Multistate Outbreak of Melioidosis Associated with Imported Aromatherapy Spray.

Melioidosis, caused by the bacterium Burkholderia pseudomallei, is an uncommon infection that is typically associated with exposure to soil and water in tropical and subtropical environments. It is rarely diagnosed in the continental United States. Patients with melioidosis in the United States commonly report travel to regions where melioidosis is endemic. We report a cluster of four non-travel-associated cases of melioidosis in Georgia, Kansas, Minnesota, and Texas. These cases were caused by the same strain of B. pseudomallei that was linked to an aromatherapy spray product imported from a melioidosis-endemic area.

The effect of aromatherapy during urodynamic testing on patients anxiety and cortisol levels: A randomized controlled trial.

BACKGROUND: During urodynamic testing (UT), patients may experience emotions such as embarrassment, discomfort, irritability, and tension, which can cause anxiety. Aromatherapy is a complementary and alternative treatment that may be employed in clinical settings to alleviate patients' anxiety before invasive procedures. OBJECTIVES: The aim of this study was to determine the effect of aromatherapy on patients' anxiety and cortisol levels during UT. MATERIALS AND METHODS: The sample of this single-center, prospective, two-armed, randomized controlled clinical study consisted of 98 patients undergoing UT. Patients were randomly assigned to the intervention group (n = 49) and the control group (n = 49). The anxiety level was assessed using the state-trait anxiety inventory (STAI), and measured with physiological responses to anxiety, such as changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), and cortisol levels, pre and post-UT. Aromatherapy was applied to the intervention group starting 5 min before UT and continuing throughout the testing. The control group received routine treatment and care. Data were analyzed using Pearson's χ2, dependent samples t-tests, and independent samples t-tests. RESULTS: In the study, post-UT anxiety in the intervention group was significantly lower than in the control group (p < 0.001), while SpO2 was higher (p = 0.021). In the study group, post-UT anxiety (p < 0.001), HR (p = 0.000), and cortisol levels (p = 0.005) decreased compared to pre-UT, whereas in the control group, anxiety (p < 0.001) and HR (p = 0.000) decreased, and SBP (p = 0.010) and RR (p = 0.004) increased. CONCLUSIONS: Aromatherapy during UT positively influenced both the psychological and physiological responses to anxiety.

The effects of aromatherapy and music on pain, anxiety, and stress levels in palliative care patients.

AIM: Pain and anxiety levels in palliative care patients negatively impact their quality of life, highlighting the need for research on non-pharmacological methods. This study aimed to evaluate the effects of music and aromatherapy interventions on pain, anxiety, and stress levels in these patients. MATERIAL AND METHODS: The research was designed as a single-blind, four-group, randomized controlled trial. The sample consisted of 88 patients hospitalized in a palliative care center (receiving palliative care services with terminal or advanced diseases). Patients were randomly assigned to four groups (n = 22, music, aromatherapy, music and aromatherapy, and control group). Patients in the experimental groups received the intervention to which they were assigned for 20 min each day for three consecutive days: music, aromatherapy, or music accompanied by aromatherapy. No intervention was applied to the control group. The patients' levels of pain, anxiety, and stress were assessed before and after the intervention using the Visual Analog Scale (VAS), the Facial Anxiety Scale (FAS), and the Distress Thermometer. RESULTS: No significant differences were found in the demographic characteristics of the groups (p > 0.05). The Wilcoxon Signed-Rank and Kruskal-Wallis tests indicated statistically significant differences in pre- and post-intervention scores for VAS, FAS, and Distress across all experimental groups on all follow-up days (p < 0.05). CONCLUSION: Implementing music, aromatherapy, and their combination effectively reduced pain, anxiety, and stress levels in palliative care patients, suggesting these non-pharmacological interventions can improve their quality of life. TRIAL REGISTRATION: ClinicalTrails.gov (Registration number: NCT06024954) at 05-SEP-2024.

Flower Power: An Overview on Chemistry and Biological Impact of Selected Essential Oils from Blossoms.

