries.
We reviewed studies from 1990 to 2010 on using aromatherapy for people with anxiety or anxiety symptoms and examined their clinical effects.
The review was conducted on available electronic databases to extract journal articles that evaluated the anxiolytic effects of aromatherapy for people with anxiety symptoms.
The results were based on 16 randomized controlled trials examining the anxiolytic effects of aromatherapy among people with anxiety symptoms. Most of the studies indicated positive effects to quell anxiety. No adverse events were reported.
It is recommended that aromatherapy could be applied as a complementary therapy for people with anxiety symptoms. Further studies with better quality on methodology should be conducted to identify its clinical effects and the underlying biologic mechanisms.
We reviewed studies from 2000 to 2008 on using essential oils for patients with depression or depressive symptoms and examined their clinical effects.
The review was conducted among five electronic databases to identify all peer-reviewed journal papers that tested the effects of aromatherapy in the form of therapeutic massage for patients with depressive symptoms.
The results were based on six studies examining the effects of aromatherapy on depressive symptoms in patients with depression and cancer. Some studies showed positive effects of this intervention among these three groups of patients.
We recommend that aromatherapy could continue to be used as a complementary and alternative therapy for patients with depression and secondary depressive symptoms arising from various types of chronic medical conditions. More controlled studies with sound methodology should be conducted in the future to ascertain its clinical effects and the underlying psychobiologic mechanisms.
The sequence of pathophysiological changes that can result from the stimulating effects of a sustained disturbance of the social environment was studied in ten colonies of socially deprived mice. Sixteen formerly isolated males were placed with 16 normal females in population cages consisting of seven intercommunicating boxes. Six of these socially disturbed 32-member colonies were terminated after periods of interaction ranging from 2 days to 9 months. The remaining four were terminated a month or more after the males had been returned to individual isolation. Indirect blood pressure measurements, body and heart weights, and sections of hearts and aortas were studied in the males. Following the shorter exposures, blood pressure reverted to normal in a few days. Exposure of 6 months or more were associated with unchanged body weights and sustained increases in heart weight and blood pressure readings. In addition, there was a significant development of aortic arteriosclerosis and myocardial fibrosis. These changes persisted despite prolonged return to isolation.
To determine if inadequate approaches to randomized controlled trial design and execution are associated with evidence of bias in estimating treatment effects.
An observational study in which we assessed the methodological quality of 250 controlled trials from 33 meta-analyses and then analyzed, using multiple logistic regression models, the associations between those assessments and estimated treatment effects.
Meta-analyses from the Cochrane Pregnancy and Childbirth Database.
The associations between estimates of treatment effects and inadequate allocation concealment, exclusions after randomization, and lack of double-blinding.
Compared with trials in which authors reported adequately concealed treatment allocation, trials in which concealment was either inadequate or unclear (did not report or incompletely reported a concealment approach) yielded larger estimates of treatment effects (P < .001). Odds ratios were exaggerated by 41% for inadequately concealed trials and by 30% for unclearly concealed trials (adjusted for other aspects of quality). Trials in which participants had been excluded after randomization did not yield larger estimates of effects, but that lack of association may be due to incomplete reporting. Trials that were not double-blind also yielded larger estimates of effects (P = .01), with odds ratios being exaggerated by 17%.
This study provides empirical evidence that inadequate methodological approaches in controlled trials, particularly those representing poor allocation concealment, are associated with bias. Readers of trial reports should be wary of these pitfalls, and investigators must improve their design, execution, and reporting of trials.
Unlabelled:
To systematically investigate location bias of controlled clinical trials in complementary/alternative medicine (CAM).
Methods:
Literature searches were performed to identify systematic reviews and meta-analyses, which were used to retrieve controlled clinical trials. Trials were categorised by whether they appeared in CAM-journals or mainstream medical (MM)-journals, and by their direction of outcome, methodological quality, and sample size.
