Embedded media: https://open.spotify.com/embed/episode/37SZ5tsIBUWGZXnYG4g8wT?utm_source=generator
Introduction
Aromatherapy is considered a complementary or alternative form of comprehensive care that uses essential oils with the aim of improving physical and mental well-being, balance, and mood. Modern aromatherapy has gained attention in recent years in many therapeutic centers as a complementary method of care. In France, aromatherapy is oriented toward conventional medicine, particularly internal use. In contrast, in England, aromatherapy is used in the form of massages or baths. Aromatherapy employs essential oils made from plants or herbs. Vinceová (2021) states that aromatherapy with essential oils is increasingly used in hospitals, cancer treatment centers, and pain management clinics. Frass and Krenner (2019) are of the opinion that aromatherapy creates a space for collaboration between nursing and medicine with a focus on patient comfort. The form of aromatherapy is the application of essential oils. According to Fradelos and Komini (2015), essential oils are a natural form of energy that alleviates patient difficulties, supports emotional well-being, and provides a sense of comfort. Worwood (2016) describes essential oils as volatile and liquid aromatic compounds extracted from plant parts that have a unique aroma and a set of chemical properties. They are organic metabolites, small droplets of oil formed through photo-biosynthesis in oil glands within or on plant tissue. They represent the foundation of aromatherapy, are found in flowers, seeds, fruit peels, leaves, roots, and wood, and are fragrant. Buehlmann (2016) defines care with essential oils as a complementary method of nursing with a focus on individual patient problems. Vinceová (2021) describes the results of scientific studies that demonstrated the positive effects of essential oils on chronic wound healing, stress reduction, facilitation of falling asleep, general prevention, prophylaxis, or pain relief in patients. The study by Özkaraman et al. (2018) conducted in Turkey with respondents suffering from oncological diseases demonstrated the therapeutic effect of lavender by reducing anxiety levels and improving sleep quality. The healing effects of lavender essential oil were also demonstrated by Rapper, Viljoen, Vuuren (2019). The results of their study confirm that essential oils are capable of acting where antibiotics fail. They represent a cost-effective and efficient form of antiseptic treatment, including for antibiotic-resistant strains such as MRSA and antimycotic-resistant Candida species. We lean toward the opinion of Mazurek (2019), that essential oils are usable in everyday care. They represent a strong environmental factor with a positive impact on emotions. According to Buckle (2015), there are several ways these substances can enter the body, for example through massage, baths, compresses, facial steam inhalation, and toiletry water. Active components reach organs through inhalation, percutaneously, orally, or through mucous membranes.
Objective
To monitor the prophylactic effect of essential oils in the care of decubitus. To demonstrate the causal justification of aromatherapy application in the healing process of stage I decubitus.
Set and Methodology
Respondents were deliberately selected from the St. Elisabeth nursing home in the city of St. Pölten in Lower Austria. The entire experimental set (n=37) of respondents was divided into two basic groups. The criterion for inclusion in the first basic group (n=7) was the nursing diagnosis D100. The second basic group (n=30) of respondents was divided into two subgroups, research – "A" (n=15) and control subgroup – "B" (n=15). The criterion for inclusion in the second basic group was the nursing diagnosis D 104. Respondents were aged 75-99 years. We used the natural experiment method. In the first basic group (n=7) of respondents with diagnosis D 100, we used rose hydrosol for wound disinfection, which has a soothing, analgesic, and antiseptic effect. Subsequently, we applied 1 drop of 100% natural lavender essential oil directly onto the stage I decubitus, which was manufactured at the Christophorus Wagram pharmacy, St. Pölten. In the second basic group (n=30), we applied the given essential oil to predilection sites in respondents of the research subgroup "A" (n=15). Respondents were repositioned at 4-hour intervals and mobilized during the day. In the control subgroup "B" (n=15), we applied lipid body milk to predilection sites (twice daily), repositioned at 4-hour intervals, and respondents were mobilized during the day. The research investigation was conducted from February 2020 to December 2020. Statistical processing was performed using the SPSS IBM ver.18 program with methods of descriptive statistics, correlation and regression analysis, and tests for non-parametric data distributions.
