Experiences of aromatherapy massage among adult female cancer patients: A qualitative study

Exploring Aromatherapy as a Complementary Approach in Palliative Care: A Systematic Review

Background: Palliative care, a cornerstone of comprehensive healthcare, prioritizes quality of life for individuals with life-threatening illnesses. Aromatherapy, with its holistic approach and patient-reported benefits, emerges as a promising complementary therapy for managing symptoms and enhancing well-being in palliative care. Objective: The objective of this systematic review is to assess the efficacy of aromatherapy interventions in symptom management, with a focus on pain, anxiety, nausea, and sleep disturbances among palliative care patients. Design: A comprehensive search was conducted across various databases to identify relevant studies. Eligibility criteria were applied, resulting in the inclusion of eight studies for analysis. The review assessed the efficacy of aromatherapy interventions, primarily through massage, in symptom management. Variations in intervention procedures and outcome measures were noted, necessitating a critical examination of the findings. Results: The review's findings suggest promising outcomes associated with aromatherapy in palliative care. Aromatherapy interventions demonstrated significant efficacy in reducing pain, anxiety, nausea, and improving sleep quality among patients. However, considerable heterogeneity was observed across studies, highlighting the need for standardized methodologies and larger-scale trials. Conclusion: This systematic review underscores the potential of aromatherapy as a complementary intervention in palliative care. While the findings support its efficacy in symptom management, methodological inconsistencies across studies warrant further research. Standardized approaches and larger trials are essential to validate the tailored effectiveness of aromatherapy for different symptoms encountered in palliative care, ultimately enhancing its clinical utility and integration into therapeutic practices.

The antibacterial effectiveness of lavender essential oil against methicillin-resistant Staphylococcus aureus: a systematic review

With the overuse and misuse of antibiotics, multi-drug resistant organisms have become a prominent issue in healthcare, increasing morbidity and mortality in affected patients. One such organism of concern is methicillin-resistant Staphylococcus aureus (MRSA) which is a leading cause of a variety of clinical infections. Therefore, in the interest of finding alternate substances to antibiotics, there has been increased interest in the antibacterial properties of lavender essential oil (LEO). This systematic review aims to collate information regarding the antibacterial properties of LEO against S. aureus and MRSA. A systematic search was conducted across four databases between the years 2002 and 2022, and through this, 23 studies were included in this paper. These studies used a variety of methods to ascertain the antibacterial effectiveness of LEO alone or in combination with other substances. Overall, there were mixed results regarding the antibacterial effectiveness of LEO against S. aureus and MRSA, with some studies reporting significant effectiveness, while other studies reporting a minimal to negligible effect. However, findings suggest that LEO works synergistically with other antibacterial substances, and it would be beneficial for additional research to be conducted in this area.

Randomized Controlled Study in the Use of Aromatherapy for Pain Reduction and to Reduce Opioid Use in the Emergency Department

INTRODUCTION

This study aimed to evaluate the effects of aromatherapy on emergency department patients' perception of pain and its ability to reduce the use of opioids in an emergency department.

METHODS

This randomized, controlled, single-blinded study was conducted in a suburban/rural freestanding emergency department with a therapeutic group, sham group, and control group.

RESULTS

A total of 230 patients, 171 females and 59 males, completed the study. Of those who received the therapeutic agent, an average reduction in pain of 1.04 points on the pain scale was reported, whereas the sham group averaged 0.38 and the control group 0.23. There was a statistically significant reduction of pain scores in the therapeutic group. A total of 13 received opioid pain medication during their visit. Of these, the therapeutic group averaged a total of 2.67 morphine milligram equivalents for their visit compared with 3.63 in the sham group and 4.36 in the control group; however, statistical significance was not achieved.

DISCUSSION

This study supported what other studies have found, indicating that aromatherapy is effective in reducing pain. A difference between the placebo effect and a true therapeutic effect was seen by using a control group apart from the sham and therapeutic groups. Despite the small effect size (0.3), implementation of aromatherapy into standard practice may be practical considering the anxiolytic effects that have been shown in other studies. Aromatherapy with essential oils should be considered as another tool to use in a multimodal approach in the treatment of pain in the emergency department setting.

