Effects of aromatherapy on nausea and vomiting in patients with cancer: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: and purpose: Aromatherapy offers a low-risk solution for effectively managing common nausea and vomiting in cancer patients. This systematic review and meta-analysis aimed to assess its impact on these symptoms to facilitate practical guidelines establishment. METHODS: PubMed, Web of Science, Cochrane Library, MEDLINE, CINAHL, and Embase were searched for articles published until April 30, 2023. Inclusion criteria were randomized controlled trials (RCTs) on the effect of aromatherapy on nausea and vomiting in patients with cancer (age ≥18 years). The effect size was calculated using standardized mean differences (SMDs) with a random effects model. Subgroup analyses, meta-analysis of variance, and meta-regression were performed using the "meta" package in R version 4.0.2. Heterogeneity was assessed using I2 statistics. Sensitivity and publication bias analyses were performed; two reviewers independently assessed risk of bias using Cochrane's risk-of-bias tool 2.0. RESULTS: Twenty-five RCTs across 10 articles revealed that aromatherapy reduced overall nausea and vomiting in patients with cancer with significant efficacy (SMD = -0.81, 95 % confidence interval [CI]: -1.11 to -0.52). Furthermore, aromatherapy reduced nausea (SMD = -0.85, 95 % CI: -1.23 to -0.46) and combined nausea and vomiting (SMD = -1.08, 95 % CI: -1.68 to -0.47), but not vomiting alone (SMD = -0.24, 95 % CI: -1.03 to 0.55). Inhalation and massage yielded positive results, especially in chemotherapy-induced cases; peppermint oil was particularly successful. CONCLUSION: Our findings underscore aromatherapy's value in managing cancer treatment-associated nausea and vomiting. Conclusive evidence on aromatherapy-led nausea reduction is lacking due to limited RCTs; research is warranted for robust conclusions.

Effects of aromatherapy on depression: A meta-analysis of randomized controlled trials.

OBJECTIVE: Non-pharmacological interventions, such as aromatherapy, have been utilized for treating depression. This systematic review and meta-analysis aimed to investigate the effects of aromatherapy on depressive symptoms. METHOD: The databases of PubMed, MEDLINE, CINAHL, EMBASE, Web of Science, and the Cochrane Library were searched from May 5, 2023, to May 20, 2023. Only randomized controlled trials that implemented aromatherapy in adults aged ≥18 years were included. The standardized mean difference (SMD) was calculated, and subgroup analysis, meta-ANOVA, and meta-regression were performed for the moderator variables. RESULTS: Thirty-two clinical trials (27 studies) were included in the final analysis. Aromatherapy demonstrated a moderate effect size for reducing depressive symptoms (SMD = -0.56, 95% CI: -0.69 to -0.43). Inhalation was the most effective method of delivery and blended essential oils were more effective than lavender or other single essential oils. Aromatherapy demonstrated a moderate effect size for reducing depressive symptoms among menopausal women, patients with heart disease (coronary artery disease or acute coronary syndrome), and psychological illnesses. However, it demonstrated no effect on postpartum or pregnant women. Mean age was a significant moderator variable. CONCLUSIONS: Reliable evidence is present for the application of aromatherapy to reduce depressive symptoms, and it can be utilized effectively to decrease depressive symptoms.

Effects of Aromatherapy on Cancer Patients' Sleep and Fatigue: A Systematic Review and Meta-Analysis.

