Use of aromatherapy to promote a therapeutic nurse environment

Evaluating the impact of lavender aromatherapy and music therapy on reducing stress, anxiety, and depression in female nurses during the COVID-19 pandemic

PURPOSE

Nurses often experience high levels of physical and psychological stress due to frequent exposure to emergency and critical situations, which can adversely affect their professional performance. This study aimed to evaluate and compare the short- and long-term impacts of combining aromatherapy with music therapy versus using aromatherapy alone on the physical and psychological well-being of nurses during the COVID-19 pandemic.

METHOD

This study employed a quasi-experimental design without non-intervention control group and recruited 60 nurses from a regional teaching hospital in central Taiwan between February and November 2023. Participants were randomly assigned to two groups: one group received aromatherapy, and the other group received a combination of aromatherapy and music therapy. The aromatherapy intervention involved inhaling gas infused with lavender essential oil. The intervention was conducted once a week during the lunch break for 20 min over a six-week period. Physiological and psychological indicators were compared before and after the intervention. Physiological indicators included systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR). Psychological indicators included scores on the Nursing Stress Scale (NSS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI), which measured stress, anxiety, and depression, respectively.

RESULTS

Overall, after each aromatherapy intervention, the physiological and psychological measures of the nurses in both groups showed significant reductions (p < 0.05) based on paired t-tests. After six measurements, a one-way repeated measures ANOVA was conducted, revealing that most physiological and psychological measures of the nurses in the aromatherapy-only group were significantly reduced (p < 0.05), although no significant differences were found for diastolic blood pressure and pulse rate. In the group receiving aromatherapy combined with music therapy, all physiological and psychological measures showed significant reductions in repeated measures tests (p < 0.05). These results suggest that aromatherapy combined with music therapy not only improved physical and psychological symptoms immediately but also had lasting effects for at least six weeks.

CONCLUSIONS

This study found that aromatherapy effectively reduced the physical and psychological stress of nurses, with even greater benefits when combined with music therapy. This approach not only provided immediate effects but also were associated with lasting benefits for an extended duration.

Anxiolytic, Antidepressant, and Anticholinesterase Effects of Essential Oil from Myrcia sylvatica (G.Mey.) DC

Aromatic plants are rich sources of essential oils (EOs), recognized for their therapeutic properties due to their diversity of phytochemicals. This study investigated the anxiolytic and antidepressant effects of Myrcia sylvatica essential oil (MsEO) through inhalation in an animal model and its in vitro anticholinesterase (AChE) activity. The EO was obtained by hydrodistillation, and its volatile constituents were analyzed by GC-MS. Swiss mice were exposed to doses of 0.1%, 1%, and 2% of the EO via an inhalation apparatus. The anxiolytic activity was assessed using the elevated plus maze and light-dark box tests, while antidepressant activity was evaluated using the tail suspension and forced swimming tests. To examine potential side effects, the animals were subjected to rotarod, Y-maze, and Morris water maze tests to assess motor coordination, memory, and learning. Anticholinesterase activity was determined by direct bioautography and colorimetry based on the Ellman method. The results demonstrated that inhalation of MsEO at doses of 0.1% and 1% significantly reduced anxiety and depressive-like behaviors without impairing memory, learning, or motor coordination in the animals. Moreover, MsEO inhibited acetylcholinesterase with an IC50 of 0.47 μg/mL. These findings suggest that MsEO has potential therapeutic applications for anxiety and depression disorders, with additional anticholinesterase activity warranting further investigation in cognitive-related conditions.

Effects of Aromatherapy Through Inhalation on Work Stress and Job Satisfaction Among Health Professionals

The aim of this study was to examine the effects of lavender oil inhalation on work stress and job satisfaction among health professionals. This randomized, experimental study involved 108 health professionals, of whom 36 were randomized into the intervention group, 35 into the placebo group, and 37 into the control group. The intervention was performed during work shifts of the intervention group (8 hours a day during a 5-day period). The intervention group was exposed to lavender oil inhalation through a diffuser and the placebo group was exposed to inhalation of distilled water containing light yellow food dye, but the control group did not receive anything. Data were collected with General Characteristics Form, The Swedish Demand-Control-Support Questionnaire, and The Minnesota Satisfaction Scale. The study was also registered at the Australia-New Zealand Clinical Trials Registry (ACTRN12621000239864). Before the intervention, no significant difference was found in work stress and job satisfaction levels between the intervention, placebo, and control groups. After the intervention, the intervention group had a significantly lower work stress level and a significantly higher job satisfaction level than the placebo and control groups ( P < .05). Lavender oil inhalation can decrease work stress and improve job satisfaction.

