Effects of aroma inhalation on examination anxiety

The effect of aromatherapy and music therapy on blood pressure and heart rate of nursing students before taking the exam

Anxiety associated with taking exams jeopardizes students' mental and physical health. Complementary alternative methods, such as aromatherapy and music therapy, have shown promise in reducing negative emotions among students. However, few studies have examined the effects of these interventions. This study aimed to investigate the effects of aromatherapy and music therapy on nursing students' blood pressure (BP) and heart rate before taking an exam. This quasi-experimental, double-blinded study was conducted in 2023 at the Nursing College of Abadan University of Medical Sciences in Abadan, Iran. The research included a total of 169 nursing students, who were randomly assigned to three groups: an aromatherapy group (n = 60), a music therapy group (n = 56), and a control group (n = 53). Aromatherapy was administered by inhaling lavender and damask rose essences, while music therapy involved listening to Beethoven's "Moonlight Sonata." The control group received a placebo intervention consisting of cotton soaked in 10 drops of water. Each intervention lasted twenty minutes and was conducted in separate rooms before an exam. Students' heart rates and BP (both systolic and diastolic) were recorded before and after the intervention. The study showed remarkable effects of aromatherapy and music therapy on blood pressure and pulse rate. While systolic blood pressure (SBP) was similar in all groups at the beginning of the study (p = 0.205), SBP decreased significantly after the intervention (p = 0.016), especially in the aromatherapy (p = 0.003) and music therapy (p < 0.001) groups. Both interventions also significantly reduced diastolic blood pressure and pulse rate (p < 0.001) compared to baseline. However, except for SBP (p = 0.021), ANCOVA tests did not reveal significant differences between the study groups for diastolic blood pressure and pulse rate (p > 0.05). The reduction in students' systolic BP before exams, observed with complementary therapies like music therapy and aromatherapy using lavender and damask rose extracts, suggests a decrease in stress-related physiological responses, However, the specific link to exam-related anxiety requires further clarification.

Effect of lavender and rosemary aromatherapy on test anxiety in chiropractic students

OBJECTIVE

Test anxiety is a debilitating disorder that can impair cognitive performance and affect academic success. Aromatherapy is commonly used for relaxation therapy. The primary aim of the study was to determine if nasal inhaler aromatherapy, utilizing a blend of rosemary and lavender essential oils, could be a useful strategy to reduce testing anxiety in students.

METHODS

This study recruited first trimester chiropractic students enrolled in both Neuroanatomy I and Biochemistry I. A randomized crossover design was utilized over 2 study days during final exams, with a 2-day wash-out period. Participants were randomly assigned into groups based on results of test anxiety analysis. On each day, students were given a nasal inhaler with either an aromatherapy blend of lavender and rosemary essential oils or distilled water as the control. Students completed pretest surveys and posttest surveys to rate their anxiety levels. Paired sample t-tests were performed to determine group differences in test anxiety. Both intention-to-treat and per-protocol analyses were conducted.

RESULTS

Forty-five students were randomly assigned into the study, whereas only 38 completed per-protocol. Between group comparisons showed no statistically significant difference between change in anxiety scores between aromatherapy and control for both intention-to-treat (p =.10) and per-protocol (p =.07).

CONCLUSION

Use of personal inhalers and aromatherapy diffusers were not shown to reduce test anxiety in a chiropractic population under high-stakes examination. Other options should be explored for future research.

Aromatherapy with inhalation effectively alleviates the test anxiety of college students: A meta-analysis

Objective

Test anxiety is one of the common psychological and behavioral problems of college students, which can result in poor academic performance and even academic failure. Aromatherapy has been proposed as a promising method to reduce test anxiety in college students, but its precise efficacy has not been fully confirmed. This meta-analysis evaluated the effects of aromatherapy on the symptoms of test anxiety in college students to serve as a reference for future research and provide more scientific and exact evidence.

Methods

PubMed, The Cochrane Library, Web of Science, Embase, CINAHL, Science Direct, Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Full-Text Database (VIP), and Wanfang Data were electronically searched from inception to June 2022 to identify randomized controlled trials (RCTs) on aromatherapy for treating students' test anxiety. The Cochrane Risk of Bias Assessment Tool for RCTs was used by two reviewers to critically and independently assess the methodological quality of the included studies. Review Manager 5.4 was used for the meta-analysis. Stata 17.0 was used for sensitivity analysis and Egger's test.

Results

Seven RCTs included 425 patients, with a moderate risk of bias in the included studies. The meta-analysis found that aromatherapy effectively reduced test anxiety in college students (SMD = -0.67, p < 0.01), with high heterogeneity of results (I 2 = 72%). The different types of essential oil devices used in the study are the source of inter-study heterogeneity. Subgroup analysis suggested that most effective methods were aromatherapy with compound essential oils (SMD = -0.91, p < 0.01), and using cloths or pads as the essential oil devices (SMD = -1.03, p < 0.01). There was no difference between aromatherapy and placebo control groups (SMD = -0.65, p = 0.25).

Conclusion

Aromatherapy with inhalation can help relieve test anxiety in college students, but more and higher-quality studies are needed. This study provides a reference for future research designs in terms of the selection of essential oil types and devices and the design of research groups.

Systematic review registration

[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022345767].

Psychophysiological and Metabolomics Responses of Adults during Horticultural Activities Using Soil Inoculated with Streptomyces rimosus: A Pilot Study

This study compared the physiological effects at a metabolomics level with autonomic nervous system responses in adults during soil mixing activities, based on the presence or absence of Streptomyces rimosus in the soil. Thirty adult participants performed soil mixing activities for 5 min using sterilized soil with culture media and Streptomyces rimosus, respectively. Blood samples were drawn twice from each participant after each activity. Electroencephalograms were measured during the activity. Serum metabolites underwent metabolite profiling by gas chromatography, followed by multivariate analyses. Serum brain-derived neurotrophic factor and C-reactive protein levels were measured by Enzyme-Linked Immunosorbent Assay. Soil-emitted volatile organic compounds were identified via solid-phase microextraction and gas chromatography-mass spectroscopy, followed by multivariate analyses. The volatile compound analysis revealed that the terpenoid and benzoid compounds, geosmin, and 2-methylisoborneol were greater in soil with Streptomyces rimosus. Serum metabolomics revealed that the treatment group (soil inoculated with Streptomyces rimosus) possessed relatively higher levels of serotonin compared to the control group (soil mixed with culture media), and serum C-reactive protein levels were significantly lower in the treatment group. In the treatment group, the electroencephalogram revealed that alpha band activity of the occipital lobe increased. This study concludes that Streptomyces rimosus soil contact can positively affect human metabolic and autonomic reactions. Therefore, this pilot study confirmed the possible role of soil microorganisms in horticultural activities for psychophysiological effects in humans.