Results:
351 trials were analysed. A predominance of positive trials was seen in non-impact factor CAM- and MM-journals, (58) / (78) (74%) and (76) / (102) (75%) respectively, and also in low impact factor CAM- and MM-journals. In high impact factor MM-journals there were equal numbers of positive and negative trials, a distribution significantly (P < 0.05) different from all other journal categories. Quality scores were significantly lower for positive than negative trials in non-impact factor CAM-journals (P < 0.02). A similar trend was seen in low-impact factor CAM journals, but not to a level of significance (P = 0.06). There were no significant differences between quality scores of positive and negative trials published in MM-journals, except for high impact factor journals, in which positive trials had significantly lower scores than negative trials (P = 0.048). There was no difference between positive and negative trials in any category in terms of sample size.
Conclusion:
More positive than negative trials of complementary therapies are published, except in high-impact factor MM-journals. In non-impact factor CAM-journals positive studies were of poorer methodological quality than the corresponding negative studies. This was not the case in MM-journals which published on a wider range of therapies, except in those with high impact factors. Thus location of trials in terms of journal type and impact factor should be taken into account when the literature on complementary therapies is being examined.
Human behaviour is influenced by what we know or believe. In research there is a particular risk of expectation influencing findings, most obviously when there is some subjectivity in assessment, leading to biased results. Blinding (sometimes called masking) is used to try to eliminate such bias.It is a tenet of randomised controlled trials that the treatment allocation for each patient is not revealed until the patient has irrevocably been entered into the trial, to avoid selection bias. This sort of blinding, better referred to as allocation concealment, will be discussed in a future statistics note. In controlled trials the term blinding, and in particular “double blind,” usually refers to keeping study participants, those involved with their management, and those collecting and analysing clinical data unaware of the assigned treatment, so that they should not be influenced by that knowledge.The relevance of blinding will vary according to circumstances. Blinding patients to the treatment they have received in a controlled trial is particularly important when the …
The effect of the lavender odorant on a Japanese version of Cox and Mackay's stress/arousal adjective checklist for three groups was studied. One group of 14 was placed into a (2 x 2- x 3 m) sound protected room for 20 min without the presentation of an odor, an analogous group of 15 received the odor oil, and one group of 13 received a nonstressful condition. Analysis suggested that lavender odorants were associated with reduced mental stress and increased arousal rate.
Although substantial evidence suggests that stressful life events predispose to the onset of episodes of depression and anxiety, the essential features of these events that are depressogenic and anxiogenic remain uncertain.
High contextual threat stressful life events, assessed in 98 592 person-months from 7322 male and female adult twins ascertained from a population-based registry, were blindly rated on the dimensions of humiliation, entrapment, loss, and danger and their categories. Onsets of pure major depression (MD), pure generalized anxiety syndrome (GAS) (defined as generalized anxiety disorder with a 2-week minimum duration), and mixed MD-GAS episodes were examined using logistic regression.
Onsets of pure MD and mixed MD-GAS were predicted by higher ratings of loss and humiliation. Onsets of pure GAS were predicted by higher ratings of loss and danger. High ratings of entrapment predicted only onsets of mixed episodes. The loss categories of death and respondent-initiated separation predicted pure MD but not pure GAS episodes. Events with a combination of humiliation (especially other-initiated separation) and loss were more depressogenic than pure loss events, including death. No sex differences were seen in the prediction of episodes of illness by event categories.
In addition to loss, humiliating events that directly devalue an individual in a core role were strongly linked to risk for depressive episodes. Event dimensions and categories that predispose to pure MD vs pure GAS episodes can be distinguished with moderate specificity. The event dimensions that preceded mixed MD-GAS episodes were largely the sum of those that preceded pure MD and pure GAS episodes.
Alertness, mood, and math computations were assessed in 11 healthy adults who sniffed a cosmetic cleansing gel with lavender floral blend aroma, developed to be relaxing using Mood Mapping. EEG patterns and heart rate were also recorded before, during, and after the aroma session. The lavender fragrance blend had a significant transient effect of improving mood, making people feel more relaxed, and performing the math computation faster. The self-report and physiological data are consistent with relaxation profiles during other sensory stimuli such as massage and music, as reported in the literature. The data suggest that a specific cosmetic fragrance can have a significant role in enhancing relaxation.