Natural raw materials such as essential oils have received more and more attention in recent decades, whether in the food industry, as flavorings and preservatives, or as insecticides and insect repellents. They are, furthermore, very popular as fragrances in perfumes, cosmetics, and household products. In addition, aromatherapy is widely used to complement conventional medicine. This review summarizes investigations on the chemical composition and the most important biological impacts of essential oils and volatile compounds extracted from selected aromatic blossoms, including Lavandula angustifolia, Matricaria recutita, Rosa x damascena, Jasminum grandiflorum, Citrus x aurantium, Cananga odorata, and Michelia alba. The literature was collected from PubMed, Google Scholar, and Science Direct. Blossom essential oils discussed in this work are used in a wide variety of clinical issues. The application is consistently described as safe in studies and meta-analyses, although there are notes that using essential oils can also have side effects, especially dermatologically. However, it can be considered as confirmed that essential oils have positive influences on humans and can improve quality of life in patients with psychiatric disorders, critically ill patients, and patients in other exceptional situations. Although the positive effect of essential oils from blossoms has repeatedly been reported, evidence-based clinical investigations are still underrepresented, and the need for research is demanded.

Laboratory features of effects of peloidotherapy and aromatherapy in patients with rheumatoid arthritis.

Peloidotherapy and aromatherapy have been used for years in the treatment of numerous inflammatory conditions, including rheumatoid arthritis (RA). The exact mechanism of their action in RA is unclear. The goal of our research is to determine the effect of peloidotherapy and aromatherapy on inflammation parameters in RA patients. Our study included 20 patients of both sexes, with confirmed diagnosis of RA, older than 18 years. Patients were treated during 28 days with combination of peloidotherapy and aromatherapy. Serum samples for detection of levels of inflammation parameters were taken at two intervals: before the start of therapy and at the end of treatment. The results of our study show that there were no significant changes in the parameters of the complete blood count. Nevertheless, a statistically significant decrease in the serum concentration of two markers of inflammation-interleukin-6 (IL-6) and nitrogen-oxide (NO)-was detected. Correlation analyses results say that there is a synchronized drop in the serum concentrations of CRP and the sedimentation rate, and the serum concentrations of fibrinogen and IL-6 are in the same relationship as well as serum levels of IL-6 and NO. Bearing in mind the importance of IL-6 and NO in the pathogenesis of inflammation in RA, we conclude that the application of our therapeutic protocol can be a significant add-on treatment to classic immunomodulators. Due to the small number of study participants, the lack of a control group, and the short follow-up time of patients, additional research is needed.

Smellscape as a healing factor in institutional gardens to enhance health and well-being for older people with dementia: A scoping review.

BACKGROUND: There is mounting evidence for the health benefits of aromatic scents for the older people with dementia. However, existing research has focused on indoor aromatherapy using essential oils. It is necessary to explore the health benefits of smellscapes in the outdoor environment for older people with dementia. AIMS AND OBJECTIVES: This scoping review aims to examine existing evidence for smellscape as a healing factor in institutional garden for older people with dementia, try to bridge the knowledge gaps between outdoor sensory garden scents and aromatherapy to develop green care techniques that incorporate outdoor activities. METHODS: Seven databases (Scopus, PubMed, PsycINFO, CINAHL, MEDLINE, Embase and Web of Science) were searched with English language articles published between 1990 and 2022. The PRISMA-ScR Checklist was used. RESULTS: Out of 1013 articles, 11 meet the inclusion criteria. The comprehensive health outcomes include five aspects: mental health; physical health; reduced agitation behaviour; improved cognitive function; and well-being. These aspects are part of the rehabilitation model comprising the person (older people with dementia), environment (garden smellscapes) and outdoor activities (active or passive interventions or a combination). CONCLUSIONS: The smellscape, as a healing factor in the garden, not only benefits from evidence on indoor aromatherapy but also creates a sensory environment for older people with dementia by compensating for functional impairment, activity support and environmental creation, thereby promoting enhanced health and well-being. RELEVANCE TO CLINICAL PRACTICE: The research on the healing effects of smellscapes presented in this review offers a novel environmental intervention technique for transferring evidence on essential oils to outdoor sensory gardens. This green care technique is suggested to assist in the creation of healing environments and interventions for people with dementia who cannot be cured. NO PATIENT OR PUBLIC CONTRIBUTION: This scoping review did not directly involve patient or public contributions to the manuscript.

