Effect of Melissa officinalis on systolic and diastolic blood pressures in essential hypertension: A double-blind crossover clinical trial.

For a long time, Melissa officinalis (M. officinalis) has been used to treat cardiovascular diseases. Therefore, this study aimed at evaluating the effects of M. officinalis on systolic and diastolic blood pressures in hypertensive patients. We conducted a double-blind, controlled, randomized crossover clinical trial on 49 patients who received either M. officinalis capsules (400 mg/d; n = 23) or the placebo (n = 26) three times per day for a 4-week period. After a 2-week washout period, the M. officinalis group received placebo and the other group received M. officinalis for another 4-week period. The systolic and diastolic blood pressures were measured once at baseline and then every 2 weeks for 10 weeks. The statistical analysis of the obtained data revealed that the chronology of the consumption of M. officinalis and placebo had no effect on the systolic and diastolic blood pressures in these two studied groups. Moreover, it was found that systolic and diastolic blood pressures significantly decreased after the consumption of M. officinalis, compared to placebo. Systolic and diastolic blood pressures in group A at the beginning of the study were 152.30 ± 5.312 mmHg and 95.52 ± 1.988 mmHg, respectively, and, after the first phase (drug use), reached 129.88 ± 9.009 mmHg and 80.13 ± 5.488 mmHg, respectively. Systolic and diastolic blood pressures in group B at the beginning of the study was 152.26 ± 5.640 mmHg and 94.44 ± 2.607 mmHg, respectively, and after the second phase (drug use), reached 131.77 ± 8.091 mmHg and 81.46 ± 7.426 mmHg, (p = .005), respectively. Also, no significant side effects were observed during the study. According to the results, M. officinalis can reduce systolic and diastolic blood pressures of the patients with essential hypertension.

The effect of foot reflexology massage on burn-specific pain anxiety and sleep quality and quantity of patients hospitalized in the burn intensive care unit (ICU).

BACKGROUND: Burn-specific pain anxiety and sleep disorders are common factors in burned patients that affect wound healing process, as well as the severity of burn pain. This study aimed to investigate the effect of foot reflexology massage on burn-specific pain anxiety and sleep condition of patients hospitalized in the burn ICU. METHOD: In this randomized controlled clinical trial, 52 patients were assigned by permuted block randomization 1:1 to the intervention (n=26) and control (n=26) groups. The intervention group received 20min of foot reflexology massage during 3 days on their third, fourth and fifth days of hospitalization and 15min before changing wound dressings. Patients in the control group merely received routine care. The Burn-Specific Pain Anxiety Scale (BSPAS) was completed for three consecutive days before and after changing wound dressings, and St. Mary's Hospital Sleep Questionnaire (SMHSQ) was filled out for four consecutive days before changing wound dressings for patients in both groups. The data were analyzed by IBM SPSS 16 software, Chicago, independent t, Chi-square, Friedman, Mann-Whitney and Wilcoxon tests. FINDINGS: We found no significant difference between pain-anxiety in the two groups before the intervention. The trend of different days in each groups were compared with Friedman test and showed that pain anxiety (p<0.001), sleep latency (p<0.001), duration of the last day's sleep (p<0.001) and satisfaction of the last night sleep (p<0.001) had a significant difference. In addition, Mann-Whitney test results showed that there were significant differences between the two groups at different times in terms of the above variables (p<0.05). The effect size was=0.82 for pain anxiety between group after the intervention. CONCLUSION: Based on the results, foot reflexology massage can effectively reduce pain anxiety levels and improve sleep quality and quantity of patients with burn injuries; therefore, this non- pharmacological therapeutic method is recommended to be used in the burn ICUs. (Clinical trial's registration code: IRCT20110906007494N27).

The effect of inhalation aromatherapy with rose essential oil on the anxiety of patients undergoing coronary artery bypass graft surgery.