Measurement of Stress Relief during Scented Cosmetic Product Application Using a Mood Questionnaire, Stress Hormone Levels and Brain Activation

Nowadays, consumers’ well-being plays a decisive role in the purchase of cosmetic products. Although factors influencing consumers' well-being are very subjective, companies strive to develop their products in such a way that a positive effect is likely. Therefore, methods are required to objectively explore and scientifically prove the product’s performance on humans. In this placebo-controlled study, a method was developed to evaluate relaxation or stress relief associated with one olfactory ingredient of a cosmetic product (face cream). Our experimental protocol included product testing in 25 healthy females, while an emotion questionnaire, analysis of saliva samples regarding the concentration of the hormones cortisol and α-amylase and mobile EEG measurement for quantification of the alpha brain waves before and after stress induction were conducted. It was shown that with this experimental design, the sample with the ingredient produced significant stress relief, as evidenced by significantly less negative emotion, significantly lowered cortisol levels and showed a trend towards a significant increase in alpha activity compared to placebo application. Our data provide evidence that this method is suitable for analyzing the differences between the two samples. In the future, this method can be utilized in the current or a further optimized form to evaluate the psychophysiological effects of cosmetic products on humans.

Effectiveness of lemon essential oil in reducing test anxiety in nursing students

PURPOSE

This study examines the effectiveness of lemon essential oil in reducing test anxiety in first-year nursing students.

METHOD

A randomized, pre-test-post-test design was used in this study. The study included 46 first-year students from the Faculty of Medical Sciences of a private university in Istanbul, Turkey. Students were divided into two groups through randomization (Intervention, N = 22; Control, N = 24). In the pre-test, a personal information form, State Test Anxiety Scale (STAS) and Test Anxiety Schedule (TAS) were administered to students in both groups. The students in the intervention group smelled lemon essential oil for 15 min. The study was completed by applying STAS and TAS as post-test.

RESULTS

After smelling lemon essential oil, a significant difference was found between the mean pre-test and post-test scores for STAS, its sub-dimensions and TAS (p < 0.01) in the intervention group. It was observed that the nursing students' mean scores for STAS, its sub-dimensions and TAS decreased after smelling lemon essential oil (p<0.05). It was found that the intervention group's mean post-test scores for STAS, cognitive sub-dimension and TAS were lower than those of the control group. Mean post-test scores of physiological sub-dimension in the intervention group were also significantly lower than the control group. It was concluded that lemon essential oil reduced test anxiety by 43.3%.

CONCLUSION

Lemon essential oil was found to be effective in reducing test anxiety in nursing students.

Essential Oils, Phytoncides, Aromachology, and Aromatherapy—A Review

Chemical compounds from plants have been used as a medicinal source for various diseases. Aromachology is a unique field that studies the olfactory effects after inhaling aromatic compounds. Aromatherapy is a complementary treatment methodology involving the use of essential oils containing phytoncides and other volatile organic compounds for various physical and mental illnesses. Phytoncides possess an inherent medicinal property. Their health benefits range from treating stress, immunosuppression, blood pressure, respiratory diseases, anxiety, and pain to anti-microbial, anti-larvicidal, anti-septic, anti-cancer effects, etc. Recent advancements in aromatherapy include forest bathing or forest therapy. The inhalation of phytoncide-rich forest air has been proven to reduce stress-induced immunosuppression, normalize immune function and neuroendocrine hormone levels, and, thus, restore physiological and psychological health. The intricate mechanisms related to how aroma converts into olfactory signals and how the olfactory signals relieve physical and mental illness still pose enormous questions and are the subject of ongoing research. Aromatherapy using the aroma of essential oils/phytoncides could be more innovative and attractive to patients. Moreover, with fewer side effects, this field might be recognized as a new field of complementary medicine in alleviating some forms of physical and mental distress. Essential oils are important assets in aromatherapy, cosmetics, and food preservatives. The use of essential oils as an aromatherapeutic agent is widespread. Detailed reports on the effects of EOs in aromatherapy and their pharmacological effects are required to uncover its complete biological mechanism. This review is about the evolution of research related to phytoncides containing EOs in treating various ailments and provides comprehensive details from complementary medicine.

Effects of Olfactory Stimulation with Aroma Oils on Psychophysiological Responses of Female Adults

This study investigated the effects of olfactory stimulation with aroma oils on the psychophysiological responses in women. Ten aromatic oils (lavender, rosemary, rose, eucalyptus, jasmine, geranium, chamomile, clary sage, thyme, and peppermint) were used on 23 women aged between 20 and 60 years. They inhaled the scent for 90 s through a glass funnel attached to their lab apron, 10 cm below their nose, while the pump was activated. Electroencephalography, blood pressure, and pulse rate were measured before and during inhalation of the aroma oils. The relative alpha (RA) power spectrums indicating relaxation and resting state of the brain significantly increased when lavender, rosemary, eucalyptus, jasmine, chamomile, clary sage, and thyme oils were inhaled compared to those of before olfactory stimulation. The ratio of alpha to high beta (RAHB), an indicator of brain stability and relaxation, significantly increased when rosemary, jasmine, clary sage, and peppermint oils were inhaled. The relative low beta (RLB) power spectrum, an indicator of brain activity in the absence of stress, significantly increased when stimulated with lavender, rosemary, rose, and geranium scents. Further, systolic blood pressure significantly decreased after introduction of all 10 types of aromatic oils, which indicates stress reduction. Thus, olfactory stimulation with aroma oil had a stabilizing effect on the prefrontal cortex and brain activity and decreased systolic blood pressure.

