The purpose of this study was to investigate the effects of aromatherapy on sleep quality.

This is a systematic review of randomized controlled trial studies (PROSPERO registration number CRD42017064519). In this study, the PICO were adults and the elderly, aromatherapy intervention, a comparative intervention with the control and placebo oil groups, and sleep. The selected articles were in English, Korean, and Chinese.

The results of the meta-analysis showed that the effect sizes of the experimental group were 1.03 (n=763, SMD=1.03, 95% CI 0.66 to 1.39) (Z=5.47, p<.001). In the aromatherapy intervention group, the effect size of sleep was statistically significant (Q_B=9.39, df=2, p=.009), with a difference of 0.77 for inhalation, 1.12 for oral intake and 2.05 for massage. A post-analysis showed that the effect of massage on sleep was significantly greater than the inhalation method. The regression coefficient of the intervention period, B=0.01 (Z=1.43, p=.154), also showed that the longer the intervention period, the larger the effect size; however, it was not statistically significant.

A total of 23 literature analyses showed that aromatherapy is effective in improving quality of sleep, and the massage method is more effective in improving quality of sleep than the inhalation method. A meta-ANOVA showed that the aromatherapy intervention affected the high heterogeneity of the effect size. Thus, future research with stricter control in methods and experimental procedures is necessary.

The purpose of this study was to examine the effects of aromatherapy on stress responses, autonomic nervous system (ANS) activity, and blood pressure in patients hospitalized to receive coronary angiography (CAG).

A non-equivalent control group with a pretest-posttest design was used. The subjects were patients admitted to the day angiography room to receive CAG at E University Hospital (34 in the experimental group and 30 in the control group). The experimental group treatment was inhalation of the aroma oil blended with lavender, ylang-ylang, and neroli at a ratio of 4:2:1 twice before and after CAG. The measurements of stress index, ANS activity, and blood pressure were performed 5 times as follows: at admission, at pre-CAG after treatment I, at post-CAG, 2 hours after treatment II, and 4 hours after treatment II. The data were analyzed using the Mann-Whitney U Test and repeated-measures analysis of variance.

Significant interactions in the high frequency of ANS (F=5.58, p=.005) were observed between group and time. Stress index (z=2.14, p=.016), systolic blood pressure (z=4.14, p<.005), and diastolic blood pressure (z=3.28, p=.001) were significantly different between the experimental and control groups after 4 hours of treatment II.

The findings showed that aromatherapy was not effective before CAG, but was effective after CAG. Therefore, aromatherapy can be used as a nursing intervention for patients receiving CAG.

The purpose of this study was to verify the effect of aromatherapy massage on abdominal fat and body image in post-menopausal women.

A Non-equivalent control group pre-post test Quasi-experimental design of random assignment was applied. All subjects received one hour of whole body massage as treatment by the same researcher every week for 6 weeks. Participants also massaged their own abdomen two times everyday for 5 days each week for 6 weeks. The two groups used different kinds of oil. The experimental group used 3% grapefruit oil, cypress and three other kinds of oil. The control group used grapeseed oil. Data was collected before and after the treatment using Siemens Somatom Sensation 4, a tape measure and MBSRQ. Data was analyzed by ANCOVA using the SPSS/PC+Win 12 Version.

Abdominal subcutaneous fat and waist circumference in the experimental group significantly decreased after aromathetapy massage compared to the control group. Body image in the experimental group was significantly better after aromathetapy massage than in the control group.

These results suggest that Aromatheapy massage could be utilized as an effective intervention to reduce abdominal subcutaneous fat, waist circumference, and to improve body image in post-menopausal women.

This experimental study was designed to verify the effect of inhalation of essential oils on body weight, feed intake, food efficiency rate and serum leptin.