Help me stay afloat

Building cohesion while working apart.

Efficacy of Aromatherapy at Relieving the Work-Related Stress of Nursing Staff from Various Hospital Departments during COVID-19

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.

Use of Topical Lavender Essential Oils to Reduce Perceptions of Burnout in Critical Care

BACKGROUND

Intensive care unit (ICU) health care workers face increased burnout. The purpose of this project was to evaluate burnout after implementing lavender essential oils.

OBJECTIVE

To assess the effectiveness of topical lavender essential oils in decreasing the instance of burnout in frontline ICU health care workers during the COVID-19 pandemic.

METHODS

A predesign and postdesign evidence-based practice project was conducted to evaluate the implications of an 8-week topical lavender oil intervention on health care worker burnout. The Maslach Burnout Inventory, including subscales of emotional exhaustion, depersonalization, and personal accomplishment, was administered before and after the intervention. Health care workers' compliance and satisfaction with the intervention were also measured.

RESULTS

Thirty-four ICU health care workers participated. Results showed significant improvements in the personal accomplishment subscale (mean [SD], 3.86 [0.81] before vs 4.14 [1.01] after intervention; P = .04). Improvements in depersonalization were not significant. Most participants were satisfied (n = 23 [67.6%]) and compliant (n = 23 [67.6%]) with the intervention.

CONCLUSION

The use of topical lavender essential oils is a cost-effective intervention that can be used to decrease components of burnout in frontline ICU workers.

The effect of lavender on stress in individuals: A systematic review and meta-analysis

BACKGROUND

Lavender is considered as one of the medicinal plants to manage stress. Although many preliminary studies evaluated the effect of lavender on individuals' stress level, to the best of our knowledge, we did not find a study that summarizes the results. Therefore, the present study aimed to estimate the Pooled effect of lavender on the stress level of individuals using systematic review and meta-analysis.

METHOD

A systematic literature review based on PRISMA 2020 was performed on the SID, MagIran, Embase, PubMed, Scopus, Web of Science (WoS) databases, and Google Scholar motor engine using related MeSH/Emtree and ‎Free Text words,‎ including "Lavender*", "Lavandula*", "Stress*", "Stress Disorders, Traumatic", and "Stress, Psychological" with no time limitation until August 2021: We also searched two Iranain free local resourses including MagIran https://www.magiran.com and Scientific Information Database (SID) https://www.sid.ir. The quality assessment of studies was performed using JBI checklist. Heterogeneity among studies was quantified using I² index and Random Effects model was used to combine the data and perform the meta-analysis.

RESULTS

In the initial search, 1520 articles were found. After excluding the irrelevant studies, finally, 21 articles with a sample size of 791 in the intervention group and 804 in the control group were included in the meta-analysis. As a result of combining the studies, stress score after using lavender in the intervention group showed a significant decrease of 0.63 ± 0.13 (95% CI) more than that in the control group (P < 0.001). The results of subgroup analysis demonstrated that the highest standardized mean difference (SMD) before and after the intervention in the intervention group compared to the control group was related to L. angustifolia species with 0.73 ± 0.22, student groups with 2.27 ± 1.34, and diagnostic tool of Perceived Stress Scale (PSS) with 0.82 ± 0.42, indicating that the difference between the groups was statistically significant (P < 0.001).

CONCLUSION

The pooled estimation of this systematic reiew and meta-analysis revealed that lavender significantly reduces individuals' stress. Therefore, it seems that the use of lavender can be considered as a part of a stress management programs, especially in student groups.