A new perspective of aroma face mask on COVID-19 pandemic

In times of the COVID-19 pandemic, wearing face masks is strongly recommended as a public health measure to stop the spread of the Sars Coronavirus. However, there are still people who ignore using this effective protective tool due to the lack of comfortable face masks on the market. Therefore, in the current study, we assessed commercially available face masks namely N95 masks, surgical masks, and cloth masks in order to find out their weakness. In addition, the identification needs of people from a face mask were collected by an online questionnaire. According to the information obtained; we achieved key factors required to design a new type of face mask using the Computer-Aided Design (CAD) and the final design was printed. Moreover, the long-term use of herbs in Iranian Traditional Medicine persuaded us to add a humidifier containing aromatic plants essential oils such as Eucalyptus globules Labill. and Rosa damascene Mill. with scientifically proven health benefits such as pain reliever, relaxing properties and antimicrobial activities. We are expected that these aromas would be an effective way to eliminate the problems of individuals suffering from air pollutants, respiratory disorders, and COVID which leads to encouraging more people to use face masks during pandemics or air pollution.

Effect of Coriander Plants on Human Emotions, Brain Electrophysiology, and Salivary Secretion

Simple Summary

This research aims to investigate the effects of coriander plants on human emotions and physiological activities. The results showed coriander plants could significantly reduce the angry sub-scores, alpha amylase and amino acids (arginine, proline, histidine, and taurine) concentrations in saliva. Theta (4–8 Hz) band activity of the cerebral cortex was significantly enhanced. Moreover, taurine significantly positively correlated with anger and negatively correlated with vigor. All the results signified that coriander plant could influence the activity of brain electrophysiological and salivary secretion through its VOCs to improve people’s negative emotions. This study will provide a theoretical basis for the living coriander plants have some therapeutic effect on the human psychological state.

Abstract

Coriander is a popular herb with versatile applications. However, the current research about coriander medicinal values have been mainly focusing on its extracts while lacking in the relationship between living coriander plants and emotion. Therefore, this study aims to investigate the effects of coriander plants on human emotions and physiological activities. The results showed that the main Volatile organic compounds (VOCs) of coriander plants were 2-ethyl-1-hexanol, d-limonene, eucalyptol, benzyl alcohol, Isophorone, dimethyl glutarate, α-terpineol, styrene, methyl methacrylate, α-pinene. Coriander plants could significantly reduce the angry sub-scores, alpha amylase and amino acids (arginine, proline, histidine, and taurine) concentrations in saliva. Theta (4–8 Hz) band activity of the cerebral cortex was significantly enhanced. Moreover, taurine significantly positively correlated with anger and negatively correlated with vigor. All the results signified that coriander plant could influence the activity of brain electrophysiological and salivary secretion through its VOCs to improve people’s negative emotions.

Aromatherapy for test anxiety in chiropractic students

OBJECTIVE

Up to 85% of college students experience test anxiety, which may contribute to decreased academic performance. The purpose of this study was to assess the feasibility of recruiting chiropractic students for a randomized trial involving aromatherapy for anxiety reduction.

METHODS

This study enrolled chiropractic students who were randomly assigned to separate rooms during a biochemistry test. Waterless diffusers dispersed a lemon and rosemary blend of essential oils in the experimental room and water in the control room. Students completed pretest surveys rating current and general anxiety. Posttest surveys included rating current anxiety. Analysis of covariance (ANCOVA) was preformed to determine within- and between-group differences for current anxiety. Feasibility was the primary aim, and the statistical significance of anxiety test scores between rooms was the secondary aim.

RESULTS

Sixty-four students were included in the study. The feasibility of research methods was noted for adherence to the study protocol (informed consent, randomization, and survey distribution and completion) and resource allocation. Design improvements are required in recruitment methods, follow-up surveys, and intervention blinding. ANCOVA for between-group comparisons showed no statistically significant difference between groups' pre- and posttest anxiety scores (p = .22). Two reported side effects, eye and sinus irritation, could not be attributed to treatment group. Most students were willing to use aromatherapy for test anxiety in the future.

CONCLUSION

We demonstrated feasibility in conducting a randomized study to measure the influence of aromatherapy on test anxiety in chiropractic students. A powered, randomized study is needed to determine if aromatherapy may be effective in reducing test anxiety.

The best route of administration of lavender for anxiety: a systematic review and network meta-analysis

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 anxiety.

Effects of lavender on anxiety: A systematic review and meta-analysis

BACKGROUND

Anxiety is one of the uprising psychiatric disorders of the last decades and lavender administration has been traditionally suggested as a possible treatment. The objective of this review is to assess the efficacy of lavender, in any form and way of administration, on anxiety and anxiety-related conditions.

METHODS

The PRISMA guidelines were followed. Retrieved data were qualitatively and quantitatively synthesized. Randomized Controlled Trials (RCTs) and Non-Randomized Studies (NRSs) which investigated the efficacy of lavender, in any form and way of administration, on patients with anxiety, involved in anxiety-inducing settings or undergoing anxiety-inducing activities, compared to any type of control, without language restrictions, were identified through electronic database searches. Medline via PubMed, Scopus, Web of Science, Cochrane Library, EMBASE, and Google Scholar were systematically searched. All databases were screened up to November 2018. Risk of bias was assessed with the Cochrane risk-of-bias tool and the following domains were considered: randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases.

