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Czakert J, Kandil FI, Boujnah H, Tavakolian P, Blakeslee SB, Stritter W, Dommisch H, Seifert G. Scenting serenity: influence of essential-oil vaporization on dental anxiety - a cluster-randomized, controlled, single-blinded study (AROMA_dent). Sci Rep 2024; 14:14143. [PMID: 38898054 DOI: 10.1038/s41598-024-63657-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Dental fear and anxiety (DFA) is known as an immense challenge in oral healthcare, which can result in compromised oral health, pain, and uncomfortable treatment. The objective of this study was to analyze the effect of essential-oil vaporization on acute anxiety of patients in dental practices. Four dental practices used five weekly cycles of vaporization with each scent: Orange (Citrus sinensis), Swiss Pine (Pinus cembra), Good Mood (blended essential oils: Citrus sinensis, Citrus aurantifolia, Citrus limon, Osmanthus fragrance (5%)), Forest Walk (blended essential oils: Abies grandis, Pinus cembra, Myrtus communis c. t. 1,8-cineol, Abies alba, Citrus paradisi, Abies sibirica, Pseudotsuga menziesii, Vetiveria zizanoides), and water. Acute anxiety was the primary outcome (state-trait-anxiety inventory (STAI-S)). Secondary outcomes were trait anxiety (STAI-T), dental anxiety (Kleinknecht dental fear survey), and pain perception in treatment (numeric rating scale). Across all patients (n = 486), STAI-S was slightly higher in the control group (40.7 ± 11.6) than in the intervention groups (38.4 ± 10.5). Post-hoc analyses revealed that the effect is only robust for the subgroup of female patients (n = 296, p = 0.044). We also conducted a post-hoc additional analysis on a subpopulation with an increased level of STAI-T ≥ 42 (n = 131 patients). For this group the difference in acute anxiety between the control group (51.1 ± 11.9, n = 30) vs. the intervention groups (46.8 ± 9.6, n = 118) was significant (T = 4.39, p = 0.0379). The results of the study indicate a promising potential of essential-oil vaporization to alleviate dental anxiety, particularly in the subgroups of patients with a high level of trait anxiety, and particularly in female patients. The calming effects of the essential-oil vaporization were also highlighted by the anecdotical statements of the dental-practice staff. The anxiety-reducing role of essential-oil vaporization alone and as one part of combined techniques to counter DFA should be further explored using multi-perspective methodological approaches in research.
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Affiliation(s)
- Judith Czakert
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
| | - Farid I Kandil
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Hiba Boujnah
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Pantea Tavakolian
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Sarah B Blakeslee
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Wiebke Stritter
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Henrik Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Dentistry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Georg Seifert
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
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Luan J, Yang M, Zhao Y, Zang Y, Zhang Z, Chen H. Aromatherapy with inhalation effectively alleviates the test anxiety of college students: A meta-analysis. Front Psychol 2023; 13:1042553. [PMID: 36687893 PMCID: PMC9853416 DOI: 10.3389/fpsyg.2022.1042553] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/15/2022] [Indexed: 01/08/2023] Open
Abstract
Objective Test anxiety is one of the common psychological and behavioral problems of college students, which can result in poor academic performance and even academic failure. Aromatherapy has been proposed as a promising method to reduce test anxiety in college students, but its precise efficacy has not been fully confirmed. This meta-analysis evaluated the effects of aromatherapy on the symptoms of test anxiety in college students to serve as a reference for future research and provide more scientific and exact evidence. Methods PubMed, The Cochrane Library, Web of Science, Embase, CINAHL, Science Direct, Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Full-Text Database (VIP), and Wanfang Data were electronically searched from inception to June 2022 to identify randomized controlled trials (RCTs) on aromatherapy for treating students' test anxiety. The Cochrane Risk of Bias Assessment Tool for RCTs was used by two reviewers to critically and independently assess the methodological quality of the included studies. Review Manager 5.4 was used for the meta-analysis. Stata 17.0 was used for sensitivity analysis and Egger's test. Results Seven RCTs included 425 patients, with a moderate risk of bias in the included studies. The meta-analysis found that aromatherapy effectively reduced test anxiety in college students (SMD = -0.67, p < 0.01), with high heterogeneity of results (I 2 = 72%). The different types of essential oil devices used in the study are the source of inter-study heterogeneity. Subgroup analysis suggested that most effective methods were aromatherapy with compound essential oils (SMD = -0.91, p < 0.01), and using cloths or pads as the essential oil devices (SMD = -1.03, p < 0.01). There was no difference between aromatherapy and placebo control groups (SMD = -0.65, p = 0.25). Conclusion Aromatherapy with inhalation can help relieve test anxiety in college students, but more and higher-quality studies are needed. This study provides a reference for future research designs in terms of the selection of essential oil types and devices and the design of research groups. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022345767].