Objective: This study aims at investigating the effectiveness of aromatherapy in enhancing sleep quality and reducing fatigue among cancer patients based on randomized controlled trials (RCTs) with a high level of evidence. Design: A systematic review and meta-analysis. Methods: Two reviewers screened and reviewed the full texts of search results obtained from six English databases and four Korean databases, and they extracted data from the selected studies independently. Risk of bias (RoB) was assessed using the revised Cochrane RoB tool for randomized trials. The review protocol was registered with the International Prospective Register of Systematic Reviews (CRD42021277515). Results: Eleven RCTs were included in this study. Aromatherapy significantly improved sleep quality among cancer patients compared with those in the control groups (routine care, no intervention, and placebo) (standardized mean difference [SMD] = -0.92, 95% confidence interval [CI]: -1.39 to -0.46; p < 0.001, I2 = 89%). However, aromatherapy did not significantly reduce fatigue among such patients (SMD = -0.40, 95% CI: -0.81 to 0.01). The results of the meta-regression confirmed that increased intervention sessions resulted in the enhanced effectiveness of aromatherapy in improving sleep quality among cancer patients (Z = -3.86, p < 0.001). Conclusion: This study showed that aromatherapy significantly improves sleep quality among cancer patients. However, aromatherapy does not significantly reduce fatigue among cancer patients. It is possible that the statistical power of the meta-analysis was weak due to the small number of included studies. Therefore, in future studies, the effects of aromatherapy on fatigue among cancer patients should be assessed further using a larger number of included studies. Further, the effects of aromatherapy should be evaluated with a focus on specific subsets of patients, such as specific cancer diagnoses and specific modalities for cancer treatment.

Effects of Lavender on Anxiety, Depression, and Physiological Parameters: Systematic Review and Meta-Analysis.

PURPOSE: The recent evidence suggested substantial anxiolytic efficacy of lavender. The aim of this study was to examine the efficacy of lavender for anxiety, depression, and physiological parameters and to elucidate the differential effects of lavender on anxiety and depression by study characteristics. METHODS: A systematic review and meta-analysis was performed following the PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature databases for randomized controlled trials investigating the efficacy of lavender on anxiety, depression, or physiological parameters in humans. We assessed the risk of bias within studies with the revised Cochrane risk of bias tool for randomized trials. We used random effect model to estimate the average effect and computed bias-corrected standardized mean difference as effect size metric, Hedges' g for all outcomes. RESULTS: Lavender was superior to placebo or no treatment in reducing anxiety (Hedges' g = -0.72, 95% confidence interval [CI] -0.90 to -0.55, p value <.001), depression (Hedges' g = -0.43, 95% CI, -0.59 to -0.27, p value <.001), and systolic blood pressure (Hedges' g = -0.23, 95% CI, -0.41to -0.05, p value = .01). The moderator analysis by meta-regression indicated that route of administration accounted 6.5% (p value = .187) for the heterogeneity in anxiolytic effects, sessions of treatment accounted 13.2% (p value = .055), and participants' health state accounted 8.9% (p value = .131) for the variance in anxiolytic effects. CONCLUSION: Lavender aromatherapy showed substantial effect in reducing anxiety and depression, and sessions of administration increased the anxiolytic effects. The effects on physiological parameters showed small with inconsistent significances and randomized controlled trials on the effect of lavender on depression were scarce. Future trials on depression and physiological parameters are recommended, and increasing the sessions of administration is recommended.

Reduction of Halitosis by a Tablet Containing Weissella cibaria CMU: A Randomized, Double-Blind, Placebo-Controlled Study.

Halitosis is referred to as an unpleasant odor coming from the mouth. Recently, probiotics have been studied as an alternative prevention for halitosis. The aim of this study was to evaluate the effects of probiotic bacterium Weissella cibaria Chonnam Medical University (CMU)-containing tablets (1 × 108 colony forming units [CFU]/g) on oral malodor. The randomized, double-blind, placebo-controlled trial was conducted in 92 healthy adults (20-39 years of age) with bad breath. All subjects were randomly assigned to a test (probiotic, n = 49) or control (placebo, n = 43) group after dental scaling and root planing. The tablets were taken once daily for 8 weeks. Measurements included an organoleptic test (OLT), volatile sulfur compounds (VSC), bad breath improvement (BBI) scores, and the oral colonization of W. cibaria CMU. This study also assessed safety variables of adverse reactions, vital signs, and the findings of hematology and blood chemistry. Most of the variables were measured at baseline, 4, and 8 weeks. Safety-related variables were measured at baseline and 8 weeks. At week 4, a significant decrease in OLT and VSC results was observed in the test group while BBI scores were significantly reduced at week 8 (P < .05). Statistically significant intergroup differences were observed for changes in W. cibaria number at weeks 4 and 8. No safety issues were encountered in either group. These results indicate that W. cibaria CMU tablets could be a safe and useful oral care product for controlling bad breath.