Results and Discussion
In the sample of 7 respondents with nursing diagnosis D 100, we evaluated the effectiveness of essential oils in the process of caring for stage I decubitus using the following monitored parameters: wound status, wound surroundings, wound infection, exudate, and pain intensity (Tab.1). By applying lavender essential oil, we achieved exudative healing of decubitus (n=3), the granulation phase of healing (n=2), and the phase of exudative healing with fibrin coating (n=2). In the set (n=7), signs of infection were absent, the exudate did not show excessive or low production, and the color of the exudate was clear and without the presence of odor. After the second application of essential oil, we recorded a decrease in pain intensity (3.5) on the numeric pain scale in respondents (n=5).
Tab.1 Results of correlation testing of variables in the process of caring for stage I decubitus
| Test Result | Wound Status | Wound Surroundings | Infection | Exudate | Pain |
|---|---|---|---|---|---|
| Pearson correlation coefficient | -0.979 | -0.913 | -0.839 | -0.846 | -0.981 |
| p-value | 0.001 | 0.002 | 0.005 | 0.016 | 0.002 |
p – significance level of the correlation coefficient
The results indicate that in the sample (n=7) of respondents, the application of essential oil has a statistically significant effect on the healing of stage I decubitus (p<0.05). In the sample (n=15) of respondents (Dg. D 104), we hypothesized that the application of lavender essential oil would have a prophylactic effect compared to the application of lipid milk in the control sample "B" (n=15). The results did not confirm our expectations. In the research subgroup, stage I decubitus occurred in the sacral area in 1 respondent. In the control subgroup, this diagnosis was established in three respondents. Statistically, p=0.145, we did not demonstrate the causal justification of essential oil application as a form of prophylaxis (Graph 1).
Graph 1 Incidence of decubitus in the research and control groups
The results of our research correspond to the findings of Mori, Kawanami, Kawahata, Aoki (2016), who examined the healing effect of lavender essential oil on wound healing. The study on a sample of 120 women demonstrated that care of episiotomy with this essential oil significantly reduced pain and redness. Similarly, Marzouk, Barakat, Ragab, Badria, Badawy (2015) demonstrated that the application of essential oils in the wound healing process significantly reduces redness, swelling, discharge, and pain intensity compared to the control group. Universally, studies confirmed the beneficial effect of lavender essential oil on wound healing. Ovayolu, Sevig, Sevinc (2014) also confirmed that aromatherapy with lavender oil maintains physical and psychological comfort. These clinical studies indicate the potential of essential oils. Ganeshkumar, Ponrasu, Krithika et al. (2012) focused their study on the effects of Acalypha indica extracts. They confirmed that the extract from the aforementioned plant accelerates the wound healing process by increasing collagen synthesis in various phases of wound healing. Similar results were achieved by Mazutti da Silva, Costa, Delfuso et al. (2018), who used myrtle essential oil in an in vitro healing process. They also confirmed the significance of essential oil in the healing process of damaged tissue. The beneficial effect of lavender oil and other preparations for wound healing creates conditions for the integration of innovative approaches and new alternative methods of comprehensive care alongside conventional treatment.
Conclusion
The results of the natural experiment indicate that aromatherapy with lavender essential oil has a positive therapeutic effect on the healing of stage I decubitus in our experimental sample of patients. It also has positive effects on mental health, regulates imbalance, reduces disease risks, and strengthens the immune system. Aromatherapy as a complementary or alternative method is a globally recognized method of treatment and prevention for all age categories. We recommend studying and further investigating the effects of other essential oils with the aim of demonstrating the effects of non-pharmacological treatment procedures and comprehensive care.
Authors: prof. PhDr. Mária Kilíková, PhD., MPH PhDr. Silvia Vinceová University of Health and Social Work of St. Elizabeth Bratislava, Detached Workplace of Blessed Sára Salkaházi Rožňava
List of Bibliographic References
BUEHLMANN, L. 2016. Anwendung von ätherischen Ölen zur Vorbereitung der Haut auf die Strahlentherapie bei Frauen mit Brustkrebs, In Schweizerische Zeitschrift für Ganzheitsmedizin/ Swiss Journal of Integrative Medicine, ISSN 1015-0684, 2016/7 s. 348-363.
BUCKLE, J. 2015. Clinical Aromatherapy.Essential Oils in Healthcare.Elsevier. Elselvier Books, 2015. 583 s. ISBN 978-0-7020-5440-2.
FRADELOS, E. ‒ KOMINI, A. 2015. The use of essential oils as a complementary treatment for anxiety In American Journal of Nursing Science. ISSN 2328-57452015, roč. IV., č 1, s.1-5.
