{"title":"Effects of aromatherapy on anxiety in patients with cancer: A systematic review and meta-analysis of randomized controlled trials","authors":"Ju Hyun Ahn, Myoungsuk Kim","doi":"10.1016/j.eujim.2023.102323","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with cancer often experience anxiety during cancer diagnosis and treatment, which can negatively impact their treatment outcomes. Although aromatherapy is believed to be effective in reducing anxiety in patients with cancer, the evidence has been limited. This review aimed to investigate the effectiveness of aromatherapy in reducing anxiety in patients with cancer and identify potential moderators of the intervention effects.</p></div><div><h3>Methods</h3><p>This review was conducted using data from PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, Cochrane Library, and Web of Science, Regional Information Sharing Systems (RISS), Korean Information Service System (KISS), KoreaMed, and DBpia until March 16, 2023. The final analysis included 11 comparisons from 10 studies that administered aromatherapy to patients with cancer aged 18 years or older. The intervention effect was calculated by the standardized mean difference (SMD), and moderator analysis was performed using subgroup, meta-analysis of variance, and meta-regression analyses. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials.</p></div><div><h3>Results</h3><p>The overall impact of aromatherapy on anxiety reduction in patients with cancer indicated a large effect size (SMD = -0.97, 95 % confidence interval: -1.60 – -0.35, I<sup>2</sup> = 94 %). In the subgroup analysis, the types of delivery methods and duration of the intervention were not found to be moderators causing heterogeneity in the effect sizes between trials. However, it was confirmed that the types of essential oils moderated the effects (Qb = 7.80, df = 2, <em>p</em><sub>b</sub> = 0.020). Additionally, continuous moderators were not found to significantly moderate the intervention effect.</p></div><div><h3>Conclusion</h3><p>This review demonstrates that aromatherapy reduces anxiety in patients with cancer, suggesting the possibility of its application in clinical and community settings. However, considering the limited quantity of randomized controlled trials (RCTs) available for subgroup analysis, which potentially impacts the precision of study outcomes, further research is warranted by incorporating additional RCTs.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"65 ","pages":"Article 102323"},"PeriodicalIF":1.9000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Integrative Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1876382023000999","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Patients with cancer often experience anxiety during cancer diagnosis and treatment, which can negatively impact their treatment outcomes. Although aromatherapy is believed to be effective in reducing anxiety in patients with cancer, the evidence has been limited. This review aimed to investigate the effectiveness of aromatherapy in reducing anxiety in patients with cancer and identify potential moderators of the intervention effects.
Methods
This review was conducted using data from PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, Cochrane Library, and Web of Science, Regional Information Sharing Systems (RISS), Korean Information Service System (KISS), KoreaMed, and DBpia until March 16, 2023. The final analysis included 11 comparisons from 10 studies that administered aromatherapy to patients with cancer aged 18 years or older. The intervention effect was calculated by the standardized mean difference (SMD), and moderator analysis was performed using subgroup, meta-analysis of variance, and meta-regression analyses. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials.
Results
The overall impact of aromatherapy on anxiety reduction in patients with cancer indicated a large effect size (SMD = -0.97, 95 % confidence interval: -1.60 – -0.35, I2 = 94 %). In the subgroup analysis, the types of delivery methods and duration of the intervention were not found to be moderators causing heterogeneity in the effect sizes between trials. However, it was confirmed that the types of essential oils moderated the effects (Qb = 7.80, df = 2, pb = 0.020). Additionally, continuous moderators were not found to significantly moderate the intervention effect.
Conclusion
This review demonstrates that aromatherapy reduces anxiety in patients with cancer, suggesting the possibility of its application in clinical and community settings. However, considering the limited quantity of randomized controlled trials (RCTs) available for subgroup analysis, which potentially impacts the precision of study outcomes, further research is warranted by incorporating additional RCTs.
导言癌症患者在癌症诊断和治疗过程中经常会感到焦虑,这会对治疗效果产生负面影响。虽然芳香疗法被认为能有效减轻癌症患者的焦虑,但相关证据却很有限。本综述旨在研究芳香疗法在减轻癌症患者焦虑方面的有效性,并确定干预效果的潜在调节因素。方法本综述使用的数据来自 PubMed、Embase、Cumulative Index to Nursing and Allied Health Literature (CINAHL)、MEDLINE、Cochrane Library 和 Web of Science、Regional Information Sharing Systems (RISS)、Korean Information Service System (KISS)、KoreaMed 和 DBpia,截止日期为 2023 年 3 月 16 日。最终分析包括 10 项研究中的 11 项比较,这些研究对 18 岁或以上的癌症患者实施了芳香疗法。干预效果以标准化均值差异(SMD)计算,并使用亚组、方差分析和元回归分析进行调节因子分析。结果芳香疗法对减轻癌症患者焦虑的总体影响显示出较大的效应大小(SMD = -0.97,95% 置信区间:-1.60 -0.35,I2 = 94%)。在亚组分析中,没有发现干预方法的类型和持续时间是导致试验间效应大小异质性的调节因素。然而,研究证实,精油的种类对效果有调节作用(Qb = 7.80,df = 2,pb = 0.020)。结论本综述表明,芳香疗法可以减轻癌症患者的焦虑,这表明芳香疗法有可能应用于临床和社区环境中。然而,考虑到可用于亚组分析的随机对照试验(RCT)数量有限,可能会影响研究结果的精确性,因此有必要通过纳入更多的 RCT 进行进一步研究。
期刊介绍:
The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education.
EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians.
The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.