Impact of Citrus Essential Oil Diffusion on Health Care Staff's Stress Levels: An Evidence-Based Practice Project

Essential oil diffusion can decrease stress. In one hospital, citrus essential oils were diffused over 6 weeks. Staff completed surveys of their stress levels before and after diffusion. Staff did not report a significant reduction in stress; however, there was an increase in feeling "relaxed."

Effects of lavender and Citrus aurantium on pain of conscious intensive care unit patients: A parallel randomized placebo-controlled trial

BACKGROUND

Conscious patients admitted to intensive care units (ICUs) suffer from pain for various reasons, which can affect their recovery process.

OBJECTIVE

The present study compared the effects of aromatherapy with Citrus aurantium and lavender essential oils against placebo for reducing pain in conscious intensive care patients.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS

This study was a parallel randomized placebo-controlled trial. The ICUs of two educational hospitals in Kerman in Southeastern Iran were the study setting. One hundred and fifty conscious intensive care patients were randomly divided into three groups using a stratified block randomization method. Two groups received aromatherapy with essential oils: one with lavender and the other with C. aurantium; these patients received a 30-minute therapy session using their assigned essential oil on the second day of their intensive care stay. The placebo group used 5 drops of normal saline instead of essential oil during their session.

MAIN OUTCOME MEASURES

Patient's pain was assessed using a visual analog scale before the aromatherapy intervention, as well as immediately after and one and three hours after intervention.

RESULTS

The mean pain score of the lavender group was 40.01 before the aromatherapy intervention and fell to 39.40, 30.60 and 23.68 immediately after the intervention, and at hour one and three post-intervention, respectively. The mean pain score of the C. aurantium group was 45.48 before the intervention and was reduced to 32.34 at three hours after the intervention. The mean pain of the placebo group decreased from 42.80 before the intervention to 35.20 at three hours after the intervention. Pain scores of all groups decreased during the study (P < 0.001). The mean pain of the lavender group was significantly lower than that of the placebo group at three hours after the intervention.

CONCLUSION

The results of this study showed that aromatherapy with lavender essential oil reduced pain in conscious ICU patients. Our data could not justify the use of C. aurantium for reducing pain in this population.

TRIAL REGISTRATION

No. IRCT20170116031972N9 (https://en.irct.ir/trial/40827).

The Effects of Lavender and Citrus aurantium on Anxiety and Agitation of the Conscious Patients in Intensive Care Units: A Parallel Randomized Placebo-Controlled Trial

BACKGROUND

Conscious patients admitted to intensive care units (ICU) suffer from anxiety and agitation for various reasons, which can affect their recovery processes.

AIMS

To compare the effects of lavender and Citrus aurantium essential oils on anxiety and agitation of conscious patients admitted to ICUs.

DESIGN

A randomized parallel placebo-controlled trial.

METHODS

One hundred and fifty conscious patients admitted to ICUs were selected by convenience sampling and were randomly divided into three groups, groups of lavender aromatherapy and Citrus aurantium aromatherapy, in addition to the routine care and inhalation of five drops of lavender or Citrus aurantium essential oils for 30 minutes. The placebo group, in addition to routine care, was provided with 5 drops of normal saline for 30 minutes. Anxiety was assessed with the state subscale of State-Trait Anxiety Inventory, and agitation was examined with Richmond Agitation-Sedation Scale before, immediately, one hour, and three hours after the intervention.

RESULTS

All three groups suffered from relatively severe state anxiety before the intervention. The level of anxiety in the lavender and Citrus aurantium groups was significantly lower than that of the placebo group immediately and three hours after the intervention (P < 0.05). No significant difference was observed between the two groups of lavender and Citrus aurantium. The majority of the samples in all three groups were agitated before the intervention, but agitation of all three groups decreased after the intervention. Restless/agitation reduced significantly in all three groups. Although restless/agitation of the lavender and Citrus aurantium groups reduced more than that of the placebo, no significant difference was found between the three groups.

CONCLUSION

The results of the present study showed the positive effects of lavender aromatherapy and Citrus aurantium aromatherapy on reducing the anxiety of patients admitted to ICUs. Relevance to Clinical Practice. Aromatherapy can be used as an effective and safe intervention to reduce anxiety in ICUs.