What Does a Community Think About Aromatherapy?

The awareness and usage of aromatherapy applications are increasing day by day in society. The current study aims to evaluate the thoughts and attitudes of individuals toward aromatherapy in Türkiye and to determine factors affecting the use of aromatherapy. This community-based descriptive study is conducted throughout Türkiye. Nine hundred eighty-five questionnaires were suitable for data quality. SPSS 23.0 statistical package program was used, and the statistical significance level was accepted as P value of less than .05. Approximately 72.4% of the participants have heard of aromatherapy. The rate of hearing about the concept of aromatherapy was found to be statistically significantly higher among women (P = .000), those residing in a province/district (P = .011), and those working in an income-generating positions (P = .003). It was determined that 58.9% of the participants used any essential oil. The 5 most commonly used essential oils are lavender, tea tree, peppermint, rose, and thyme, respectively. The rate of essential oil use in women is higher than in men (P = .000). The conditions in which essential oils are most frequently used are to provide beauty to the skin (51.7%), skin diseases (51.0%), and respiratory tract diseases (46.0%), respectively. The most common sources of information about the essential oils used by the participants are the Internet/social media (57.6%) and pharmacists (53.4%). The results of this research revealed that the awareness and use of aromatherapy practice in the community are high according to the literature. Considering the high tendency to use these products among the public, physicians, pharmacists, and nurses must provide consultancy services on the use of these products.

Nonpharmacological Nursing Interventions in Postoperative Nausea and Vomiting: A Systematic Review.

PURPOSE: This study aims to assess the impact of nonpharmacological nursing interventions on postoperative nausea and vomiting (PONV). DESIGN: This is a systematic review. METHODS: MEDLINE, Web of Science, ScienceDirect, Tübitak-ULAKBIM, and TRDizin databases were searched for the following search terms, including "Postoperative Nausea and Vomiting," "Nurse," "Nursing," and "Nonpharmacological Interventions" to identify nonpharmacological nursing interventions for PONV. A systematic review of English and Turkish articles published in the period between January 1, 2012 and June 1, 2023 was conducted. The PICOT-SD method was used to determine the compatibility of the pieces with the eligibility criteria. FINDINGS: Fifty-eight of 3,874 articles obtained from databases fulfilled the eligibility criteria. This study demonstrated that acupuncture, aromatherapy, the oral intake of ginger, listening to music, education, and visits to patients decreased the incidence of nausea and vomiting and increased the quality of life. Additionally, it was found that patients' quality of life tended to improve along with reductions in postoperative complications. CONCLUSIONS: The results of this study support previous findings in the literature and demonstrate that nonpharmacological nursing interventions help reduce and prevent PONV. Based on our results, we suggest that nonpharmacological nursing interventions can be employed for the management of PONV in patients undergoing surgery.

Comparison of the Effects of Aromatherapy With Damask Rose and Chamomile Essential Oil on Preoperative Pain and Anxiety in Emergency Orthopedic Surgery: A Randomized Controlled Trial.

PURPOSE: Patients who are awaiting emergency surgery experience high levels of anxiety and pain. This study aimed to compare the effects of aromatherapy with damask rose and chamomile essential oil on the preoperative pain and anxiety associated with emergency orthopedic surgery. DESIGN: A parallel-group randomized controlled design was used. METHODS: Ninety participants were selected and randomly assigned to three groups: the damask rose group (n = 30), the chamomile group (n = 30), and the control group (n = 30). In the damask rose and chamomile groups, three drops of 40% essential of each plant were used for inhalation aromatherapy (three drops every hour for 3 hours) Visual Analog Scales were used to evaluate participants' pain and anxiety levels at baseline, immediately after the intervention, and 1 hour after the intervention. FINDINGS: The results of repeated measures Analysis of Variance (ANOVA) showed that both of the intervention groups experienced a decrease in pain and anxiety over time compared to the control group (P < .001). ANOVA results showed that immediately after the intervention, the anxiety level of the damask rose group compared to the chamomile and control groups was significantly lower (P = .01). However, there was no significant difference in terms of anxiety between the damask rose and chamomile groups 1 hour after the intervention (P = .07). CONCLUSIONS: The use of damask rose and chamomile in aromatherapy was found to effectively lower anxiety and pain levels in emergency orthopedic surgery patients. The antianxiety effect of damask rose is faster than chamomile.