The subjects of this study were 90 growing SD rats (46 males and 44 females). They were allocated into one of four groups, the Fennel group, Patchouli group, Bergamot group and control group. The experimental treatment was the inhalation of aromatherapy essential oils which was applied two times a day for 10 minutes each during 8 weeks. To evaluate the effects, body weight, feed intake, food efficiency rate and serum leptin were measured before and after the treatment. The collected data was analyzed by repeated measures of Kolmogorov-smirnov test and Normal Q-Q plot for nomality, Kruskal Wallis test and χ²-test for experimental effects with the SPSS program.

The food efficiency rate was significantly lower in the Patchouli group and Fennel group than in the Bergamot group and control group (P=.000). No significant group effects were found for SD rat's body weight, feeding amount and serum leptin.

In conclusion, these findings indicate that the inhalation of essential oils could be effective in lowering the food efficiency rate rather than the feed intake.

This study was designed to investigate the effect of delivery nursing care using essential oils on labor stress response, labor anxiety and postpartum status anxiety for primipara.

This study used nonequivalent control group pretest-posttest design. The subjects of this experiment consisted of forty eight primipara with single gestation, full term, & uncomplicated pregnancies. Twenty four primipra were in the experimental and control group each. Their mean age was 27.9 years old, their mean gestation period 279.9 days. As a treatment, delivery nursing care using essential oils was applied by nurses. Data collected epinephrine, norepinephrine, anxiety during labor. In the 24 hours after birth, the data for the postpartum mother's status anxiety was collected. Data was analyzed by t-test, repeated measures ANOVA, Mann-Whitney U test, & Wilcoxon signed ranks test with SPSS Program.

Plasma epinephrine, norepinephrine were significantly low in the experimental group (P=0.001, P=0.033, respectively). There was no significant difference between the two groups in anxiety during labor and postpartum mother's status anxiety.

These findings indicate that delivery nursing care using essential oils could be effective in decreasing plasma epinephrine, norepinephrine. But, that could not be verified in decreasing mother's anxiety.

This study was to develop an aromatherapy hand massage program, and to evaluate the effects of lavender aromatherapy on cognitive function, emotion, and aggressive behavior of elderly with dementia of the Alzheimer's type.

The Research design was a nonequivalent control group non-synchronized quasiexperimental study. Lavender aromatherapy was administrated to experimental group I for 2 weeks, jojoba oil massage was administrated to experimental group II for 2 weeks, and no treatment was administrated to the control group for 2 weeks. Data was analyzed using the chi-square-test, ANOVA, repeated measures of ANCOVA and ANCOVA in the SPSS program package.

1. Experimental group I did not show significant differences in cognitive function in relation to the experimental group II and control group. 2. Experimental group I showed significant differences in emotion and aggressive behavior in relation to the experimental group II and control group.

A Lavender aromatherapy hand massage program is effective on emotions and aggressive behavior of elderly with dementia of the Alzheimer's type.

The purpose of this study was to verify the effect of aromatherapy massage on constipation in the elderly.

This study for 10 day, employed a randomized control group pretest-posttest design. The experimental group received abdominal massage using essential oils with Rosemary, Lemon, and Peppermint, and the control group received a placebo massage. To evaluate the effect of aromatherapy, the degree of constipation was measured using the CAS(constipation assessment scale) and the number of bowel movements per week. Data was analyzed by repeated measures of ANOVA using the SPSS program.

The score of CAS of the experimental group was significantly lower than that of the control group. In addition the average number of bowel movements in the experimental group was higher than that of the control group. The effect of aromatherapy lasted 2 weeks after treatment, while the placebo effect lasted 7~10 days after treatment.

The finding of this study showed that aromatherapy helps relieve constipation in the elderly.

The purpose of this study was to investigate the effect of aromatherapy on pain, depression, and feelings of satisfaction in life of arthritis patients.