RESULTS

65 RCTs (7993 participants) and 25 NRSs (1200 participants) were included in the qualitative synthesis and 37 RCTs (3964 participants) were included in the quantitative synthesis. Overall, the qualitative synthesis indicated that 54 RCTs and 17 NRSs reported at least a significant result in favor of lavender use for anxiety. The quantitative synthesis showed that lavender inhalation can significantly reduce anxiety levels measured with any validated scale (Hedges' g = -0.73 [95% CI -1.00 to -0.46], p < 0.00001, 1682 participants), as well as state anxiety (Spielberger's state-trait anxiety inventory (STAI)-State mean difference = -5.99 [95% CI -9.39 to -2.59], p < 0.001, 901 participants) and trait anxiety (STAI-Trait mean difference = -8.14 [95% CI -14.44 to -1.84], p < 0.05, 196 participants). Lavender inhalation did not show a significant effect in reducing systolic blood pressure as a physiological parameter of anxiety. A significant effect in diminishing anxiety levels was also found in favor of the use of oral Silexan® 80 mg/die for at least 6 weeks (Hamilton Anxiety Scale mean difference = -2.90 [95% CI -4.86 to -0.95], p = 0.004, 1173 participants; Zung Self-rating Anxiety Scale mean difference = -2.62 [95% CI -4.84 to -0.39], p < 0.05, 451 participants) or of the administration of massage with lavender oil (Hedges' g = -0.66 [95% CI -0.97 to -0.35], p < 0.0001, 448 participants).

DISCUSSION

The most important limitation of this review is the low average quality of available studies on the topic. The majority of included RCTs were characterized by a high overall risk of bias. Another limitation regards the heterogeneity of study designs, especially with regard to non-oral ways of administration. Overall, oral administration of lavender essential oil proves to be effective in the treatment of anxiety, whereas for inhalation there is only an indication of an effect of reasonable size, due to the heterogeneity of available studies. Lavender essential oil administered through massage appears effective, but available studies are not sufficient to determine whether the benefit is due to a specific effect of lavender. Further high-quality RCTs with more homogeneous study designs are needed to confirm these findings. Available information outlines a safe profile for lavender-based interventions, although more attention should be paid to the collection and reporting of safety data in future studies. Considering these findings, since treatments with lavender essential oil generally seem safe, and, in the case of inhalation, also simple and inexpensive, they are a therapeutic option which may be considered in some clinical contexts.

OTHER

The present systematic review was not funded and was registered in PROSPERO under the following number: CRD42019130126.

Effects of Aromatherapy Combined with Music Therapy on Anxiety, Stress, and Fundamental Nursing Skills in Nursing Students: A Randomized Controlled Trial

Purpose: Nursing students often experience anxiety and stress when taking exams that test their fundamental nursing skills. Complementary alternative methods, such as aromatherapy and music therapy, have effectively alleviated such negative emotions among nursing students. However, few studies have examined the effects of combined therapy interventions or compared the effects of different interventions. This study identified the individual and combined effects of aromatherapy and music therapy on test anxiety, state anxiety, stress, and fundamental nursing skills among nursing students in Korea. Methods: A double-blinded, randomized, controlled trial design was used. The study was conducted at the nursing college at Sungshin Women’s University, Seoul, Republic of Korea. Ninety-eight sophomore female nursing students participated in the study. Subjects were randomly categorized under three groups: aromatherapy (n = 32), music therapy (n = 32), and aromatherapy combined with music therapy (n = 34). Aromatherapy was carried out through the inhalation method using an aroma lamp and three drops of Origanum majorana and Citrus sinensis. Music therapy was carried out using Beethoven’s Moonlight Sonata. Twenty-minute interventions were performed in separate rooms before an exam was administered. Data were collected through self-report questionnaires, including demographics, test anxiety, state anxiety, and stress. Participants’ Foley catheterization skill was likewise evaluated. Results: Aromatherapy combined with music therapy had a significant effect on test anxiety (F = 4.29, p = 0.016), state anxiety (F = 4.77, p = 0.011), stress (F = 4.62, p = 0.012), and performance of fundamental nursing skills (F = 8.04, p = 0.001) compared with aromatherapy and music therapy as separate interventions. Conclusions: The results suggest that nursing education that includes aromatherapy combined with music therapy may be effective for improving the performance of fundamental nursing skills and reducing anxiety and stress among nursing students.

Comparing acupressure with aromatherapy using Citrus aurantium in terms of their effectiveness in sleep quality in patients undergoing percutaneous coronary interventions: A randomized clinical trial

INTRODUCTION

Poor sleep quality is prevalent in candidates for percutaneous coronary interventions (PCIs). The present study was conducted to compare aromatherapy with acupressure in terms of their effectiveness in sleep quality in patients undergoing PCIs.

MATERIALS AND METHODS

The present study was conducted on 85 patients undergoing PCIs and randomly assigned, using block randomization, to five groups, namely (1)aromatherapy, (2)placebo aromatherapy, (3)acupressure, (4)placebo acupressure (acupressure applied to a point not traditionally associated with improving sleep) and (5)control. The intervention groups received aromatherapy or acupressure or placebo from 10pm to 8am the following day. The control group received only routine care. Sleep quality was measured in the patients using a visual analog scale (VAS) that was completed by them before and after the intervention.

RESULTS

The mean pretest score of sleep quality was 2.91 ± 0.53 in the aromatherapy group, 2.84 ± 0.47 in the placebo aromatherapy group, 2.98 ± 0.59 in the acupressure group, 2.75 ± 0.41 in the placebo acupressure group and 2.88 ± 0.41 in the controls. ANOVA suggested no significant differences among these groups in the pretest (P = 0.746). The mean posttest score of sleep quality was 3.72 ± 1.84 in the aromatherapy group, 3.70 ± 1.83 in the placebo aromatherapy group, 7.35 ± 0.99 in the acupressure group, 2.67 ± 0.41in the placebo acupressure group and 2.72 ± 0.34 in the controls, suggesting significant differences among the five groups based on the ANOVA results showed significant differences among the five groups (P < 0.001). The mean posttest score of sleep quality was higher than the pretest score by 4.37 in the acupressure group compared to in the other groups (P < 0.001).

CONCLUSION

The present findings provided scientific evidence for the benefits of using different methods, including acupressure, for sleep quality in patients undergoing PCIs.

IRANIAN REGISTRY OF CLINICAL TRIALS NUMBER

IRCT201707248665N6.