BACKGROUND AND PURPOSE: Anxiety is one of the most common responses of patients awaiting coronary artery bypass graft (CABG) surgery to stressful conditions before surgery. This study is intended to examine the effect of inhalation aromatherapy with rose essential oil on the anxiety of patients undergoing CABG surgery. MATERIALS AND METHODS: This was a single-blind randomized clinical trial of 66 patients undergoing CABG surgery. The experimental group inhaled three drops of 4% rose essential oil for 10 minutes one night and one hour before surgery. The control group did not receive any intervention from the research team. RESULTS: The level of anxiety was measured before and 30 minutes after the intervention using the Spielberger's Anxiety Inventory. Prior to surgery, an independent t-test showed that the mean score of anxiety was not significantly different between the experimental and control groups (p = 0.41). Aromatherapy with rose essential oil did not cause any significant differences in state anxiety (P = 0.41), trait anxiety (P = 0.90), and total anxiety (P = 0.69). CONCLUSION: Our results revealed that inhalation aromatherapy with rose essential oil could not significantly reduce anxiety in CABG patients. Future research with larger sample sizes and using different concentrations of rose essential oil are needed to achieve more definitive conclusions.

Knowledge, attitude and use of complementary and alternative medicine among nurses: A systematic review.

OBJECTIVES: The purpose of this study was to systematically review the literature to describe the knowledge, attitude and practice of CAM by nurses. METHODS: Three databases were searched for relevant studies from launch through September of 2017 and included MEDLINE, Scopus and Web of science. RESULTS: The average knowledge of CAM therapies by nurses was 62.2% with attitude about use averaging 65.7%. Close to two-thirds (65.9%) reported use of CAM therapies with patients. The primary reasons nurses suggested use of CAM were for stress and anxiety reduction and health improvement. CONCLUSION: Current evidence demonstrates the need for nurse education programs to integrate and strengthen CAM content into existing curricula. Similarly, documentation of the nature and extent of nurse use of CAM therapies in the clinical setting, as well as patient-reported use and preferences for CAM therapies, would provide valuable prospective data.

The effect of pleasant olfactory mental imagery on the incidence and extent of atelectasis in patients after open heart surgery.

BACKGROUND AND PURPOSE: Atelectasis is the most common pulmonary complication after open heart surgery. This study was intended to examine the effects of pleasant olfactory mental imagery on postoperative atelectasis in patients undergoing open heart surgery. MATERIALS AND METHODS: This is a randomized controlled clinical trial. The sample consisted of 80 patients who were randomly assigned to either practice olfactory mental imagery (test group) or receive routine care (control group). A card with the image of roses was given to patients and they were asked to look at the image, visualize the scent of roses in the mind, and then sniff as much as possible, hold their breath for 2s and eventually exhale slowly through the nose. This procedure was consecutively repeated five times. After a fifteen-minute break, patients proceeded to practice olfactory mental imagery with other fruit images (banana, apple, and lemon). The test group executed the olfactory mental imagery for two hours in the morning and two hours in the afternoon on postoperative days 1 and 2. The control group received the routine ICU care. A questionnaire collected information on sociodemographic characteristics and clinical parameters. Chest radiographs were used to diagnose atelectasis, which were evaluated by the hospital radiologist. RESULTS: No statistically significant differences were observed between the two groups regarding sociodemographic, medical and surgical information. The incidence of atelectasis in the test group (40%, n=16) was significantly lower than in the control group (67.5%, n=27) on postoperative day 2 (p=0.02). CONCLUSION: Our findings suggest that olfactory mental imagery can improve respiratory function and reduce the risk of atelectasis in patients with cardiac surgery.

Effects of pleasant olfactory mental imagery on the arterial oxygenation in patients with open heart surgery: A randomized controlled trial.

BACKGROUND AND PURPOSE: Arterial hypoxemia is one of the most common respiratory complications following cardiac surgery. This study was intended to examine the effects of pleasant olfactory mental imagery on postoperative hypoxemia in patients undergoing open heart surgery. MATERIALS AND METHODS: This is a randomized controlled clinical trial. The sample consisted of 80 patients who were randomly assigned to either practice olfactory mental imagery (experimental group) or receive routine care (control group). A card with the image of roses was given to patients and they were asked to look at the image, visualize the scent of roses in the mind, and then sniff as much as possible, hold their breath for 2 s and eventually exhale slowly through the nose. This procedure was consecutively repeated five times. After a fifteen-minute break, patients proceeded to practice olfactory mental imagery with other fruit images. The experimental group executed the olfactory mental imagery for two hours in the morning and two hours in the afternoon on postoperative days 1 and 2. RESULTS: No statistically significant differences were observed between the experimental and control groups regarding sociodemographic characteristics, medical and surgical information. This study also demonstrated that the mean Spao2 was significantly higher in the experimental group (97.400 ± 1.70) than the control group (96.465 ± 1.70) (p = 0.015). CONCLUSION: The results of this study suggest that olfactory mental imagery can improve arterial oxygenation in patients with cardiac surgery.

