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

초록

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, p<inf>b</inf> = 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. © 2023

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