| Date: 07-31-2015 | HC# 011537-525 |
Najafi Z, Taghadosi M, Sharifi K, Farrokhian A, Tagharrobi Z. The effects of inhalation aromatherapy on anxiety in patients with myocardial infarction: a randomized clinical trial. Iran Red Crescent Med J. 2014;16(8):e15485. doi: 10.5812/ircmj.15485.
Myocardial infarction (MI), a serious complication of coronary artery disease, is a common health problem worldwide. In Iran, cardiovascular disease (CVD) is the leading cause of death. In addition to its high mortality rate, CVD causes personal, familial, social, and economic problems, as well as psychological disorders such as anxiety, despair, fatigue, low self-confidence, and depression. Half of patients suffering from MI experience anxiety that affects their quality of life and increases the risk for cardiac complications. Pharmacological treatment of anxiety can significantly improve patient outcomes, but it is associated with various adverse side effects such as fatigue, confusion, and restlessness. Aromatherapy is a nonpharmacological strategy for anxiety management. These authors conducted a randomized, clinical trial from February to August 2013 to investigate the effects of inhalation aromatherapy on anxiety in patients with MI.
Patients who had suffered an MI and were in their second day of hospitalization at one of the coronary care units of a general teaching hospital affiliated with Kashan University of Medical Sciences in Kashan, Iran were recruited. The authors enrolled 70 patients who were aged between 20 and 80 years, with no previous history of MI, no cardiopulmonary resuscitation at the time of hospital admission, and no history of addiction, olfactory impairments, mental disorder, allergic rhinitis, eczema, respiratory disease, or uncontrolled contagious disease. They were mentally oriented, had stable vital signs, and were without pain. They scored more than 20 on the Spielberger's State Anxiety Inventory (SSAI).
Thirty-five patients received inhalation aromatherapy with Spanish lavender (Lavandula stoechas, Lamiaceae) aroma twice daily on the second and third days of hospitalization. During each treatment session, 3 drops of lavender essence prepared from lavender flower buds (Barij Essence Pharmaceutical Company; Kashan, Iran) were placed on a Kleenex®, which was attached to the patient's collar. Patients were asked to breathe normally for 20 minutes. Thirty-five patients in the control group received the routine care of the hospital without aromatherapy.
To assess the patients' anxiety, the authors used the SSAI, on which higher scores reflect higher levels of anxiety. The SSAI was applied to the aromatherapy group at baseline (T1) and 20 minutes after each aromatherapy session (T2-T5). Patients in the control group completed the SSAI at the same times.
The authors report that the levels of anxiety in the aromatherapy group differed significantly among the 5 time points (P<0.001); scores decreased from 43.15 ± 12.179 at baseline to 29.61 ± 7.318 at T5. However, the decreases between T1 and T2 and between T3 and T4 were not significant. In the control group, none of the differences in the levels of anxiety among the 5 measured time points were statistically significant.
Between-group differences in anxiety were significant among the 5 measured time points (P<0.001). At baseline, the mean and the standard deviation of anxiety were 43.15 ± 12.179 in the aromatherapy group and 41.31 ± 12.890 in the control group, a nonsignificant difference. However, at T2-T5, the levels of anxiety in the aromatherapy group were significantly lower than in the control group (P<0.05).
These study findings revealed that inhalation aromatherapy significantly reduced anxiety in patients with MI. The authors point out that earlier studies had conflicting results.
The authors explain that oil essences can regulate mood and emotions and reduce anxiety by stimulating olfactory receptors in the olfactory bulb and by stimulating the limbic system.1 "Lavender exerts its anxiolytic effects presumably through the same mechanism stimulating the limbic system," they write.
The authors conclude that "inhalation aromatherapy with lavender aroma can help relieve post-MI anxiety. Given the paramount importance and high prevalence of anxiety in patients with MI as well as the cost-effectiveness and simplicity of aromatherapy with lavender aroma, healthcare providers, particularly nurses, can use this strategy to improve post-MI anxiety management."
―Shari Henson
Reference
1Attarha M, Vakillian K, Rozbahany N, Bekhradi R. Effect of perineal massage with lavender essence on episiotomy and laceration.Journal of Babol University of Medical Sciences. 2009;11(4):25-30.