Effect of aromatherapy on autonomic nervous system regulation with treadmill exercise-induced stress among adolescents

Introduction

Stress is a major health issue in adolescents owing to the important transitions experienced during this period. Aromatherapy is an effective method for the reduction of stress in adolescents.

Purpose

The aims of this study were to examine the effect of aromatherapy on the regulation of the autonomic nervous system (ANS) along with stress relief and to explore the effect of aromatherapy on adolescents with different levels of stress.

Methods

This quasi-experimental study comprised three types of treatments: control (no essential oil), pure essential oil therapy (sandalwood), and blended essential oil therapy (sandalwood-lavender). The heart rate variability (HRV) was calculated to evaluate the post-exercise recovery of the ANS to the baseline level in the recruited adolescents. To examine the efficiency of aromatherapy, Friedman test was used to assess the significance of difference in all parameters (i.e., mean heart rate, SDNN, normalized LF, normalized HF, and LF/HF) between baseline and after exercise among the three treatment conditions.

Results

The participants comprised 43 junior college students (8 males and 35 females) with a mean age of 18.21 ± 0.99. Significant differences in changes of two HRV parameters (normalized LF and LF/HF) were associated with both essential oil therapies compared to those in the control group (p<0.05), and one more HRV parameter (normalized HF) exhibited significant difference related to blended essential oil therapy compared to that of the control group. Besides, changes in two HRV parameters (mean heart rate and normalized HF) of both essential oil therapies in the low level stress subgroup showed significant differences compared to those of the control group (p<0.05).

Conclusions

This study demonstrated that aromatherapy could be used for ANS regulation with stress-relieving effects in adolescents. The participants with a low stress level appeared to respond better to the blended essential oil therapy, whereas those with medium to high levels of stress appeared to respond poorly to aromatherapy compared to the control.

In the Moment: Fostering Mindfulness and Reducing Stressors in the Healthcare Workplace

While healthcare design research has primarily focused on patient outcomes, there is a growing recognition that environmental interventions could do more by promoting the overall quality of care, and this requires expanding the focus to the health and well-being of those who deliver care to patients. Healthcare professionals are under high levels of stress, leading to burnout, job dissatisfaction, and poor patient care. Among other tools, mindfulness is recommended as a way of decreasing stress and helping workers function at higher levels. This article aims to identify potential environmental strategies for reducing work-related stressors and facilitating mindfulness in healthcare settings. By examining existing evidence on workplace mindfulness and stress-reducing design strategies, we highlight the power of the physical environment in not only alleviating stressful conditions but intentionally encouraging a mindful perspective. Strategies like minimizing distractions or avoiding overstimulation in the healthcare environment can be more effective if implemented along with the provision of designated spaces for mindfulness-based programs. Future research may explore optimal methods and hospital workers' preferences for environments that support mindfulness and stress management. The long-term goal of all these efforts is to enhance healthcare professionals' well-being, reignite their professional enthusiasm, and help them be resilient in times of stress.

Effects of diffused essential oils for reducing stress and improving mood for clinical nurses: An interventional time series study

PURPOSE

This study examined the effect of EO diffusion in the clinical setting on nurses' mood.

DESIGN

Interventional interrupted time series study with two data collection points: prior to, and in the second week of diffusion.

METHODS

Self-report questionnaires measured the impact of EO diffusion on nurses' stress, depression, anxiety, distress, and mood. Three EOs (Citrus Bliss, Grapefruit, Wild Orange) were diffused in 2-week blocks, with a 1-week wash-out period. Descriptive statistics and paired sample t test were performed.

RESULTS

A paired sample was returned for 39 participants. There were significant improvements after diffusion of Citrus Bliss for stress (mean difference [MD]: 2.58; 95% confidence interval [CI]: 0.82, 4.35), depression (MD: 1.83; 95% CI: 0.03, 3.64), distress (MD: 2.39; 95% CI: 0.58, 4.19) and mood (MD: 4.89; 95% CI: 0.52, 9.27). A large effect (Cohen's d effect >0.80) for depression and distress was observed for nurses who had previously used EOs and those with no reported external stressors.