An aromatherapy massage intervention on sleep in the ICU: A randomized controlled feasibility study.

We conducted a feasibility randomized controlled trial exploring the effect of aromatherapy massage on sleep in critically ill patients. Patients were randomized to receive aromatherapy massage or usual care, and feasibility of recruitment and outcome data completion was captured. Sleep (depth) was assessed through Bispectral Index monitoring and self/nurse-reported Richards-Campbell Sleep Questionnaires, and the Sleep in the ICU Questionnaire. Thirty-four patients participated: 17 were randomized to aromatherapy massage and 17 to control. Five participants who received the intervention completed outcomes for analysis (alongside eight controls). A larger study was deemed unfeasible in this population, highlighting the value of testing feasibility of complex interventions, such as massage for sleep in ICU.

Effect of aromatic massage on brain waves and physiological indices of older adults.

BACKGROUND: Massage and aromatherapy are frequently used by older adults as alternative interventions to enhance immunity and induce relaxation. This pilot study evaluated the effect of massage therapy with oil and aromatherapy alone and in combination using objective biological indices. METHODS: Twenty-eight participants recruited by convenience sampling included adults aged between 25 and 65 years (Group 1), elderly individuals over 65 years without nursing care (Group 2), and older adults over 65 needing long-term nursing support (Group 3). A multiple-group pretest-post-test design was employed, and the effect among the three groups was compared. Interventions included: (i) oil massage therapy; (ii) aromatherapy; and (iii) aroma oil massage therapy. Each therapy session lasted 5 min, with 3 min of observation before and after the session and 10 min interval between sessions. Group 3 omitted one therapy (2: aromatherapy) to reduce their physical burden. An electroencephalogram (EEG) was recorded for α, ß, and θ activities of brain waves. EEG data were collected at three points: before, during, and after each treatment. Salivary secretory immunoglobulin A (s-IgA) concentration, oxygen saturation (SPO2), and pulse rate were measured before and after each session. RESULTS: Across all therapy modalities, there was a noticeable increase in the α wave, indicative of relaxation, during the treatment. Significant differences were observed before and during the oil massage in both Group 1 and Group 2. Aromatherapy demonstrated a significant difference before and during treatment in Group 1. Among the biological parameters, s-IgA levels indicated no significant changes. The pulse rate decreased with oil massage. Significant differences were noted before and after therapy in all cases for SPO2 and in Group 2 for pulse rate. CONCLUSIONS: Three therapies induced EEG and physiological changes in the adult group and older adults without nursing care. However, these effects are limited in older adults requiring nursing care.

Impact of aromatherapy on anxiety among ICU nurses: A randomized, blinded, placebo-controlled trial.

PURPOSE: The purpose of this study was to examine the effect of aromatherapy with an essential oil blend containing lavender, bergamot, ylang-ylang, and sweet orange, compared with placebo, on perceptions of anxiety in ICU RNs. METHODS: Nurses recruited from six adult ICUs and a neonatal ICU participated in this blinded, randomized, placebo-controlled study, which took place over a 30-day intervention period. RESULTS: Although there were no statistically significant changes in anxiety pre- to postintervention or between the intervention and placebo groups, there were also no adverse events or untoward effects. CONCLUSION: The results of this study may support aromatherapy as an evidence-based strategy to reduce anxiety in ICU nurses. Additional research is needed.

Novel non-pharmacological strategies for managing dentophobia in adult patients - literature review.