The effect of self-selected soothing music on fistula puncture-related pain in hemodialysis patients.

OBJECTIVE: This study was intended to examine the effect of selective soothing music on fistula puncture-related pain in hemodialysis patients. MATERIALS AND METHODS: This is a randomized clinical trial in which 114 participants were selected from two hemodialysis units by means of a non-random, convenience sampling method. The participants were then allocated in three groups of music (N = 38), headphone (N = 38), and control (N = 38). The fistula puncture-related pain was measured 1 min after venipuncture procedure in all three groups. The music group listened to their self-selected and preferred music 6 min before needle insertion into a fistula until the end of procedure. The headphone group wore a headphone alone without listening to music 6 min before needle insertion into a fistula until the end of procedure. The control group did not receive any intervention from the research team during needle insertion into a fistula. The pain intensity was measured immediately after the intervention in all three groups. RESULTS: This study showed a significant difference between the music and control groups, and the music and headphone groups in terms of the mean pain score after the intervention. However, the analysis did not indicate any significant difference between the headphone and control groups with regard to the mean pain score after the intervention. CONCLUSION: It is concluded that music can be used effectively for pain related to needle insertion into a fistula in hemodialysis patients. Future research should investigate the comparative effects of pharmacological and non-pharmacological interventions on fistula puncture-related pain.

Complementary and Alternative Medicine: Italian Validation of a Questionnaire on Nurses' Personal and Professional Use, Knowledge, and Attitudes.

BACKGROUND: Patients are showing an increasing interest in the use of complementary and alternative medicine (CAM). Most nurses are open to the adoption of CAM into clinical nursing practice, but they may experience a lack of knowledge about the safe and effective use of these therapies. Several studies concerning nurses' knowledge and attitudes toward CAM have been published, but only in one, the authors (Shorofi and Arbon) used a validated questionnaire. In Italy, there are no validated questionnaires to investigate this aspect of nursing practice. PURPOSE: To test the psychometric properties of the Italian Shorofi and Arbon questionnaire for use with Italian nurses. METHODS: A forward-backward translation method was used to translate the questionnaire from English to Italian. Content validity, face validity and reliability were established. RESULTS AND CONCLUSIONS: This study examined the potential usefulness of the Shorofi and Arbon questionnaire for the evaluation of CAM knowledge of Italian speaking nurses, which showed good content validity and good reliability.

Complementary and alternative medicine (CAM) among Australian hospital-based nurses: knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users.

OBJECTIVE: This study was intended to examine CAM among Australian hospital-based nurses, identifying their knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. METHODS AND MATERIALS: Nurses holding a qualification in nursing and working in surgical wards were included using a convenience sampling technique. A self-complete questionnaire was developed to achieve the aims of the study. Descriptive and non-parametric statistics were calculated to describe and analyse data. RESULTS: Overall, 95.7% and 49.7% of nurses reported personal and professional use of CAM, respectively. The most popular CAM/CAM domain personally and professionally used by nurses was massage therapy and mind-body therapies. The primary reason for personal use of CAM was "[it] fits into my way of life/philosophy". Furthermore, massage therapists were the most commonly recommended CAM practitioners to patients. Only 15.8% of nurses would always ask patients about use of herbal medicines as part of nursing history taking. Over one-fifth (22.4%) of nurses rated their attitude as having a very positive, and 60.3% rated themselves as having very little or no knowledge of CAM. A positive correlation was also found between knowledge and attitude about CAM. Positive attitude and higher knowledge about CAM were positively correlated to CAM referrals. Several socio-demographic factors predicted personal and professional use of CAM. CONCLUSION: This study revealed that nurses generally believe not to have sufficient knowledge of CAM but are open to use CAM with patients. Nurses' positive attitude toward and personal use of CAM could be an indication that they are poised for further integration of evidence-based CAM into nursing practice to treat whole person.