Many hypertensive patients try complementary/alternative medicine for blood pressure control. Based on extensive electronic literature searches, the evidence from clinical trials is summarised. Numerous herbal remedies, non-herbal remedies and other approaches have been tested and some seem to have antihypertensive effects. The effect size is usually modest, and independent replications are frequently missing. The most encouraging data pertain to garlic, autogenic training, biofeedback and yoga. More research is required before firm recommendations can be offered.
Large-artery stiffness and arterial wave reflections have been identified as independent markers and prognosticators of cardiovascular risk. Mental stress is a novel risk factor for coronary artery disease and has been associated with left ventricular dysfunction, myocardial ischemia and infarction, and sudden cardiac death. The purpose of this study was to assess the effect of acute mental stress on aortic stiffness and wave reflections.
The effect of a mental arithmetic test was assessed in 19 healthy individuals using a randomized, sham-procedure-controlled, crossover design. Carotid-femoral pulse wave velocity and augmentation index were measured as indices of aortic stiffness and wave reflections, respectively.
Mental stress induced a sustained increase in central systolic and pulse pressure throughout the whole study (systolic: by 7.5 mm Hg, p < .05; pulse: by 5.7 mm Hg, p < .01). The increase in peripheral systolic and pulse pressure was not significant throughout the study, but only when their peak values were compared with baseline (systolic: by 6.2 mm Hg, peak at 0 minutes; pulse: by 6.6 mm Hg, peak at 5 minutes, p < .05 for both). There was a sustained increase in pulse wave velocity (by 0.57 m/s, p < .005) throughout the study denoting a sustained increase in aortic stiffness. Similarly, augmentation index showed a sustained increase with mental stress (by 6.16%, p < .05) denoting increased wave reflections from the periphery.
Acute mental stress results in a prolonged increase in aortic stiffness and wave reflections. Given the important pathophysiologic and prognostic role of these parameters, our results provide important mechanistic links between acute mental stress and increased cardiovascular risk.
To assess a possible relationship between perceived stress and first-time incidence of primary endometrial cancer. Psychological stress may affect the synthesis and metabolism of estrogens and thereby be related to risk of endometrial cancer.
The 6760 women participating in the Copenhagen City Heart Study were asked about their stress level at baseline from 1981 to 1983. These women were prospectively followed up in the Danish nationwide cancer registry until 2000 and <0.1% were lost to follow-up. Cox proportional hazard models were used to analyze data.
During follow-up, 72 women were diagnosed with endometrial cancer. For each increase in stress level on a 7-point stress scale, there was a lower risk of primary endometrial cancer (hazard ratio (HR) = 0.88; 95% confidence interval (CI), 0.76-1.01). This inverse association was particularly strong in women who received hormone therapy (HR = 0.77; 95% CI, 0.61-0.96) and in normal-weight women (HR = 0.73; 95% CI, 0.58-0.91).
Stress may affect gonadal synthesis of estrogens and alter the sensitivity of the uterus toward estrogen stimulation. These mechanisms may explain the lower risk of endometrial cancer observed among stressed women in this study. Despite these results, stress may still be a risk factor for a range of other diseases and should therefore not be considered a healthy response.
Cardiovascular psychophysiology: a perspective
- K A Brownley
- B E Hurwitz
- N Schneiderman
Brownley KA, Hurwitz BE, Schneiderman N. Cardiovascular psychophysiology:
a perspective. Cambridge University Press: New York, NY; 2000.
Assessing risk of bias in included studies The Cochrane Collaboration
- Jpt Higgins
- Dg Altman
- Jac Sterne
Higgins JPT, Altman DG, Sterne JAC. Assessing risk of bias in included studies.
In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of
interventions version 510 (updated March 2011). The Cochrane Collaboration;
2011 (Chapter 8). Available from www.cochrane-handbook.org.
Reduction of mental stress with lavender odorant
- Motomura
Location bias in controlled clinical trials of complementary/alternative therapies