Dentophobia concerns a substantial portion of the adult population, often leading to avoidance of dental care and subsequent deterioration in oral health. This comprehensive review explores the multifaceted nature of odontophobia and examines various non-pharmacological strategies aimed at its management in adult patients. Factors contributing to dentophobia, including past traumatic experiences, feelings of vulnerability, and mistrust in dental professionals, are discussed, highlighting the complex interplay of psychological, physiological, and environmental influences. Novel approaches such as Virtual Reality Exposure Therapy offer promising avenues for systematically desensitising patients to their fears and enhancing treatment acceptance. Aromatherapy utilising essential oils like chamomile, orange, and lavender, as well as dog-assisted therapy, have shown potential in creating calming environments and reducing patient anxiety during dental procedures. Muscle relaxation therapy, biofeedback techniques, and process simulations provide additional tools for addressing the physiological and cognitive aspects of odontophobia. Cognitive-behavioural therapy interventions, including brief sessions focused on cognitive restructuring and exposure therapy, demonstrate efficacy in reducing fear of dentists and improving treatment outcomes. By incorporating these diverse non-pharmacological strategies into dental practice, clinicians can enhance patient experiences, increase treatment acceptance and adherence, and ultimately improve oral health outcomes. While these interventions show promising results, further research is needed to refine their implementation, optimize their effectiveness, and ensure accessibility to patients with dentophobia. By addressing the multifaceted nature of dental anxiety and adopting a patient-centred approach, clinicians can provide holistic care, fostering better oral health and overall well-being in their patients.

The Effect of Aromatherapy with Lavender Essential Oil on the Sleep and Fatigue Level of Patients with Multiple Sclerosis in Turkey: A Randomized Controlled Trial.

BACKGROUND: Fatigue is a common problem in patients with multiple sclerosis (MS) and is one of the most serious symptoms of the disease. Although many factors play a role in the etiology of fatigue in patients with MS, it has been reported that fatigue is caused by irregular or disrupted sleep patterns. AIM: The purpose of the study was to examine the effects of lavender oil aromatherapy on the sleep and fatigue of MS patients. METHODS: The study was designed as a randomized controlled trial and was conducted in Turkey. The data of the study were collected using the Patient Description Form, Fatigue Severity Scale, and Pittsburgh Sleep Quality Index. RESULTS: The mean FSS score in the experimental group was 6.86 ± 0.94 before the procedure and 3.42 ± 0.85 after the procedure, the mean PSQI score was 9.45 ± 1.23 before the procedure and 6.68 ± 2.87 after the procedure, and the difference in the mean scores between the two groups was found to be statistically significant (P < 0.001). CONCLUSION: The results showed that aromatherapy with lavender essential oil has significant impacts on fatigue and sleep in MS patients. Lavender essential oil aromatherapy can be used by nurses as an independent nursing practice. It is an inexpensive, noninvasive, and reliable technique to manage fatigue in individuals with MS.

Effects of aromatherapy and music therapy on patients' anxiety during MRI examinations: a randomized controlled trial.

OBJECTIVES: Many patients experience anxiety during MRI examinations. However, little attention has been focused on decreasing patient anxiety and minimizing on-site cancellations. Here, we aimed to investigate the effects of aromatherapy and music therapy on alleviating anxiety during MRI examinations. METHODS: This single-center, double-blinded, randomized control trial was conducted between November 1, 2021, and January 10, 2022. Patients undergoing MRI examinations were assigned randomly into either the aromatherapy group (AG), music therapy group (MG), aromatherapy plus music therapy group (AMTG), or routine care group (RG) at a ratio of 1:1:1:1. Aromatherapy was conducted through inhalation of lavender oil. Music therapy was performed using Pachelbel's Canon in D major. The primary outcome was the change in anxiety before and after the MRI scan, assessed using both the State-Trait Anxiety Inventory form 1 (STAI-1) and Self-Rating Anxiety Scale (SAS). The second outcome was the participant's comfort, measured using Kolcaba's General Comfort Questionnaire (GCQ). RESULTS: A total of 200 participants (mean age: 48.3 ± 14.9 years; 126 [63.0%] females) were enrolled, with 50 per group. The mean anxiety scores of the AMTG showed greater reduction compared with the AG, MG, and RG (ΔSTAI-1: 6.5 vs 2.6 vs 2.7 vs 1.9, p < 0.001; ΔSAS: 4.0 vs 1.4 vs 1.7 vs 0.6, p < 0.001). The mean GCQ score of the AMTG was higher compared with the AG, MG, and RG (98.0 vs 92.6 vs 91.2 vs 89.2, respectively, p < 0.001). CONCLUSION: Aromatherapy combined with music therapy is effective for reducing patients' anxiety and improving their comfort level during MRI scans. KEY POINTS: • In this randomized control trial of 200 participants undergoing MRI scans, aromatherapy plus music therapy is effective in reducing STAI-1 and SAS, as well as improving GCQ scores. • Although there was a significant difference between the aromatherapy plus music therapy and the single-intervention modalities, no significant differences were observed between the aromatherapy and music therapy themselves for state anxiety and comfort score. • Aromatherapy plus music therapy is a safe, non-invasive, nonpharmacological, and inexpensive patient-centered intervention for reducing anxiety and improving comfort in adults undergoing MRI examinations.