The effects of aromatherapy with lavender essential oil on fatigue levels in haemodialysis patients: A randomized clinical trial.

OBJECTIVE: This study was intended to examine the efficacy of lavender essential oil for the alleviation of fatigue in haemodialysis patients. METHODS AND MATERIALS: This randomized clinical trial was conducted on 59 haemodialysis patients in two groups. The routine care group received the routine care, but the experimental group inhaled lavender essence 5% for 10 min, three times a week for 4 consecutive weeks. The Fatigue Severity Scale was used to assess fatigue before the intervention and after the last intervention in the second and fourth weeks. RESULTS: No statistically significant differences were observed between the two groups in terms of the fatigue scores before, and after the last intervention in the second and fourth weeks. CONCLUSION: Our result does not support other studies suggesting that lavender essential oil is effective on fatigue in haemodialysis patients. This conflicting result can mostly be ascribed to a variety of factors such as duration of aromatherapy and differences in concentrations of lavender essential oil.

The effects of family-friend visits on anxiety, physiological indices and well-being of MI patients admitted to a coronary care unit.

OBJECTIVE: To investigate the effect of family-friend visits on anxiety, physiological indices and well-being of patients with acute myocardial infarction. METHODS: A checklist was used to gather socio-demographic data and physiologic indices including blood pressure, heart rate, respiratory rate, and arterial oxygen saturation. The short-form of the Spielberger state anxiety inventory, a visual analog scale well-being and cardiac monitoring devices were used for collecting data. RESULTS: Patients exhibited a lower heart rate and respiratory rate in the normal range during the 10-min visiting period and within 10 and 30 min after the visiting period. The arterial oxygen saturation increased in this period. After the visiting period, patients exhibited an increase in the sense of well-being and a decrease in the level of anxiety. CONCLUSION: Family-friend visits can improve MI patients' sense of well-being and decrease their anxiety. Moreover, the visits can help to keep the physiological indices within normal limits.

The effects of lavender aromatherapy on pain following needle insertion into a fistula in hemodialysis patients.

OBJECTIVE: This study sought to determine the effects of lavender aromatherapy on pain following needle insertion into a fistula in patients undergoing hemodialysis. METHOD: This is a randomized controlled clinical trial in which 92 patients undergoing hemodialysis with arteriovenous fistulas were randomly divided into two groups. The experimental-group patients inhaled lavender essence with a concentration of 10% for 5 min during 3 hemodialysis sessions, while the control-group patients received aromatherapy free of lavender essence. RESULTS: The mean VAS pain intensity score in the experimental and control groups before the intervention was 3.78 ± 0.24 and 4.16 ± 0.32, respectively (p = 0.35). The mean VAS pain intensity score in the experimental and control groups after three aromatherapy sessions was 2.36 ± 0.25 and 3.43 ± 0.31, respectively (p = 0.009). CONCLUSION: Lavender aromatherapy may be an effective technique to reduce pain following needle insertion into a fistula in hemodialysis patients.

The effects of foot reflexology massage on anxiety in patients following coronary artery bypass graft surgery: a randomized controlled trial.

OBJECTIVE: To examine the effects of foot reflexology massage on anxiety in patients following CABG surgery. METHODS: In this randomized controlled trial, 80 patients who met the inclusion criteria were conveniently sampled and randomly allocated to the experimental and control groups after they were matched on age and gender. On the days following surgery, the experimental group received foot reflexology massage on their left foot 20 min a day for 4 days, while the control group was given a gentle foot rub with oil for one minute. Anxiety was measured using the short-form of the Spielberger State-Trait Anxiety Inventory and the Visual Analogue Scale-Anxiety. RESULTS: Both measurement instruments confirmed a significant decrease in anxiety following the foot reflexology massage. CONCLUSION: The significant decrease in anxiety in the experimental group following the foot reflexology massage supports the use of this complementary therapy technique for the relief of anxiety.