Efficacy of Essential Oils in Relieving Cancer Pain: A Systematic Review and Meta-Analysis

Over 80% of patients affected by cancer develops cancer-related pain, one of the most feared consequences because of its intractable nature, particularly in the terminal stage of the disease. Recent evidence-based recommendations on integrative medicine for the management of cancer pain underline the role of natural products. The present systematic review and meta-analysis aims at appraising for the first time the efficacy of aromatherapy in cancer pain in clinical studies with different design according to the most updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 recommendations. The search retrieves 1002 total records. Twelve studies are included and six are eligible for meta-analysis. The present study demonstrates significant efficacy of the use of essential oils in the reduction of the intensity of pain associated with cancer (p < 0.00001), highlighting the need for earlier, more homogeneous, and appropriately designed clinical trials. Good certainty body of evidence is needed for effective and safe management of cancer-related pain using essential oils by establishment of a step-by-step preclinical-to-clinical pathway to provide a rational basis for clinical use in integrative oncology. PROSPERO registration: CRD42023393182.

A Unitary Theory of Healing Through Touch

Touch has been linked empirically to healing outcomes; therefore, developing theories about the dynamics between touch and healing is important for nursing. A practice-based theory is described within a Unitary Science perspective emerging from the findings of a qualitative descriptive study of the experiences of persons with advanced cancer receiving touch (massage and simple touch) during hospice care. Seventeen participants were interviewed. Through content analysis and retroductive constructivist theory development, healing through touch was described as a dynamic process cocreated by healer and healee, characterized by the simultaneous activities of sensing , reflecting , and connecting . Interpretation of findings from a unitary lens led to an overarching theme of touch as sanctuary and explication of theoretical alignment with the concepts of wholeness, awareness, and presence.

Aromatherapy in Nursing and Midwifery Practice: A Scoping Review of Published Studies Since 2005

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.

"Like one part of a puzzle" - individualized aromatherapy for women with gynecological cancers in aftercare: results from a qualitative-focused mixed-methods study

BACKGROUND

Gynecological cancer(s), including breast cancer patients in aftercare and survivors, need supportive strategies to cope with symptoms that are adapted to their individual needs and circumstances. Aromatherapy has potential to be such strategy, but (qualitative) empirical research taking users' own views into consideration about the potential and challenge of aromatherapy is lacking.

PURPOSE

The purpose of the study is to gain insights from individualized aromatherapy as a supportive care treatment, regarding their use and evaluation by women with gynecological cancers in aftercare.

METHODS

We conducted a study with a mixed-methods design, focused on qualitative research. Five essential oil products were given to 18 participants to apply individually over a 4-week period. After the intervention, qualitative semi-structured interviews were conducted. Further, we documented and assessed symptomatic burdens of the women (MYMOP2) before and after intervention quantitatively.

RESULTS

Aromatherapy was customized by the participants according to their needs. It showed potential for relief of symptomatic burdens - especially nausea, peripheral neuropathy, pain, and sleep. Additionally, opportunities emerged to indirectly affect symptomatic burdens. These developed out of new coping strategies (e.g., sleep routines) or by combining with existing strategies (e.g., meditation). Furthermore, aromatherapy was successfully used to promote well-being and encourage mindfulness.

CONCLUSION

Our findings demonstrated the potential of aromatherapy as a supportive treatment modality that can be used as a kind of toolbox. Challenges, such as individual odor aversions and intolerances, and limitations due to medication or illness should be considered in future aromatherapy research.

The Introspective Patient Experience of Mistletoe Therapy in Cancer: A Qualitative Study

INTRODUCTION

The introspective experience of cancer patients using mistletoe therapy has received little scientific interest, although it is crucial for a holistic understanding of this therapy. This study contributes to patient-centered research and treatment by documenting the subjective experiences of individuals undergoing mistletoe therapy.

METHODS

In this qualitative, explorative study, 20 outpatients with a history of various cancer types were recruited from Arlesheim Hospital (Arlesheim, Switzerland). All patients received subcutaneous mistletoe therapy for at least 2 years (median 7.5 years). Data was collected through 2 semi-structured, in-depth interviews per patient. Qualitative content analysis was applied to examine the data. The individual experience of mistletoe therapy was analyzed in relation to 6 predefined levels of human experience: physical, vital, emotional, mental, spiritual and social. In addition, 3 further aspects, considered as cross-dimensional perspectives, emerged out of the material: warmth, immune strengthening, and general wellbeing.

RESULTS

Data analysis revealed considerable heterogeneity among patients' experiences with mistletoe therapy. The importance of specific aspects became apparent, such as increased vitality to manage daily life, greater emotional and mental stability, warmth as a multidimensional phenomenon, feelings of safety and protection through mistletoe therapy, heightened self-awareness and improved self-care, as well as sensations of spiritual connectedness.