This study used a quasi-experimental design with a non-equivalent control group, pre-and post-test. The sample consisted of 40 patients, enrolled in the Rheumatics Center, Kangnam St. Mary's Hospital, South Korea. The essential oils used were lavender, marjoram, eucalyptus, rosemary, and peppermint blended in proportions of 2:1:2:1:1. They were mixed with a carrier oil composed of almond (45%), apricot(45%), and jojoba oil(10%) and they were diluted to 1.5% after blending. The data were analyzed using an 2-test, Fisher's exact test, t-test and paired t-test.

Aromatherapy significantly decreased both the pain score and the depression score of the experimental group compared with the control group. However, aromatherapy didn't increase the feeling of satisfaction in life of the experimental group compared with the control group.

The result of this study clearly shows that aromatherapy has major effects on decreasing pain and depression levels. Based on our experiment's findings, we suggest that aromatherapy can be a useful nursing intervention for arthritis patients.

The purpose of this study is to identify the effect of aroma inhalation on stress responses (physical symptoms, levels of anxiety, perceived stresses)of nursing students.

This study was a quasi-experimental research using anon-equivalent pre-post design and was conducted from June 1 to June 5, 2002. The subjects consisted of 77 junior nursing students who were divided into 39 experimental group members and 38 control group members. A pretest and Post-test were conducted to measure body symptoms, the level of anxiety, and the level of perceived stress. In the experimental group, aromas were given using an aroma lamp, lavender, peppermint, rosemary and Clary-Sage. In the control group, the treatment was not administered.

As a result of administering aroma inhalation to nursing students, their physical symptoms decreased, their anxiety scores were low, and their perceived stress scores were low, showing that aroma inhalation could be a very effective stress management method.

Nursing educators should play an important role in contributing to college students' physical and psychological health by helping enhance their recognition of stress management and effectively relieving their stress using essential oils.

This study was designed to verify the effect of aromatherapy on a postpartum mother's perineal healing.

The research design was a clinical trial. The methods of aromatherapy were applied sitz bath or soap application using essential oils with Lavender, Myrrh, Neroli, Rose, Grapefruit, Mandarin, Orange, and Roman Chamomile. The subjects of this experiment were postpartum mothers who delivered vaginally with an episiotomy. They were allocated to one of three groups; the aroma-sitz bath group, aroma-soap application group or control group. To evaluate the effect of aromatherapy, the perineal healing status was measured using the REEDA scale and smears of episiotomy wound were obtained. The data were analyzed by repeated measures of ANOVA, ANCOVA, χ²-test, and multiple response analysis via SPSS program.

The REEDA scale was significantly low in the experimental group at postpartum 5th and 7th days (P=.009, P=.003), respectively. Most were observed ‘ few’(5-10 bacteria per field) bacteria in the smears of episiotomy wound. The one bacteria was identified in the 50.8% of subjects in pretest and two bacteria in the 60.3% in posttest. Most frequently identified bacteria were Escherichia coli and Enterococcus faecalis.

In conclusion, these findings indicate that postpartum aromatherapy for perineal care could be effective in healing the perineum perineal care could be effective in healing the perineum.

Objectives of the study is to examine the effectiveness of aromatherapy massage among middle aged women with abdominal obesity.

AB/BA crossover design of random blind assignment was applied. Aromatherapy and placebo massage were given to Group(A), Group(B), each groups applied each massages for 2weeks alternatively. Weight, abdominal circumference and appetite were compared for results check among the subjects.

The apparent effectiveness of Aromatherapy Massage in reducing weight, abdominal circumference and appetite was noted.

On the basis of results, they strongly support the facts of reduction of abdominal obesity by applying aromatherapy massage for middle aged women.

This study was an experimental study to compare the inhalation effects of aroma essential oil on the quality of sleep (QOS) for shift nurses after working nights.

The participants were 60 healthy adults who didn't have any disease. As an experimental treatment, the participants in the experimental group were asked to inhale essential oil for 3 minutes at a distance of approximately 10 cm fromt heir nose and then they were asked to sleep with the aroma stone beside their head (within a 30 cm distance). QOS were measured four times on Pretest, Day 1, Day 2, and Day 3 after they slept. To measure QOS, Perceived QOS (Numeric Rating Scale), the Verran & Synder-Halpern (VSH) Sleep Scale were used, and number of awakenings (NoA) was measured by Actigraph.