Complementary and alternative medicine (CAM) among hospitalised patients: reported use of CAM and reasons for use, CAM preferred during hospitalisation, and the socio-demographic determinants of CAM users.

PURPOSE: This paper reports a study to examine hospitalised patients' frequency and patterns of CAM use, their reasons for CAM use, their preferences of CAMs during hospitalisation, and the association between patients' socio-demographic variables and use of each individual CAM/CAM domain. METHODS: A convenience sample of 353 patients hospitalised in 19 surgical wards at four metropolitan hospitals completed a questionnaire on CAM use and socio-demographic variables. RESULTS: The response rate was 73.5%, and over 90% of the sample acknowledged using CAMs. Non-herbal supplements (60.3%) and massage therapy (45%) were the most frequently used CAMs, with biologically based therapies (68.8%) as well as mind-body interventions (65.4%) being the most often used CAM domains. About 1 in 10 patients (9.6%) used CAMs from all five domains. With the exception of herbal-botanical therapies, self-prayer for health reasons/spiritual healing and music therapy, all CAMs were mainly used on an 'only when needed' basis. The most common reason nominated for using CAMs was that '[it] fits into my way of life/philosophy' (26%). The majority of patients declared interest in and support for the hospital providing CAMs. Patients were most inclined to choose therapies categorised as manipulative and body-based methods (65.4%) for use in hospital. Massage therapy (53.5%) and non-herbal supplements (43.1%) were the top two CAMs favoured for use in hospital. CAM use was also dependent of socio-demographic data (age, gender, marital status, place of residence, education level, religion, and income in hospitalised patients). CONCLUSION: The use of CAMs is pervasive amongst surgical in-patients, making it feasible to initially assess these patients for CAM use and provide them with clinically approved CAMs where possible. Notwithstanding that CAM use is fairly predictable by socio-demographic variables, further studies should be directed to know the variables useful for predicting the use of each CAM approach.

Nurses' knowledge, attitudes, and professional use of complementary and alternative medicine (CAM): a survey at five metropolitan hospitals in Adelaide.

PURPOSE: To determine nurses' knowledge, attitudes, and professional use of complementary and alternative medicine (CAM) at five metropolitan hospitals in Adelaide, while also investigating the relationships between socio-demographic factors and use of CAM domains. METHOD: Information on nurses' demographics, knowledge, attitudes, and professional use of CAM was obtained using a self-administered questionnaire. Data were analysed using descriptive and non-parametric statistics. RESULTS: Almost 50% of nurses were using CAM for patients, with mind-body interventions being the most common form of CAM domain used in practice (31.4%). While 59% of nurses were positive about CAM, more than 60% of them had very little or no knowledge of CAM. Nurses' professional use of CAM was also associated with diverse socio-demographic factors, and a positive association was found between the nurses' knowledge and their attitudes towards CAM. CONCLUSION: Nurses have limited knowledge of CAM but remain open towards CAM use. Nurses' positive attitudes towards CAM use could be an indication that they are poised for further integration of clinically approved CAM into nursing care of patients.

Complementary and alternative medicine (CAM) among hospitalised patients: an Australian study.

PURPOSE: To identify patients' report of complementary and alternative medicine (CAM) use, along with their knowledge, their attitudes, and their use/willingness to use CAM. METHODS: A total of 353 patients were recruited through a 'convenience' sampling method in four metropolitan hospitals in Adelaide. Data were collected by means of questionnaires with open- and close-ended questions. RESULTS: The prevalence of CAM use among patients was 90.4%; although a considerable proportion of patients using CAM did not disclose this information to nurses/doctors (39.9%) and 20.7% said they would report it as "only when needed/or if asked to". A high proportion of patients reported using non-herbal supplements (60.3%) and massage therapy (45%) while most forms of therapies were mainly used "only when needed". The CAM domain most frequently used was biologically based therapies (68.8%). Patients rated themselves as having "none" (24.4%) or "very little" (42.5%) knowledge about most CAM, although nearly half (46.4%) of them had a positive attitude towards CAM. Use, knowledge, and attitudes towards CAM were also associated with diverse socio-demographic variables. This study provides a comprehensive analysis of the use of CAM by patients.