Effect of Inhaled Lemon Essential Oil on Cognitive Test Anxiety Among Nursing Students

Nursing programs are stressful learning environments, and students are expected to maintain high academic performance to successfully graduate. Cognitive test anxiety has been minimally studied among nursing students, including how to successfully manage. The Cognitive Test Anxiety Scale (CTAS) was administered to 31 students before and after a high-stakes nursing examination. The intervention was inhaled lemon essential oil delivered via a personal nasal device. Neither the control nor the experimental group demonstrated a statistically significant change in the CTAS score from pretest to posttest (P = .19). More quantitative studies are warranted with undergraduate nursing students, the CTAS, and aromatherapy to reduce the burden of cognitive test anxiety.

Olfactory Stimulation Effect of Aldehydes, Nonanal, and Decanal on the Human Electroencephalographic Activity, According to Nostril Variation

Fragrances play a pivotal role in humans' psychological and physiological functions through the olfactory system. Aldehydes are important organic compounds with a variety of fragrance notes. Particularly, nonanal (C9) and decanal (C10) aldehydes are important natural fragrant components used to enhance floral, as well as citrus notes in perfumery products. In general, each nostril of the human nose is tuned to smell certain odor molecules better than others due to slight turbinate swelling between the nostrils. Hence, the objective of the present investigation was aimed to evaluate the influence of binasal and uninasal inhalations of C9 and C10 aldehydes on human electroencephalographic (EEG) activity. Twenty healthy participants (10 males and 10 females) participated in this study. The EEG readings were recorded from 8 electrodes (QEEG-8 system) according to the International 10-20 System. The results revealed that C10 exposure exhibited significantly different EEG changes, during binasal and uninasal inhalations. In different brain regions, C10 odor markedly decreased the absolute alpha and absolute beta power spectra. In regards to C9 odor, significant changes of EEG power spectra were noticed only during binasal inhalation. In addition, C10 mainly produced changes at the left parietal site (P3) than other brain sites. In conclusion, the variations in EEG activities of C9 and C10 aldehydes might be owing to their characteristic fragrance quality, as well as the influence of nostril differences.

Behavioural effects of inhalation exposure to dizocilpine (MK-801) in mice

The complex pathophysiology of brain disorders and the difficulty of delivering therapeutic agents to the brain remain major obstacles in the research and development of new therapeutic methods for brain disorders. Therefore, delivering existing therapeutic agents to the central nervous system is expected to provide benefits in various diseases. In this study, we investigated whether inhaled central nervous system drugs reached the brain and affected mouse behaviour. Dizocilpine (MK-801), which increases locomotor activity in mice, was mainly used to study this hypothesis. First, we administered MK-801, an N-methyl-d-aspartate receptor antagonist, to mice via inhalation and examined whether it induced excessive activity similar to that observed after intraperitoneal administration. We also examined the time- and dose-dependency of drug induced changes in mouse behaviour after MK-801 inhalation. Next, we investigated whether inhalation of scopolamine, pentobarbital, and imipramine also affected mouse behaviour. Mice that inhaled MK-801 showed MK-801-induced hyperactivity similar to that observed following intraperitoneal administration. Furthermore, the extent of activity changed in a time- and dose-dependent manner after MK-801 inhalation. Inhalation of pentobarbital, scopolamine, and imipramine also changed mouse behaviour. These results demonstrate that inhalation of MK-801 exerts effects similar to those achieved with intraperitoneal and oral administration in mice. Thus, central nervous system agonists can reach the brain efficiently via inhalation. This finding may facilitate the development of improved therapies for brain disorders.

The Effect of Lavender Oil Application via Inhalation Pathway on Hemodialysis Patients' Anxiety Level and Sleep Quality

Sleep and anxiety problems occur in hemodialysis (HD) patients due to physical symptoms, lifestyle changes, and psychosocial changes. To remove these sleep and anxiety problems, lavender oil inhalation is one of the nonpharmacological treatment options with less adverse effects than pharmacological methods. The purpose of this study was to determine the effect of lavender oil application via inhalation pathway on HD patients' anxiety level and sleep quality. The study was conducted with 34 HD patients who have been on HD treatment at 2 dialysis centers. The patients of the intervention group (n = 17) were told to drip 2 drops into the box and to place it 15 to 20 cm away from the pillow, 30 minutes before going to bed for 1 week. Control group (n = 17) received no intervention. Data were collected with questionnaire form, Visual Analog Scale, and Hamilton Anxiety Assessment Scale with a face-to-face interview. Subjective sleep quality of the intervention group was higher than that of control group, mean Visual Analog Scale daytime sleepiness score declined (P < .05), and mean score of sleep duration increased (P < .001) in the intervention group. However, the differences of mean score of time for falling asleep between the 2 groups were not different. The mean score of total and subdimensions of Hamilton Anxiety Assessment Scale of intervention group and control group was significantly different (P < .001). These study results provide new promising information about the effect of lavender inhalation on sleep problems and anxiety and these have made significant contributions to nursing, especially for dialysis nurses.

Effect of essential oil and supercritical carbon dioxide extract from the root of Angelica gigas on human EEG activity

OBJECTIVES

The present study aimed to investigate the effect of inhalation of essential oil (EO) and supercritical carbon dioxide extract (SC-CO₂) from the root of A. gigas on human electroencephalographic (EEG) activity.

MATERIALS AND METHODS

For this purpose, the EO was obtained from the root of A. gigas by steam distillation and SC-CO₂ was obtained at 50 °C and 400 bar for 1 h. The EEG readings were recorded using the QEEG-8 system from 8 electrode sites according to the International 10-20 system.

RESULTS

In the EEG study, the absolute low beta (left temporal and left parietal) activity significantly increased during the inhalation of EO. In the case of SC-CO₂ inhalation, there was no significant change in absolute waves.

CONCLUSION

The results revealed that the EO of A. gigas root produced significant changes in the absolute low beta activity and these changes may enhance the language learning abilities of human brain.

The effect of music listening on the anxiety of nursing students during their first blood draw experience

BACKGROUND

Nursing education is a process aimed both at theoretical knowledge and skill development. The Fundamentals of Nursing is a course that furnishes students with professional knowledge, concepts and technical skills, and, also, is the keystone of nursing education in our country. Students experience a great deal of anxiety as they face basic nursing practices for the first time. Studies have revealed the effectiveness of music in relieving anxiety in many patient groups. However, no previous studies were found where music was used with the intent to lower the anxiety that students experience over the course of skill learning. The experimental study is aimed at determining the effect of music in decreasing anxiety during the first nursing practices of students in a laboratory setting.