There were no significant differences in the homogeneity tests for general characteristics and dependent variables prior to the experiments, except for VSH of subjective sleep quality. Also, there was no significant interaction between group and time. The VSH of the experimental group was higher than the control group (F=6.39, p=.002). The NoA between the experimental group and the control group was significantly different after experimental treatment 3rd day (F=13.35, p=.001).

The findings show that the inhalation of aroma essential oil had effects to increase the quality of sleep. Therefore, the inhalation of aroma essential oil could be applied to general nursing interventions to improve the quality of sleep.

This study was a systematic review to evaluate the effects of aromatherapy on menopausal symptoms, perceived stress and depression in middle aged-women.

Eight databases were searched from their inception September 8, 2015. Two reviewers independently performed the selection of the studies, data abstraction and validations. The risk of bias was assessed using Cochrane criteria. For analysis of the data, a meta-analysis of the studies was performed.

From the electronic databases, 73 articles were selected, and 19 removed due to duplication. After two reviewers read the abstracts of 54 studies, 34 studies were selected. Complete papers for 34 original articles were read and, 12 studies which met selection criteria were reviewed and the effects of aromatherapy on menopausal symptoms, stress and depression analyzed using meta-analysis with RevMan. In the 2 studies which included Randomized Controlled Trials testing of aromatherapy on menopausal symptoms and comparison of control and placebo groups were done. Aromatherapy massage was favorably effective in reducing the menopausal symptoms compared to the control group (n=118, MD=-6.33; 95% CI -11.51 to -1.15), and compared to the placebo group (n=117, MD=-4.14; 95% CI -7.63 to -0.64). Also aromatherapy was effective in reducing stress (n=72, SMD=-0.64; 95% CI -1.12 to -0.17) and depression (n=158, MD=-5.63; 95% CI -10.04 to -1.22).

There is limited evidence suggesting that aromatherapy for middle-aged women may be effective in controlling menopausal symptoms, perceived stress and depression.

This study was conducted to examine the effect of oral care with an aroma solution on oral status and oral cavity microorganism growth in elderly patients with stroke.

A non-equivalent control group, with a pretest-posttest design was used in this study. The participants were assigned to the experimental group (n=30) that received oral care with an aroma solution or the control group (n=31) that received 0.9% saline solution. To identify the effect of the experimental treatments, objective/subjective assessments of oral status and oral cavity microorganism growth were performed using the oral assessment guide, oral perception guide, and oral swab culture. Data were analyzed using Chi-square test, Fisher's exact test, and t-test with the SPSS version 21.0 program.

The objective oral status was significantly lower in the experimental group than in the control group (t= -3.64, p<.001). There was no significant difference between the subjective oral status of the experimental group and control groups (t= -1.24, p=.109). Oral microorganism growth was significantly lower in the experimental group than in the control group (t= -7.39, p<.001).

These findings indicate that special mouth care using an aroma solution could be an effective oral health nursing intervention for elderly patients with stroke.

The purpose of this study was to examine the effects of aroma massage on pruritus, skin pH, skin hydration and sleep in elders in long-term care hospitals.

The participants were elders over 65 years old admitted to long-term care. They were assigned to the experimental group (26) or control group (28). Data were collected from May to August, 2012. Visual Analogue Scale and Verran and Snyder-Halpern Sleep scale were used to identify levels of pruritus and sleep. A skin-pH meter and moisture checker were used to measure skin pH and skin hydration. Aroma massage was performed three times a week for 4 weeks for elders in the experimental group. The data were analyzed using the SPSS Win 17.0 program.

There were significant differences in pruritus, skin pH and skin hydration between the two groups. However there was no significant difference in sleep.