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Affiliation(s)
- Jiage Luan
- School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Mengshu Yang
- School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Yan Zhao
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yu Zang
- School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Ziyu Zhang
- School of Nursing, Hebei Medical University, Shijiazhuang, China
| | - Haiying Chen
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Czakert J, Stritter W, Blakeslee SB, Grabowski JP, Sehouli J, Seifert G. "Like one part of a puzzle" - individualized aromatherapy for women with gynecological cancers in aftercare: results from a qualitative-focused mixed-methods study. Support Care Cancer 2023; 31:80. [PMID: 36562853 PMCID: PMC9789001 DOI: 10.1007/s00520-022-07543-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
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.
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Affiliation(s)
- Judith Czakert
- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Pediatric Oncology and Hematology, Integrative Medicine in Pediatric Oncology, Berlin, Germany.
| | - Wiebke Stritter
- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Pediatric Oncology and Hematology, Integrative Medicine in Pediatric Oncology, Berlin, Germany
| | - Sarah B Blakeslee
- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Pediatric Oncology and Hematology, Integrative Medicine in Pediatric Oncology, Berlin, Germany
| | - Jacek P Grabowski
- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Berlin, Germany
| | - Jalid Sehouli
- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Berlin, Germany
| | - Georg Seifert
- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Pediatric Oncology and Hematology, Integrative Medicine in Pediatric Oncology, Berlin, Germany
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Aragão VM, Lima MMDS, Fernandes CDS, Barros LM, Rodrigues AB, Caetano JÁ. EFFECTS OF AROMATHERAPY ON ANXIETY SYMPTOMS IN WOMEN WITH BREAST CANCER: A SYSTEMATIC REVIEW. TEXTO & CONTEXTO ENFERMAGEM 2023. [DOI: 10.1590/1980-265x-tce-2022-0132en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
ABSTRACT Objective: to assess the effect of aromatherapy on anxiety symptoms in women undergoing treatment for breast cancer. Method: a systematic review, carried out from the PEOT strategy: what are the effects of aromatherapy in reducing anxiety symptoms in women undergoing treatment for breast cancer? The research was conducted in six databases and in eight other data sources. Randomized clinical trials without date and language restrictions were included. Results: the sample consisted of seven studies. Aromatherapy was applied by inhalation (57.1%) and massage (42.8%), and was adopted alone or in conjunction with other interventions, demonstrating a reduction in anxiety symptoms in 71.4% of studies. The predominance of lavender, bergamot, frankincense and sandalwood essential oils is highlighted for their anxiolytic, relaxing, sedative, invigorating, antidepressant and muscle tension reducing effects. Conclusion: aromatherapy showed positive and significant results in reducing anxiety symptoms in women undergoing treatment for breast cancer.
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Mühlenpfordt I, Blakeslee SB, Everding J, Cramer H, Seifert G, Stritter W. Touching body, soul, and spirit? Understanding external applications from integrative medicine: A mixed methods systematic review. Front Med (Lausanne) 2022; 9:960960. [PMID: 36619637 PMCID: PMC9813495 DOI: 10.3389/fmed.2022.960960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction External applications from anthroposophic medicine (EAAM) are touch-based applications such as rhythmical massages, embrocations, and compresses that serve as components of complementary treatment concepts for various diseases. The aim of this review is to gain an understanding of typical indications and outcomes and to systematically assess the effectiveness and safety of EAAM. Materials and methods Medline/PubMed, CINAHL, the Cochrane Library, Embase, and PsycINFO were searched through May 2021 and supplemented by searches in specialized databases and personal requests to experts in the field. Studies and case reports on EAAM in patients, as well as healthy individuals, were included in the qualitative synthesis. Outcome parameters depending on each study were grouped as effect themes and assigned to study clusters using Thematic Analysis for a thematic overview of effect patterns. Results Four RCTs, 7 cohort studies, 1 mixed-methods, 1 retrospective, 4 qualitative studies, 3 case series, and 25 case reports on EAAM were identified. The analysis indicated various effects of EAAM on physiological as well as psychological health indicators and patterns of effect development. Study quality was found to be high for only 2 studies, and moderate for 1 study, and all remaining 45 studies showed a moderate or high risk of bias or were not ratable with used rating tools. Conclusion The included studies present a wide range of potential indications for EAAM, while showing methodological drawbacks. To determine whether EAAM can be considered an effective treatment option, clinical studies exploring the effect of different EAAM modalities on defined patient groups are recommended for the future. Systematic review registration [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214030], identifier [CRD42020214030].
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Affiliation(s)
- Inga Mühlenpfordt
- Department of Pediatrics, Division of Oncology and Hematology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany,*Correspondence: Inga Mühlenpfordt,
| | - Sarah B. Blakeslee
- Department of Pediatrics, Division of Oncology and Hematology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Janina Everding
- Department of Pediatrics, Division of Oncology and Hematology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Holger Cramer
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany,Bosch Health Campus, Stuttgart, Germany
| | - Georg Seifert
- Department of Pediatrics, Division of Oncology and Hematology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany,Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Wiebke Stritter
- Department of Pediatrics, Division of Oncology and Hematology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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