METHODS

The experimental study was conducted on nursing students of Akdeniz University attending Fundamentals of Nursing, a freshman course, during the 2013-2014 academic year. A total of 73 students, of which 34 were assigned to the experimental group and 39 to the control group, participated in the study. Data collection was carried out using (a) the student identification form prepared by the authors, (b) skill control lists and (c) the Situational Anxiety Scale. The students in the experimental group listened to music during blood draw skill practice in a laboratory environment. The students were assessed with respect to their performance of blood drawing through skill control lists using the statements "True", "False" and "Forgotten". The anxiety levels and vital signs of students were assessed before and after the practice.

RESULTS

The mean age of the students was 19.08. 64.7% of the experimental group and 82.1% of the control group were female. The age group of 64.7% of the students in the experimental group was female. The age group of 82.1% of the students in the control group was female. After music listening, the mean anxiety score of the students was 38.70±3.83 in the experimental group and 39.76±4.72 in the control group. The difference between the mean anxiety scores of the two groups was statistically significant (p<0.05). The evaluation made before and after the blood draw revealed a statistically significant difference in diastolic blood pressure values in the experimental group that listened to music(p<0.05).

CONCLUSIONS

The results of the study showed that listening to music decreased the anxiety levels of nursing students during their first blood draw experience.

Interventions for Test Anxiety in Undergraduate Nursing Students: An Integrative Review

AIM

An integrative review was conducted to identify and evaluate interventions for test anxiety (TA) in undergraduate nursing students.

BACKGROUND

Test performance has a major impact on the academic success of nursing students. Therefore, testing is a source of stress and anxiety, which may impair academic performance.

METHOD

A systematic search was conducted to locate peer-reviewed literature about interventions for TA in undergraduate nursing students.

RESULTS

Review of 33 publications dated 1973 to 2014 identified 19 interventions for TA in undergraduate nursing students. Findings included experimental evidence supporting aromatherapy, music therapy, and various cognitive or behavioral interventions. Nonexperimental evidence supporting collaborative testing, crib sheets, and humorous exam items was also found.

CONCLUSION

Many interventions for mitigating TA in nursing students have been evaluated since the 1970s. Current research is needed to corroborate and strengthen the evidentiary support for existing interventions and to evaluate new interventions.

Biological Activities of Essential Oils: From Plant Chemoecology to Traditional Healing Systems

Essential oils are complex mixtures of hydrocarbons and their oxygenated derivatives arising from two different isoprenoid pathways. Essential oils are produced by glandular trichomes and other secretory structures, specialized secretory tissues mainly diffused onto the surface of plant organs, particularly flowers and leaves, thus exerting a pivotal ecological role in plant. In addition, essential oils have been used, since ancient times, in many different traditional healing systems all over the world, because of their biological activities. Many preclinical studies have documented antimicrobial, antioxidant, anti-inflammatory and anticancer activities of essential oils in a number of cell and animal models, also elucidating their mechanism of action and pharmacological targets, though the paucity of in human studies limits the potential of essential oils as effective and safe phytotherapeutic agents. More well-designed clinical trials are needed in order to ascertain the real efficacy and safety of these plant products.

Influence of Binasal and Uninasal Inhalations of Essential Oil of Abies koreana Twigs on Electroencephalographic Activity of Human

Objectives. The present work investigates the effect of essential oil from the twigs of Abies koreana on electroencephalographic (EEG) activity of human brain in order to understand the influence of binasal and uninasal inhalations. Methods. To accomplish this study, the essential oil from the twigs of A. koreana (AEO) was isolated by steam distillation and the EEG readings were recorded using QEEG-8 system from 8 grounding electrodes according to the International 10-20 System. Results. D-Limonene (25.29%), bornyl acetate (19.31%), camphene (12.48%), α-pinene (11.88%), β-pinene (6.45%), and eudesm-7(11)-en-ol (5.38%) were the major components in the essential oil. In the EEG study, the absolute alpha (left frontal and right parietal) and absolute fast alpha (right parietal) values significantly increased during the binasal inhalation of AEO. In the uninasal inhalation, absolute beta and theta values decreased significantly, especially in the right frontal and left and right parietal regions. The results revealed that the AEO produced different EEG power spectrum changes according to the nostril difference. Conclusion. The changes in EEG values due to the inhalation of AEO may contribute to the enhancement of relaxation (binasal inhalation) and alertness/attention (right uninasal inhalation) states of brain which could be used in aromatherapy treatments.

Influence of Fragrances on Human Psychophysiological Activity: With Special Reference to Human Electroencephalographic Response

The influence of fragrances such as perfumes and room fresheners on the psychophysiological activities of humans has been known for a long time, and its significance is gradually increasing in the medicinal and cosmetic industries. A fragrance consists of volatile chemicals with a molecular weight of less than 300 Da that humans perceive through the olfactory system. In humans, about 300 active olfactory receptor genes are devoted to detecting thousands of different fragrance molecules through a large family of olfactory receptors of a diverse protein sequence. The sense of smell plays an important role in the physiological effects of mood, stress, and working capacity. Electrophysiological studies have revealed that various fragrances affected spontaneous brain activities and cognitive functions, which are measured by an electroencephalograph (EEG). The EEG is a good temporal measure of responses in the central nervous system and it provides information about the physiological state of the brain both in health and disease. The EEG power spectrum is classified into different frequency bands such as delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz) and gamma (30-50 Hz), and each band is correlated with different features of brain states. A quantitative EEG uses computer software to provide the topographic mapping of the brain activity in frontal, temporal, parietal and occipital brain regions. It is well known that decreases of alpha and beta activities and increases of delta and theta activities are associated with brain pathology and general cognitive decline. In the last few decades, many scientific studies were conducted to investigate the effect of inhalation of aroma on human brain functions. The studies have suggested a significant role for olfactory stimulation in the alteration of cognition, mood, and social behavior. This review aims to evaluate the available literature regarding the influence of fragrances on the psychophysiological activities of humans with special reference to EEG changes.