CONCLUSIONS

Prior to this study it had not been shown that cancer patients using mistletoe therapy do have observations on different levels of experience. These results may lead to a deeper understanding of patients receiving mistletoe therapy, enabling them to be supported in a more holistic way both during mistletoe treatment and on their life path. Further investigations into the effects of mistletoe therapy on the emotional, mental, and spiritual level are warranted.

Aromatherapy with single essential oils can significantly improve the sleep quality of cancer patients: a meta-analysis

Objective

To investigate the effect of aromatherapy on sleep quality in cancer patients.

Methods

Published literature on the effect of aromatherapy in cancer patients with sleep disorders in the form of randomized controlled trials (RCTs) were systematically retrieved and screened from PubMed, Cochrane Library, Embase, CBM, CNKI, VIP, and Wanfang databases from inception to November 2021. The methodological quality of the included studies was critically and independently evaluated by two reviewers using the Cochrane Risk of Bias Assessment Tool for RCTs. The correlated data were extracted using the pre-designed form, and all analyses were performed using Reviewer Manager version 5.4. Due to the difference in sleep quality instruments, the data extracted in this study were in the form of standard mean difference (SMD).

Results

Ten RCTs included 933 patients (experimental group: 474, control group: 459), and the risk of bias in the included studies was moderate. Aromatherapy could significantly improve the sleep quality of cancer patients [SMD = − 0.79, 95% CI (− 0.93, − 0.66), p < 0.01], especially those with breast cancer [SMD = − 0.98, 95% CI (− 1.57, − 0.40), p < 0.01]. Aromatherapy with single essential oil had a better effect on sleep quality [SMD = -0.94, 95%CI (− 1.25, − 0.62), p < 0.01], of which lavender essential oil had the best effect [SMD = -1.06,95%CI (− 1.49, − 0.63), p < 0.01] while compound essential oils had no effect on sleep quality improvement in cancer patients [SMD = -0.21, 95%CI (− 0.57, 0.14), p = 0.23]. Four of the ten RCTs reported the occurrence of adverse events, of which only one RCT indicated that patients had headache and sneezing while the remaining six did not.

Conclusions

This meta-analysis of 10 RCTs reveals that aromatherapy with single essential oil had a substantial effect on the sleep quality of cancer patients and should be recommended as a beneficial complementary therapy to promote sleep quality in cancer patients.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-022-03668-0.

Aromatherapy with inhalation can effectively improve the anxiety and depression of cancer patients: A meta-analysis

PURPOSE

This meta-analysis was to critically evaluate the effects of aromatherapy on the symptoms of anxiety and depression in cancer patients.

METHODS

Eight Chinese and English databases (CNKI, Wanfang, VIP, CBM, Cochrane Library, PubMed, Embase, and PsycINFO) were systematically searched from the inception of databases to October 2021 for randomized controlled trials (RCTs). According to Cochrane Collaboration criteria, two reviewers independently assessed the risk of bias and extract data from included studies. All analyses were performed with Review Manager 5.4.

RESULTS

Eleven qualified studies were included in the meta-analysis, ten of which reported the effect of aromatherapy on anxiety in cancer patients, including 1724 patients; five of the studies reported the effect on depression, including 1039 patients. The quality of the included studies was low, and most studies compared aromatherapy to usual care. This meta-analysis indicated that aromatherapy appeared to be effective for anxiety [SMD = -0.51, 95%CI (-0.83, -0.19), P = 0.002] and depression [SMD = -0.44, 95%CI (-0.76, -0.12), P = 0.008] symptoms in cancer patients. Inhalation aromatherapy may be more effective than massage. Aromatherapy seemed to improve the anxiety symptoms in cancer patients in a short time, especially in perioperative patients, but had no effect for patients treated with radiation, chemotherapy or palliative therapy. Placebo also appeared to be effective in some studies.

CONCLUSIONS

Aromatherapy, especially inhalation aromatherapy, may help relieve symptoms of anxiety and depression in cancer patients, but more and higher-quality studies are needed. The literature does not yet support clinical implementation.

Plant Fragrances Are Like Music for Our Senses: A Scoping Review of Aromatherapy in Gynecologic Cancers and Breast Cancer Care

