Nursing is one of the professions characterized by overwhelming stress and anxiety degrees because of high amounts of work and burnout. Stress is closely related to anxiety. According to Carpenter & Dawson (2015), a survey on nurses’ well-being conducted by the American Nurses Association indicated that stress is the leading risk in the nursing work environment. The Health Risk Assessment (HRA) survey’s findings suggest that 82% of nurses indicated that they feel stressed (Carpenter & Dawson, 2015). In comparison, the average percentage of workers who experience stress in the work environment is only 36 percent. These statistics indicate that nurses have very high workplace-related pressure compared to employees in other professions. Intensive care units are considered the most stressful hospital environment compared to other departments. ICU nurses have different stress experiences because of ICU working conditions such as emergency admissions and dire or deteriorating patient’s prognosis, among other factors. Nurses must be provided with ways to cope with stress successfully and effectively. The current study aims to investigate the impact of aromatherapy on ICU nurses’ stress and anxiety degrees.
The PICOT Question is:
Is there a significant reduction in stress and anxiety levels in intensive care unit (ICU) nurses who use aromatherapy (essential oils) compared to ICU nurses who do not use aromatherapy within one week?
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P (Population) – Intensive care unit nurses
I (Intervention) – Aromatherapy (Essential oils)
C (Comparison) – Intensive care unit nurses who do not use aromatherapy
O (Outcome) – Reduction in stress and anxiety levels
T (Time) – One week
Eren & Oztunc (2017) conducted self-controlled, quasi-experimental research on all ICU nurses in two hospitals. The study’s findings indicate no significant difference between the experimental and control groups’ Perceived Stress Scale (PSS) and anxiety scores. At the end of the intervention administration, no significant variations were recorded between the scores collected from both groups. Despite a decrease in anxiety levels in the two groups, the decline did not have a statistical significance prior to and after intervention implementation. However, by the end of the study process, a significant reduction in anxiety scores was identified. Also, blood pressure and pulse rate figures of participants in the control and experimental categories were similar before and after intervention implementation. However, variations within the two groups showed a significant reduction in both systolic and diastolic blood pressure (Eren & Oztunc, 2017)). There were no changes identified in pulse values. However, all participants indicated that even though no changes were identified in stress levels, they were happy with the intervention. These findings are relevant to the PICOT question because they provide existing evidence on the impact of aromatherapy on stress and anxiety reduction in nurses.
The study’s dependent variables were stress levels, anxiety scores, arterial blood pressure, and pulse rate. The i ndependent variable was a romatherapy. The researchers addressed internal validity in the article. Internal validity refers to the degree to which research ensures a trustworthy cause and outcome relationship between an intervention and results. Besides, internal validity shows that a study makes it possible to avoid other explanations for the outcomes. The researchers ensured that participants were not informed of the type of oils used. Lavender oil was used for the experimental group, while sunflower seed oil was used in the control group. They were put in dark bottles and labeled number 1 for lavender oil and number 2 for sunflower oil. The bottles were dropped on white gowns that participants were supposed to wear during the application. Also, participants were allowed into the application room one by one. They were allowed to be alone throughout the intervention application process. By so doing, the researchers ensured that participants did not influence one another. Participants were not told about the type of oils used to prevent them from influencing one another and enhance an objective method to the intervention. The researchers addressed test-retest reliability. They conducted the study in two stages. In both phases, participants picked numbers (1 or 2) from a box. As a result, some participants in the control group in stage one ended up in the experimental group in phase two and vice versa. Also, some participants maintained their stage one groups depending on the numbers picked in step two. Therefore, for participants who kept their groups, results in both phases were consistent.
The study had high levels of reliability, and this was a significant strength. Data were collected in two different stages, and according to the researchers, the findings were consistent across the two stages. It ensured the consistency of the data collected using the data collection tools applied. Therefore, results can be linked to the intervention administered and not some extraneous variables. The use of a self-controlled design helped to ensure that confounders that function multiplicatively were controlled for. The method ensured that results were as a result of the intervention and mot time-invariant confounding factors.
On their website, https://tisserandinstitute.org/ , Tisserand Institute provides a clinical aromatherapy guideline (Clinical Aromatherapy Generic Policy). According to the approach, an individual/patient receiving aromatherapy should be assessed for allergies, sensitivity, skin integrity, presence of unmanaged chronic illnesses, aroma preferences, history of seizures, and tumors that depend on estrogen (Buckle, 2014). Also, application methods should be discussed. Essential oils can be inhaled, applied on the skin with suitable dilution, or used in a bath. Safety considerations should be addressed in the application of aromatherapy. For example, good ventilation should be maintained during treatment. A minimum of five minutes should be allowed for breathing in fresh air during aromatherapy sessions, and bottles containing essential oils should not be carried in patients’ rooms (Buckle, 2014).
According to Reynolds et al. (2018), aromatherapy is an effective intervention in reducing stress and anxiety among nurses. The article proposes continuous infusion of essential oils in nursing work stations in unit hallways. Reynolds et al. (2018) provide proof that after infusing eseential oils in nurses’ work stations, their perceived stress and anxiety levels were reduced. A combination of frankincense, chamomile, wood, spruce, and blue tansy is recommended for aromatherapy. According to Reynolds et al. (2018), the essential oils have balancing and grounding characteristics. It is critical to use pure and quality oils, and the article proposes the use of gas chromatography as well as mass spectrometry.
This paper aims to examine aromatherapy’s effect on intensive care unit nurses’ stress and anxiety scores. The PICOT question is: Is there a significant reduction in stress and anxiety levels (O) in intensive care unit (ICU) nurses (P) who use aromatherapy (essential oils) (I) compared to ICU nurses who do not use aromatherapy (C) within one week (T)? Findings indicate that essential oils have a significant impact on anxiety levels. They decrease levels of anxiety. When applying aromatherapy, it is necessary to follow guidelines to ensure safety. Ventilation is crucial during the therapy, and assess health aspects such as allergies and sensitiveness should be conducted. Based on the research done, aromatherapy would be recommended as an alternative to pharmacology to treat anxiety. Although findings of the reviewed article indicate no significant reduction of stress levels when aromatherapy is applied, it is essential to reduce anxiety related to stress. The practice can improve the well-being of nurses in the ICU.
References
Buckle, R. J. (2014). Tisserand Institute - Tap into the Pool of Essential Oil Safety. https://tisserandinstitute.org/wp-content/uploads/2019/02/Clinical-Aromatherapy-Generic-Policy-2019.pdf
Carpenter, H., & Dawson, J. M. (2015). Keeping nurses healthy, safe, and well. Retrieved from https://www.myamericannurse.com/wp-content/uploads/2015/09/Special-Report-Workforce-Keeping.pdf
Eren, N. B., & Oztunc, G. (2017). The Effects of Aromatherapy on the Stress and Anxiety Levels of Nurses Working in Intensive Care Units. International Journal of Caring Sciences , 10 (3), 1615-1623.
Reynolds, J., Parker, B., Wells, N., & Card, E. (2018, June 6). Using aromatherapy in the clinical setting: Making sense of scents . American Nurse. https://www.myamericannurse.com/aromatherapy-clinical-setting/