A Systematic Review on the Adult Alpha Brainwave Activity After Essential Oil Inhalation.

Aroma extracts from plant species have been utilized since ancient times for a variety of discomforting circumstances. Aromatherapy is a recognized complementary therapeutic treatment performed in various ways such as massage or dermal application, with its main uses involving relaxation, pain relief, and stress management. Several studies have outlined that inhalation of fragrance may influence the brain function since their components can cross the blood-brain barrier and interact with central nervous system receptors. The aim of this review was to systematically present findings regarding alpha brain wave activity reported exclusively by electroencephalography. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed and Scopus databases were screened for relevant papers, based on specific eligibility criteria. The final step of the process resulted in 13 studies published between 1998 and 2021, using different essential oils. Most of the studies revealed the increase of alpha brainwave activity post-essential oil inhalation. Given the proven positive outcomes of increased alpha wave activity on several domains such as cognitive performance and better mental state, further research on the impact of essential oil inhalation is warranted.

Aromatherapy Massage for Relief of Pruritus and Stress in Older Women.

Context: Pruritus is a common skin disease among older adults. With aging, there is a decrease in skin elasticity and thickness, and vascular changes occur that decrease the skin's ability to retain moisture. Objective: To investigate the effects of aromatherapy massage on pruritis and stress levels in older women. Design: This was a nonequivalence, pre-post, quasi-experimental study. To enhance the appropriateness and accuracy of the intervention, a pilot study was conducted before the main study. Setting: The participants were recruited from six senior citizens' centers in Changwon City, Gyeongnam, South Korea. Participants: The participants were 64 women ≥65 years of age with an average age of 80.7 years and 79.7 years in the intervention and the control groups, respectively. Intervention: The intervention comprised aromatherapy massage with a blend of three essential oils: 1 mL of lavender, 0.25 mL of Roman chamomile, and 0.25 mL of sandalwood diluted to 1.5% with a sweet-almond carrier oil. The control group received massages with 0.25% sandalwood oil. Outcome Measures: The symptom score table of the Pruritus Score Scale was used to measure the degree, area, and frequency of pruritus and its impact on everyday life. The study also measured skin hydration levels using moisture-measuring module sensor, skin pH using the Howskin device, and stress using the Perceived Stress Scale. Results: Of the 64 initial participants, 5 dropped out of the study, resulting in 59 being included in the analysis. A significant difference was found between the intervention and control groups regarding relief of pruritus (U = 302.5, P = .039) and stress levels (U = -6.36, P < .001). No adverse effects were observed. Conclusions: Aromatherapy massage can be an effective intervention to decrease pruritus and stress in older women. Further studies with larger samples that also include men are required to confirm the generalizability of these results.

Randomized Trial Examining Efficacy of Mentha piperita in Reducing Chronic Headache Discomfort in Youth.