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.

How Strong is the Evidence for the Anxiolytic Efficacy of Lavender?: Systematic Review and Meta-analysis of Randomized Controlled Trials.

PURPOSE: Although lavender is purported to possess anxiolytic and sedative properties and is often recommended for relieving anxiety, the efficacy of lavender has not been well established. Thus, this review aimed to evaluate the anxiolytic effects of lavender aromatherapy. METHODS: Ten data bases were searched for studies published between 2000 and 2018. Randomized controlled trials investigating the anxiolytic effects of lavender aromatherapy with any type of application for persons with or without clinical anxiety were included. The outcome variables included self-rated anxiety, vital signs, and salivary cortisol and chromogranin A (CgA) levels. In the meta-analysis, standardized mean difference and 95% confidence interval were calculated as effect measures by applying the random effect model and inverse variance method. RESULTS: Twenty-two trials met our inclusion criteria. Lavender aromatherapy was found to have favorable effects in relieving anxiety (Hedges' g = -0.65; 95% CI, -0.84 to -0.46) and decreasing systolic blood pressure (g = -0.22; 95% CI, -0.43 to -0.02), heart rate (g = -0.53; 95% CI, -0.74 to -0.32), and salivary cortisol (g = -1.29; 95% CI, -2.23 to -0.35) and CgA (g = -2.29; 95% CI, -3.24 to -1.34) levels. However, the meta-analysis did not reveal any significant effects of lavender on diastolic blood pressure (effect size: -0.17; 95% CI, -0.37-0.04). CONCLUSION: Aromatherapy using lavender oil might have favorable effects on anxiety and its physiological manifestations. Future studies are recommended with an emphasis on methodological quality. In nursing practice, it is suggested that lavender aromatherapy be included in programs intended to manage anxiety in patients across diverse healthcare settings.

[Effects of a Sleep Improvement Program Combined with Aroma-Necklace on Sleep, Depression, Anxiety and Blood Pressure in Elderly Women].

PURPOSE: The purpose of this study was to evaluate the effectiveness of a sleep improvement program combined with an aroma-necklace on sleep, depression, anxiety, and blood pressure in elderly women living at home. METHODS: A program consisting of a four-week (one hour per week) sleep improvement intervention plus use of an aroma-necklace, was developed based on Cox's Interaction Model of Client Health Behavior. 70 elderly women were assigned to the experimental (n=35) or control group with no intervention (n=35). Data from 62 participants (32 in the experimental and 30 in the control) were analyzed using the SPSS 21.0 program. Women in the experimental group were instructed to constantly wear the aroma necklace filled with marjoram and orange oil until the program was completed. Sleep quality, sleep duration, sleep satisfaction, depression, anxiety, and blood pressure were measured to identify the effectiveness of the program. RESULTS: Significant group differences were found in sleep quality (t=-5.10, p<.001), sleep duration (z=-3.10, p=.002), sleep satisfaction (z=-4.13, p=<.001), depression (t=2.53, p=.015), and anxiety (z=-2.47, p=.014). No differences were found in the systolic or diastolic blood pressure. CONCLUSION: The results indicate that a sleep improvement program combined with an aroma-necklace was effective in improving sleep disturbances in elderly women living at home. Nurses may contribute to improving sleep among elderly women by applying this program to aged women living in various environments.