Introduction: Essential oil (EO) applications via inhalation and/or absorption through the skin-often referred to as aromatherapy-have particular relevance as complementary to cancer treatment and follow-up care. Aromatherapy is of particular interest for controlling symptoms and enhancing the general well-being of people with cancer. This is indicated by the increasing number of empirical studies on this topic. Although numerous reviews have summarized the extensive primary research about aromatherapy and cancer, no review on aromatherapy use targeting women with gynecologic and breast cancers currently exists. Our scoping review aims at giving an overview of the state of research about aromatherapy in this specific target group. By summarizing and describing study characteristics, based on methodological decisions and content, we intend to offer implications for future research, focused on the use of EO in women with gynecologic and breast cancers. Methods: A systematic scoping review was conducted, based on the literature, and using the extension of the PRISMA statement for scoping reviews (PRISMA-ScR). The databases PubMed and CINHAHL were searched in a multi-stage, iterative process taking the most relevant terms under consideration, given our research interest and Boolean operators. The included studies were analyzed and summarized through (1) a table matrix including categories of interest and (2) qualitative content analysis. Results: One hundred seventy studies were examined, and 10 were included in this review. They show high heterogeneity in how the term aromatherapy is defined, in content, research design, EO used, application, and outcomes. However, all 10 studies exclusively targeted women with breast cancer in different states of cancer treatment. Conclusions: Challenges of research within this field point to the heterogeneous use and classification of the term aromatherapy, the differentiation of the principle of action of EO, the lack of transparency in how EO are reported and described (e.g., botanical names, company, dosage, mixing ratios), and the need to include subjective perceptions. Ten implications for future research based on these challenges are given.

Efficacy of the complementary therapies in the management of cancer pain in palliative care: A systematic review

OBJECTIVE

to synthesize the knowledge and to critically evaluate the evidences arising from randomized controlled trials on the efficacy of the complementary therapies in the management of cancer pain in adult patients with cancer in palliative care.

METHOD

a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search for articles in the MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane, and PsycINFO databases, as well as the manual search, selection of studies, data extraction, and methodological assessment using the Cochrane Bias Risk tool were performed independently by two reviewers.

RESULTS

eight hundred and fifteen (815) studies were identified, six of them being selected and analyzed, of which three used massage therapy, one study used a combination of progressive muscle relaxation and guided imaging, and another two studies used acupuncture. Most of the studies had an uncertain risk of bias (n=4; 67%).

CONCLUSION

while the evidence from the studies evaluating the use of massage therapy or the use of progressive muscle relaxation and guided imaging for the management of cancer pain in these patients demonstrated significant benefits, the other two studies that evaluated the use of acupuncture as a complementary therapy showed contradictory results, therefore, needing more research studies to elucidate such findings.

Complementary and alternative medicine use during chemotherapy for neuroendocrine tumours

Exploring the patient experience of complementary and alternative medicine (CAM) can provide insight into the needs, preferences and values of patients with an neuroendocrine tumour (NET). Use and interest in CAM after a NET diagnosis has not been investigated until now. The authors aimed to identify the types of CAM being used by patients undergoing chemotherapy and what types of CAM patients considered most beneficial. Patients were identified for clinical audit from one hospital's NET nurse chemotherapy database. A questionnaire was given to 79 patients who had completed intravenous chemotherapy during the previous 3 years. CAM use by NET patients was found to be popular and included practices to support both physical and emotional health. Massage and taking vitamin and mineral supplements were most widely used. The antioxidant effects of some high-dose supplements may impact on chemotherapy outcomes. Massage, despite its irregular use, was perceived by patients to be the most useful CAM.

Antimicrobial Activity of Six Essential Oils Against a Group of Human Pathogens: A Comparative Study

Essential oils are concentrated natural extracts derived from plants, which were proved to be good sources of bioactive compounds with antioxidative and antimicrobial properties. This study followed the effect of some commonly used essential oils in micellar and aqueous extract on some of the most common pathogenic bacteria. Frankincense, myrtle, thyme, lemon, oregano and lavender essential oils were tested against Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Both micellar and aqueous extracts were used for determination of their minimal inhibitory (MIC) and bactericidal concentrations (MBC). The most active oils were oregano, thyme, lemon and lavender, while the least active were frankincense and myrtle. Oregano oil presented up to 64 times lower MICs/MBCs than ethylic alcohol, if considered as standard, on all bacteria. Most susceptible bacteria were the Gram-positive cocci, including methicillin resistant S. aureus, while the most resistant was P. aeruginosa. With some exceptions, the best activity was achieved by micelles suspension of essential oils, with MICs and MBCs ranging from 0.1% to > 50% v/v. Only oregano and lavender aqueous extracts presented bactericidal activity and only on K. pneumoniae (MIC = 6.3%). Thyme, lemon and oregano oils present significantly lower overall average MICs for their micellar form than for their aqueous extracts. The present results may suggest some formulas of colloid or micelle suspensions of whole essential oils such as oregano, thyme or lemon oil, that may help in antimicrobial fight. Aqueous extracts of oregano or thyme oil with good antibacterial activity could also be used in selected cases.