FRASS, M. ‒ KRENNER, L. 2019. Integrative Medizin, Evidenzbasierte komplementärmedizinische Methoden. Springer Verlag GmbH. 2019. 834 s. 2019. ISBN 978-3-662-48878-2.
GANESHKUMAR, M. ‒ PONRASU, T. ‒ KRITHIKA, R. et al. 2012. Topical application of Acalypha indica accelerates rat cutaneous wound healing by up-regulating the expression of Type I and III collagen. In Journal of ethnopharmacology.[online]. 6/2012. [cit. 2020-12-05]. Available at: https://pubmed.ncbi.nlm.nih.gov/22521732/.
MARZOUK, T. ‒ BARAKAT, R. ‒ RAGAB, A. ‒ BADRIA, F. ‒ BADAWY. 2015. Lavender-thymol as a new topical aromatherapy preparation for episiotomy: A randomised clinical trial. In Journal of Obstetrics and gynaecology. [online]. 05/2015. [cit. 2020-05-06]. s. 472-475. Available at: https://pubmed.ncbi.nlm.nih.gov/25384116/.
MAZUTTI DA SILVA, S.M. ‒ COSTA, C.R.R. ‒ GELFUSO, G.M. ‒ NEVES SILVA GUERA, E. ‒ KARLA DE MEDEIROS NOBREGA, Y. ‒ MARIA GOMES, S. ‒ PIC- TAYLOR, A. ‒ FONSECA-BAZZO, Y.M. ‒ SILVEIRA, D. ‒ MAGALHAES, P.O. 2018. Wound Healing Effect of Essential Oil Extracted from Eugenia dysenterica DC (Myrtaceae) Leaves. In Molecules. [online]. 12/2018. [cit.2020-15-03]. Available at: https://pubmed.ncbi.nlm.nih.gov/30577426/.
MAZUREK, CH. 2019. Aromapflege:Das riecht aber gut! In Psych Pflege, [online]. 25/2019. [cit. 2020-15-02].s.162-165. Available at: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-0897- 9192.
MORI, H.M. ‒ KAWANAMI, H. ‒ KAWAHATA, H. ‒ AOKI, M. 2016, Wound healing potential of lavender oil by acceleration of granulation and wound contraction through induction of TGF-β in a rat model. In BMC Complementary and Alternative Medicine. [online].5/2016.[cit. 2020-10-06]. Available at: https://pubmed.ncbi.nlm.nih.gov/27229681/.
OVAYOLU, O. ‒ SEVIG, U. ‒ OVAYOLU, N. ‒ SEVINC, A. 2014. The effect of aromatherapy and massage administered in different ways to women with breast cancer on their symptoms and quality of life. In International Journal of Nursing Practice. [online]. 8/2014. [cit. 2020-15-01]. s. 108-417. Available at: https://www.ncbi.nlm.nih.gov/pubmed/25157942.
ÖZKARAMAN, A. ‒ DÜGÜM, O. ‒ YILMAZ, Ö. H. ‒ YESILBALKAN, U. Ö. 2018. The effect of lavender on anxiety and sleep quality in patients In Clinical Journal of Oncology Nursing. [online]. 4/2018. [cit. 2020-15-05]. s.203-210. Available at: https://avesis.ogu.edu.tr/yayin/bdc4831e-5188-44cc-9d44-66ae52b790d4/aromatherapy-the-effect-of-lavender-on-anxiety-and-sleep-quality-in-patients-treated-with-chemotherapy/document.pdf
RAPPER, S. ‒ VILJOEN, A. ‒ VUUREN, S. 2016. The In Vitro Antimicrobial Effects of Lavandula angustifolia Essential Oil in Combination with Conventional Antimicrobial Agents, In Evidence-Based Complementary and Alternative Medicine. [online]. 11/2016.[cit. 2019-18-12].s.1-9. Available at: https://www.hindawi.com/journals/ecam/2016/2752739/.
VINCEOVÁ, S. Využitie éterických olejov v ošetrovateľskej starostlivosti o dekubity. Rigorózna práca. Bratislava: Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety. 2021, 127s.
WORWOOD, V. A. 2016. The Complete Book of Essential Oils and Aromatherapy: New World Library, 2016. 712 s. ISBN 978-157-73-11-393.