Aromatherapy Improves Work Performance Through Balancing the Autonomic Nervous System

OBJECTIVE

This study analyzed the efficacy of aromatherapy in improving work performance and reducing workplace stress.

SUBJECTS

The initial sample comprised 42 administrative university workers (M_age = 42.21 years, standard deviation = 7.12; 10 male).

INTERVENTION

All sessions were performed in a university computer classroom. The participants were randomly assigned into an aromatherapy group (AG) and a control group (CG), and they were invited to participate in a specific session only once. They were seated in front of a computer. During the intervention period, some oil diffusers were switched on and were in operation throughout the session with petitgrain essential oil for AG sessions and a neutral oil (almond) for CG sessions. At the same time, participants completed a computer task on a specific Web site typing on their keyboard until they had finished it. The single times were different for all participants and were recorded on the Web site as "performance time."

OUTCOME MEASURES

Before and after the intervention, participants completed anxiety and mood state questionnaires (the Stait-Trait Anxiety Inventory [STAI] and the Profile of Mood States [POMS]). Heart-rate variability (HRV) was measured before (PRE), during (20-25 min), and after (POS) the intervention to analyze autonomic nervous system regulation.

RESULTS

The AG performed the Web site task 2.28 min faster than the CG (p = 0.05). The two groups showed differences in the following HRV parameters: low frequency (p = 0.05), high frequency (p = 0.02), standard deviation of all RR intervals (p = 0.05), and root mean square of differences (p = 0.02). All participants in all groups showed a decrease from PRE to POST for STAI (p < 0.001), Tension-POMS (p < 0.001), and Vigour-POMS (p = 0.01) scales.

CONCLUSIONS

Aromatherapy (inhaling petitgrain essential oil) can improve performance in the workplace. These results could be explained by an autonomic balance on the sympathetic/parasympathetic system through a combined action of the petitgrain main components (linalyl acetate, linalool, and myrcene). The final effect could be an improvement of the mental and emotional condition by a combination of reducing the stress level and increasing the arousal level of the participants in terms of attentiveness and alertness.

The Effect of Aromatherapy on Anxiety in Patients

BACKGROUND

Anxiety is the most common mental disorder in end-stage renal disease patients. The use of aromatherapy as a treatment for anxiety has increased substantially in most countries.

OBJECTIVES

This study aimed to investigate the effect of inhaling rose water aromatherapy on anxiety in hemodialysis patients.

METHODS

This randomized controlled clinical trial was carried out in the hemodialysis ward of Birjand Vali-Asr hospital on 46 patients who were randomly divided into control and experimental groups. The standard state-trait anxiety inventory of Spielberger was used to investigate the anxiety level of the samples. The experimental group inhaled rose water for 4 weeks, but the control group did not undergo any intervention. At the end of week 2 and week 4, the participants' anxiety was measured, and the results were statistically analyzed.

RESULTS

Mean scores of state and trait anxiety in the experimental group before intervention were 47/47 ± 7/6 and 49/56 ± 13/8, respectively; those after week 4 following the intervention were reduced to 37/1 ± 6/5 and 42/9 ± 10/1; inhalation of rose water fragrance in the experimental group caused a significant decrease (P < 0.001) in the state and trait anxiety levels compared with controls (P = 0.43).

CONCLUSIONS

According to the present study, rose water noticeably reduces the anxiety of hemodialysis patients. Therefore, inhalation of rose water can improve the patient's emotional and spiritual condition during hemodialysis treatment.

Aromatherapy with two essential oils from Satureja genre and mindfulness meditation to reduce anxiety in humans

The goal of this study was to verify whether association of aromatherapy with essential oils of Satureja brevicalyx or Satureja boliviana and mindfulness meditation can reduce anxiety levels in humans. A randomized experimental trial was carried out with 108 participants who were divided into 6 groups, comprising a waiting list control group and five experimental groups. Aromatherapy was carried out by inhalation of essential oils while mindfulness intervention program was focused on "flow meditation". The anxiety index was evaluated by State-Trait Anxiety Inventory (STAI). Measures were taken two times: pretest and posttest. State and Trait anxiety scores showed a decrease in posttest study phase in comparison with pretest in all experimental groups (p < 0.005), especially in those where aromatherapy and mindfulness meditation were used together. All Cohen's d scores were over to 1 that means a large size effect in anxiety variable. Percentages of change showed reductions of anxiety variable ranging between 20% and 47%. All treatments used isolated or associated, may be considered alternative treatment options for anxiety.

Effect of inhalation aromatherapy with lavender essential oil on stress and vital signs in patients undergoing coronary artery bypass surgery: A single-blinded randomized clinical trial

OBJECTIVES

At present, aromatherapy is used widely in medical research. This study aimed to investigate the effects of inhalation aromatherapy using lavender essential oil to reduce mental stress and improve the vital signs of patients after coronary artery bypass surgery (CABG).

DESIGN

A single-blinded randomized controlled trial was conducted with 60 patients who had undergone CABG in a 2-day intervention that targeted stress reduction.

PARTICIPANTS

Sixty subjects following coronary artery bypass surgery in two aromatherapy and control groups.

SETTING

The study was conducted in Ekbatan Therapeutic and Educational Center, Hamadan, Iran, in 2013.

INTERVENTIONS

On the second and third days after surgery, the aromatherapy group patients received two drops of 2% lavender essential oil for 20min and the control group received two drops of distilled water as a placebo.

MAIN OUTCOME MEASURES

The primary outcome was mental stress, which was measured before and after the intervention using the DASS-21 questionnaire. The secondary outcomes were vital signs, including the heart rate, respiratory rate, and systolic and diastolic blood pressure, which were measured before and after the intervention.

RESULTS

The individual characteristics of the aromatherapy and control groups were the same. There were no significant difference in the mean mental stress scores and vital signs of the aromatherapy and control groups on the second or third days after surgery.