The results indicate that aroma massage is effective in reducing pruritus, skin pH and increasing skin hydration in elders. Therefore, this intervention can be utilized in clinical practice as an effective nursing intervention to reduce pruritus in elders in long-term care hospitals.

This study was done to evaluate the effects of 3 times/week and 5 times/week abdominal meridian massage with aroma oils (AMMAO) on the relief of constipation among hospitalized children with disabilities involving the brain lesions (cerebral palsy, epilepsy, and others).

The participants were 33 hospitalized children with a disability involving the brain (15 were in the 5 times/week of AMMAO group and 18 were in the 3 times/week of AMMAO group). Data were collected from March 21 to May 1, 2011. Chi-square test, t-test, and repeated measures ANOVA with SPSS 18.0 were used to evaluate the effects of AMMAO.

While there was no significant difference between the two groups, there was a significant difference within groups between baseline and the end of the intervention period for the following, frequency of suppository use or enemas, amount of stool, and number of bowel movements.

The results of this study indicate that AMMAO is an effective nursing intervention in relief of constipation for hospitalized children with a disability involving the brain. Therefore it is recommended that AMMAO be used in clinical practice as an effective nursing intervention for relief of constipation to these children.

The aim of this study was to explore the effects of A-solution on halitosis and oral status in preoperative NPO patients.

A nonequivalent control group, non-synchronized pretest-posttest design was used in this study. The participants in this study were 66 patients who were admitted for gynecologic surgery. The experimental treatment was to give oral gargling with A-solution, blended essential oils and diluted with distilled water. To identify the experimental treatment effects, halitosis, salivary pH, and oral status were measured by a portable halitosis detector, visual analogue scale, Bromo Thymol Blue (BTB), Bromo Cresol Purple (BCP) test paper and oral assessment guide. Data were analyzed using χ²-test, t-test with PASW 18.0 version.

Participants were homogeneous before experimental treatment. Objective halitosis in the experimental group, measured by a portable halitosis detector (t= -8.34, p<.001) was significantly lower than the control group. Subjective halitosis was significantly lower in the experimental group (t= -9.29, p<.001). Salivary pH was significantly different between two groups (t=8.81, p<.001). Oral status was significantly better in the experimental group (t= -13.31, p<.001).

These findings indicate that oral gargling using A-solution is effective in reducing patient halitosis, and improving oral status.

This study was done to compare the effects of abdominal aroma massage and meridian massage on constipation and stress in college women with functional constipation.

The participants were 38 college women, 18 were in the aroma group and 20 in the meridian group. The aroma massage was given using aroma oil which was a mixture of lemon, lavender, rosemary, and cyprus. The meridian massage was given at 9 accupoints which influence intestinal functions. The treatment was given 5 days a week for 4 weeks. A constipation severity score, weekly defecation frequency, and a stress response score were measured before and every week of 4 weeks of the experiment.

While there was no significant difference between two groups, there was a significant difference within the groups in the constipation severity (aroma group: 1st week, meridian group: except 4th week), defecation frequency (aroma group: 3rd week, meridian group: 2nd and 3rd week), and stress (aroma group: all weeks, meridian group: except 4th week) after different duration of experiment.

Based on these results, both abdominal massages relieved constipation and stress. Resorting to either types of massage will contribute to the reduction of use of stool softeners, suppositories, or enemas.

To investigate the effectiveness of aromatherapy on blood pressure, heart rate variability, aortic pulse wave velocity and the aortic augmentation index of essential hypertensive patients.

Using a coin toss, 22 participants were assigned to the experimental group and 20 to the control. The experimental group was given a blend of oils of lemon (Citrus limonum), lavender (Lavandula angustifolia), and ylang ylang (Cananga odorata) which were prepared in the ratio of 2:2:1, respectively. The control group was given an artificial lemon fragrance of Limonene (35 cc) and Citral (15 cc) mixture. The experiment, inhalation, was conducted for 3 weeks (2 min per inhalation, 2 times per day) to both groups.