CONCLUSION

Diffusion of citrus EOs in the clinical setting positively affected nurses' mood. Future studies could also explore effect for patients and visitors.

Physician and Nurse Research in Multidisciplinary Intensive Care Units

BACKGROUND

Although clinical care is multidisciplinary, intensive care unit research commonly focuses on single-discipline themes. We sought to characterize intensive care unit research conducted by physicians and nurses.

METHODS

One hundred randomly selected reports of clinical studies published in critical care medical and nursing journals were reviewed.

RESULTS

Of the 100 articles reviewed, 50 were published in medical journals and 50 were published in nursing journals. Only 1 medical study (2%) used qualitative methods, compared with 9 nursing studies (18%) (P = .02). The distribution of quantitative study designs differed between medical and nursing journals (P < .001), with medical journals having a predominance of cohort studies (29 articles [58%]). Compared with medical journal articles, nursing journal articles had significantly fewer authors (median [interquartile range], 5 [3-6] vs 8 [6-10]; P < .001) and study participants (94 [51-237] vs 375 [86-4183]; P < .001) and a significantly lower proportion of male study participants (55% [26%-65%] vs 60% [51%-65%]; P = .02). Studies published in medical journals were much more likely than those published in nursing journals to exclusively involve patients as participants (47 [94%] vs 25 [50%]; P < .001). Coauthorship between physicians and nurses was evident in 14 articles (14%), with infrequent inclusion of authors from other health care disciplines.

CONCLUSIONS

Physician research and nurse research differ in several important aspects and tend to occur within silos. Increased interprofessional collaboration is possible and worthwhile.

Patient safety in Work Environments: Perceptions of Pediatric Healthcare Providers in Taiwan

BACKGROUND

Extensive research on the link between the organizational characteristics of the work environment and patient safety in a healthcare organization has been conducted; yet, only a few studies have concentrated on care providers in a pediatric unit.

OBJECTIVES

To determine the correlation between different work environment factors impacting patient safety in a pediatric care unit from the perspective of registered nurses working in these units.

DESIGN

Cross-sectional design.

DATA SOURCES AND METHODS

The study was conducted with 155 registered nurses from a pediatric unit in a medical center in Taiwan with the Chinese version of the Safety Attitudes Questionnaire (SAQ) 2014-2017.

RESULTS

Teamwork climate, higher job satisfaction, and better working conditions are linked to positive perceptions of patient safety culture. Emotional exhaustion is negatively related to most dimensions of patient safety.

CONCLUSION

Teamwork climate, job satisfaction, working conditions, and emotional exhaustion were identified as critical factors impacting the patient safety climate.

IMPLICATIONS FOR NURSING OR HEALTH POLICY

Investments to improve teamwork climate, job satisfaction, and working conditions and reduce emotional exhaustion may have a positive effect on patient safety in pediatric care units.

Use of Essential Oils by Health Care Professionals for Health Maintenance

This study explores essential oils' use by health care professionals for health maintenance. A qualitative, descriptive design was employed, and a convenience sample of 10 participants was interviewed. Four themes were identified: an essential oils' community, essential oils' use, essential oils' acceptance, and essential oils' benefits and harms.

Using Complementary and Alternative Medicine to Treat Pain and Agitation in Dementia: A Review of Randomized Controlled Trials from Long-Term Care with Potential Use in Critical Care

The risk of pain in adults with dementia worsens with advancing age. Painful comorbidities may be underassessed and inadequately treated. Receiving treatment in critical care settings may indicate greater occurrences of pain and complications. Pain may exacerbate behavioral and psychological symptoms of dementia (BPSD), such as agitation. Complementary and alternative medicine (CAM) therapies may alleviate pain and BPSD, and continuity of therapy may bolster these therapeutic effects. This review did not reveal an apparent benefit of aromatherapy; however, improvements in BPSD have been shown previously. Massage and human interaction did demonstrate efficacy in reducing BPSD and pain.