CONCLUSION

Inhalation aromatherapy with lavender essential oil had no significant effects on mental stress and vital signs in patients following CABG, except the systolic blood pressure.

A conceptual view of test anxiety

PURPOSE

The purpose of this study is to clarify the term test anxiety with a focus on nursing education.

CONCLUSION

Walker and Avant's concept analysis technique was used to examine the term test anxiety. The attributes of the concept of test anxiety include administration of a test, negative subjective feelings, behavioral aspects, physical signs, and cognitive aspects.

PRACTICE IMPLICATIONS

Understanding test anxiety in the nursing student can help develop research-based interventions. Assessing test anxiety in nursing students is important for nurse educators to better understand the challenges that face these upcoming nursing professionals. Nursing research that further explores test anxiety is needed.

The effects of inhalation aromatherapy on anxiety in patients with myocardial infarction: a randomized clinical trial

Background:

Anxiety is an important mental health problem in patients with cardiac disease. Anxiety reduces patients’ quality of life and increases the risk of different cardiac complications.

Objectives:

The aim of this study was to investigate the effects of inhalation aromatherapy on anxiety in patients with myocardial infarction.

Patients and Methods:

This was a randomized clinical trial conduced on 68 patients with myocardial infarction hospitalized in coronary care units of a large-scale teaching hospital affiliated to Kashan University of Medical Sciences, Kashan, Iran in 2013. By using the block randomization technique, patients were randomly assigned to experimental (33 patients receiving inhalation aromatherapy with lavender aroma twice a day for two subsequent days) and control (35 patients receiving routine care of study setting including no aromatherapy) groups. At the beginning of study and twenty minutes after each aromatherapy session, anxiety state of patients was assessed using the Spielberger’s State Anxiety Inventory. Data was analyzed using SPSS v. 16.0. We used Chi-square, Fisher’s exact, independent-samples T-test and repeated measures analysis of variance to analyze the study data.

Results:

The study groups did not differ significantly regarding baseline anxiety mean and demographic characteristics. However, after the administration of aromatherapy, anxiety mean in the experimental group was significantly lower than the control group.

Conclusions:

Inhalation aromatherapy with lavender aroma can reduce anxiety in patients with myocardial infarction. Consequently, healthcare providers, particularly nurses, can use this strategy to improve postmyocardial infarction anxiety management.

The effects of aromatherapy in relieving symptoms related to job stress among nurses

Workplace-related stress has become today's most serious occupational hazard. Aromatherapy is a simple, convenient and non-invasive method of stress relief. There is little research regarding the efficacy of aromatherapy by means of inhaling essential oil in reducing workplace stress-related symptoms among nurses. Therefore, this study was to examine the effectiveness of lavender oil inhalation in reducing job stress-related symptoms among nurses. The 53 nurses in the experimental group pinned small bottles containing 3% lavender oil on the clothes of their right chests, whereas 57 participants in the control group pinned bottles with no lavender oil. Aromatherapy was shown to be effective in the reduction of the number of stress symptoms for 3 or 4 days. The stress symptoms of the experimental group decreased from 6.1 to 2.8 after aromatherapy was carried out (P = 0.126, 0.159, 0.035 and 0.026). This represented a significant decrease in stress, whereas the stress symptoms in the control group increased from 5.6 to 5.8. Hospital staff managers are still encouraged to include aromatherapy concepts and techniques in the continuing education of nursing staff. Concurrently, future research should focus on the possible side effects of aromatherapy to assure safety.

Effects of Ylang-Ylang aroma on blood pressure and heart rate in healthy men

Although the Ylang-Ylang aroma (YYA) has used as a general method for enhancing sedative effect, there was a little report on the efficacy of YYA on heart function using the electrocardiogram (EKG). Therefore, identifying of the effects of YYA on blood pressure (BP) and heart rate (HR) is important in order to demonstrate the effectiveness of YYA. The aim of this study was to investigate the effects of YYA on BP and HR in healthy men. Twenty-nine men took part in this study. The subjects were randomly divided into 2 groups: Ylang-Ylang group (YYG, n= 15) and control group (CG, n= 14). Physiological parameters recorded were BP by using a sphygmomanometer and HR by using an EKG. The present results demonstrated that inhalation of YYA significantly decreased the systolic and diastolic blood pressure. Inhalation of YYA also significantly decreased the HRs in 10 leads, except in lead I and aVR. This indicates that the HRs recorded in lead I and aVR were less sensitive or obtuse compared to those in the 10 other leads. Therefore, such a result reveals that it is necessary to be aware of the terms regarding the position. In the present results, YYA caused a reduction of HR and BP, and a relief of the arousal level in healthy men. The present results show a sedative effect of YYA, and this study provides some evidences for the usage of YYA in medicinal agent.

Is lavender an anxiolytic drug? A systematic review of randomised clinical trials

BACKGROUND

Lavender (Lavandula angustifolia) is often recommended for stress/anxiety relief and believed to possess anxiolytic effects.

AIM

To critically evaluate the efficacy/effectiveness of lavender for the reduction of stress/anxiety.

METHODS

Seven electronic databases were searched to identify all relevant studies. All methods of lavender administration were included. Data extraction and the assessment of the methodological quality of all included trials were conducted by two independent reviewers.

RESULTS

Fifteen RCTs met the inclusion criteria. Two trials scored 4 points on the 5-point Jadad scale, the remaining 13 scored two or less. Results from seven trials appeared to favour lavender over controls for at least one relevant outcome.

CONCLUSION

Methodological issues limit the extent to which any conclusions can be drawn regarding the efficacy/effectiveness of lavender. The best evidence suggests that oral lavender supplements may have some therapeutic effects. However, further independent replications are needed before firm conclusions can be drawn.

A systematic review on the anxiolytic effects of aromatherapy in people with anxiety symptoms

PURPOSE

We reviewed studies from 1990 to 2010 on using aromatherapy for people with anxiety or anxiety symptoms and examined their clinical effects.

METHODS

The review was conducted on available electronic databases to extract journal articles that evaluated the anxiolytic effects of aromatherapy for people with anxiety symptoms.

RESULTS

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.

CONCLUSIONS

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.