There was a noticeable difference in systolic blood pressure between the groups (p=.001), however the difference in diastolic blood pressure between the two groups was not significant. There was a notable difference in sympathetic nerve system activity of heart rate variability (p=.047). However, the differences in aortic pulse wave velocity or the aortic augmentation index were not significant.

Aromatherapy is effective in lowering systolic blood pressure and sympathetic nerve system activity.

This study was done to examine the effects of aromatherapy on stress and stress responses in adolescents.

A two-group cross-over design was used for this study. The experimental treatment was aroma essential oil inhalation and the placebo treatment was carrier oil inhalation using a necklace. The sample included 36 female high school students. Fisher's exact test, t-test, and paired t-test using SPSS/WIN program were used to analyze the data.

Stress levels were significantly lower when the students received the aroma treatment compared to when they received the placebo treatment. The stress responses except salivary IgA levels were significantly lower when the students received the aroma treatment.

Aroma inhalation could be a very effective stress management method for high school students. Therefore, it is recommended that this program be used in clinical practice as an effective nursing intervention for high school students.

The purpose of this study was to identify the effects of a multi agent obesity control program in obese school children. This program was composed of strategies to modify diet and exercise habits and to change cognitive behavior variables(stress, coping, and self-efficacy).

The subjects were 40 obese school children who participated in our project voluntarily via homepage, TV, newspaper, public paper and school official documents. The program was implemented daily for 4 sessions per day for ten days from August 16 to 26, 2004. The daily program consisted of exercise therapy, dance therapy, cognitive behavior therapy and aroma therapy. The data was analyzed by paired t-test using the SPSSWIN program.

There was a significant decrease in children's waist-hip ratio (p=.04) and in children's stress (p=.00) after the program. There was a significant increase in children's self-confidence after the program(p=.02) and a significant decrease in children's diet habit after the program(p=.02).

This study provides evidence that a multiagent obese control program is effective in changing waist-hip ratio, stress, self-confidence, and diet habits in obese school children.

The purpose of this study was to identify the effects of aromatherapy on blood pressure and stress responses of clients with essential hypertension.

There were fifty-two subjects divided into an essential oil group, placebo group, and control group by random assignment. The application of aromatherapy was the inhalation method of blending oils with lavender, ylangylang, and bergamot once daily for 4 weeks. To evaluate the effects of aromatherapy, blood pressure and pulse were measured two times a week and serum cortisol levels, catecholamine levels, subjective stress, and state anxiety were measured before and after treatment in the three groups. Data was analyzed by repeated measures of ANOVA, one-way ANOVA, and χ²-test using the SPSS 10.0 program.

The blood pressure, pulse, subjective stress, state anxiety, and serum cortisol levels among the three groups were significantly statistically different. The differences of catecholamine among the three groups were not significant statistically.

The results suggest that the inhalation method using essential oils can be considered an effective nursing intervention that reduces psychological stress responses and serum cortisol levels, as well as the blood pressure of clients with essential hypertension.

The purpose of this study was to explore the effects of the lavender fragrance on sleep and depression in women college students.

Forty-two women college students who complained of insomnia were studied during a four-week protocol(control treatment week, 60% lavender fragrance treatment week, washout week, 100% lavender fragrance treatment week). All subjects were in the department of nursing in “K” college and the study was a single blind repeated measurements experiment. For the duration of the study, weekly evaluations of sleep, patterns of sleep disturbance, severity of insomnia scale, self satisfaction with sleep, and severity of depression were performed.

Among sleep variables, length of time taken to fall asleep, severity of insomnia, and self satisfaction with sleep were improved for the 60%(p=.000, p=.000, p=.000) and 100%(p=.000, p=.000, p=.000) week while the severity of depression was improved only for the 100%(p=.002)week.

According to the study results, it can be concluded that the lavender fragrance had a beneficial effect on insomnia and depression in women college students. Repeated studies are needed to confirm effective proportions of lavender oil and carrier oil for insomnia and depression.