BACKGROUND: Youth with chronic headache experience disruption to routine activities and require significant health care utilization. While interventions targeting a relaxation response have shown clinically significant benefit in headache outcomes, peppermint oil has not been evaluated for efficacy in a pediatric headache population. AIMS: To explore the extent to which a brief aromatherapy intervention improves subjective and objective indicators of discomfort beyond passive relaxation in youth with chronic headaches. DESIGN: Single-center, randomized, experimental study. METHODS: Patients were randomly assigned to a brief foot bath or foot bath plus peppermint oil group. Measurements were collected at baseline, mid-intervention, and post-intervention. Data included heart rate and subjective pain, anxiety, and satisfaction scores. RESULTS: Forty-six adolescents (89% female, mean age 15.2 years) diagnosed with a primary headache disorder were enrolled. Both groups reported a significant decrease in pain, though the intervention group plateaued (p < .01) and the control group progressively decreased intensity at each time-point (p < .01). Whereas both groups reported a decrease in anxiety over time (p < .01), the control group reported less of a decrease in anxiety than the intervention group (p = .03). The control group had a significant decrease in mean heart rate (p < .01). There were no adverse events. The intervention was well tolerated, liked, and recommended by 95.5% of study participants. CONCLUSIONS: A brief intervention intended to activate the relaxation response produced a subjective reduction in pain and anxiety. However, the addition of peppermint oil to a foot bath did not significantly improve pain or anxiety beyond the control condition.

The Effects of Self-Aromatherapy Massage on Pain and Sleep Quality in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial.

BACKGROUND: Rheumatoid arthritis is the most common form of inflammatory arthritis and can lead to pain, joint deformity, and disability, resulting in poor sleep quality and lower quality of life. The efficacy of aromatherapy massage on pain levels and sleep quality among rheumatoid arthritis patients remains unclear. AIMS: To investigate the effects of aromatherapy on pain and sleep quality among rheumatoid arthritis patients. METHODS: This randomized controlled trial enrolled 102 patients with rheumatoid arthritis from one regional hospital in Taoyuan, Taiwan. Patients were randomly assigned to the intervention (n = 32), placebo (n = 36), or control groups (n = 34). The intervention and placebo groups underwent self-aromatherapy hand massage guided by a self-aromatherapy hand massage manual and video for 10 minutes 3 times a week for 3 weeks. The intervention group used 5% compound essential oils, the placebo group used sweet almond oil, and the control group had no intervention. Pain, sleep quality and sleepiness were measured by using the numerical rating scale for pain, the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale at baseline and at 1, 2, and 3 weeks after the intervention. RESULTS: The intervention and placebo groups had significantly decreased sleep quality and sleepiness scores from baseline to 3 weeks after aromatherapy massage. Compared with the control group, the intervention group showed statistically significant improvement in the sleep quality scores in the first weeks after aromatherapy massage (B = -1.19, 95% confidence interval [CI]: -2.35, -0.02, P =.046), but no statistically significant differences were found in the changes in pain levels from baseline to the three time points. CONCLUSIONS: Aromatherapy massage is effective in improving sleep quality in rheumatoid arthritis patients. More studies are needed to evaluate the effects of aromatherapy hand massage on the pain levels of rheumatoid arthritis patients.

Interventions to improve the sleep of nurses: A systematic review.

Nurses are at a high risk for short sleep duration and poor sleep quality due to irregular work schedules and high occupational stress. Considering the effect of nurses' sleep on the safety and health of themselves and their patients, it is important to promote healthy sleep for nurses. We sought to synthesize the published experimental and quasi-experimental studies that address interventions to improve sleep in nurses. A systematic search was conducted for studies published in English up until May 15, 2023, using the databases PubMed, CINAHL, Academic Search Ultimate, and PsycINFO. In total, 38 articles were included, covering 22 experimental and 16 quasi-experimental studies with sample sizes ranging from 9 to 207. Studies were assessed using the Cochrane Risk of Bias tool and considered as low to medium quality. Thirty-six of the 38 studies reported positive findings for at least one sleep outcome. Intervention types included aroma therapy, dietary supplements, cognitive behavioral therapy, light therapy, mind-body therapy, sleep education, exercise, napping, shift schedule modification, and multicomponent intervention, all of which showed moderate effectiveness in promoting sleep outcomes of nurses. Comparing and contrasting studies on specific interventions for improving sleep in nurses is sparse and often equivocal. With the variations of research methodology and outcome measures, it is difficult to make a conclusion about each intervention's effectiveness on specific sleep outcomes. Additional high-quality research, including randomized controlled trials, is needed to evaluate strategies for improving sleep in this unique, safety-sensitive occupational group.