EFFECTS OF AROMATHERAPY ON ANXIETY SYMPTOMS IN WOMEN WITH BREAST CANCER: A SYSTEMATIC REVIEW

Aragão, Vivianne Melo; Lima, Magda Milleyde de Sousa; Fernandes, Cristina da Silva; Barros, Lívia Moreira; Rodrigues, Andrea Bezerra; Caetano, Joselany Áfio

doi:10.1590/1980-265X-TCE-2022-0132en

Vivianne Melo Aragão

visualization

data curation

formal analysis

Escola de Saúde Pública do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brasil.

http://orcid.org/0000-0003-0228-5399

Magda Milleyde de Sousa Lima

data curation

formal analysis

writing – original draft

Universidade Federal do Ceará, Programa de Pós-Graduação em Enfermagem. Fortaleza, Ceará, Brasil.

http://orcid.org/0000-0001-5763-8791

Cristina da Silva Fernandes

validation

writing – original draft

Universidade Federal do Ceará, Programa de Pós-Graduação em Enfermagem. Fortaleza, Ceará, Brasil.

http://orcid.org/0000-0002-4514-3107

Lívia Moreira Barros

writing – review & editing

Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Departamento de Enfermagem. Redenção, Ceará, Brasil.

http://orcid.org/0000-0002-9763-280X

Andrea Bezerra Rodrigues

writing – review & editing

Universidade Federal do Ceará, Departamento de Enfermagem. Fortaleza, Ceará, Brasil.

http://orcid.org/0000-0002-2137-0663

Joselany Áfio Caetano

visualization

writing – review & editing

Universidade Federal do Ceará, Departamento de Enfermagem. Fortaleza, Ceará, Brasil.

http://orcid.org/0000-0002-0807-056X

CORRESPONDING AUTHOR
Cristina da Silva Fernandes cristina.sednanref@gmail.com

CONTRIBUTION OF AUTHORITY

Study design: Aragão VM, Caetano JA. Data collection: Aragão VM, Lima MMS. Data analysis and interpretation: Aragão VM, Lima MMS. Discussion of results: Fernandes CS. Content writing and/or critical review: Lima MMS, Fernandes CS. Review and final approval of the final version: Barros LM, Rodrigues AB, Caetano JA.

CONFLICT OF INTEREST

There is no conflict of interest.

EDITORS

Associated Editors: Bruno Miguel Borges de Sousa Magalhães, Monica Motta Lino. Editor-in-chief: Elisiane Lorenzini.

Database	CINAHL/Ebsco	(“breast cancer” OR “breast neoplasm” OR “breast carcinoma” OR “breast tumor” OR “breast malignancy”) AND (aromatherapy OR “essential oils” OR “aroma-therapy” OR inhalation) AND anxiety
	Cochrane Library	(“Breast Neoplasms” OR “Breast Cancer” OR “Breast Tumors” OR “Neoplasms, Breast” OR “Tumors, Breast” OR “Breast Tumor”) AND (“Oils, Volatile” OR Aromatherapy OR “Essential Oil” OR Aromatherapies OR “Aroma Therapy” OR “Aroma Therapies” OR “Therapies, Aroma” OR “Therapy, Aroma”) AND Anxiety
	PubMed/MEDLINE
	Scopus
	Web of Science
	Embase	(‘breast tumor’/exp OR ‘breast neoplasms’ OR ‘mammary tumor’ OR ‘mammary neoplasms’ OR ‘breast tumor’ OR ‘breast tumour’ OR ‘female breast neoplasm’ OR ‘female breast tumor’) AND ‘essential oil’/exp AND (‘anxiety’/exp OR ‘anxiety’)
Other data sources	Traditional, Complementary and Integrative Medicines	(“Neoplasias da Mama” OR “Breast Neoplasms” OR “Neoplasias de la Mama”) AND (Aromaterapia OR Aromatherapy OR Aromaterapia) AND (Ansiedade OR Anxiety OR Ansiedad)
	OpenGrey	“Breast Neoplasms” OR “Breast tumor” AND “Oils, Volatile” OR “Essential Oil” AND “Anxiety”
	CAPES Bank of Theses and Dissertations	“cancer de mama” OR “cancer da mama” OR “mama - cancer” AND ansiedade
	Brazilian Digital Library of Theses and Dissertations	“cancer de mama” E “oleos essenciais” E “oleo essencial” E “Cancer da mama” E “mama - cancer” E “mamas - cancer”
	Clinical Trials	Breast Cancer Female AND Anxiety AND Oils, Volatile OR Essential Oil
	NCI	(aromatherapy OR essential oil) AND anxiety
	REBEC	aromatherapy
	REBEC	essential oil
	Google Scholar	anxiety AND “aroma therapy” AND “breast cancer patients”
	Google Scholar	anxiety AND “aromatherapy massage” AND “breast cancer patients”

Study code	Sample	Intervention used in the IG	Exposure time	Main results
S11616. Beyliklioğlu A, Arslan S. Effect of lavender oil on the anxiety of patients before breast surgery. J Perianesth Nurs [Internet]. 2019 [cited 2022 Mar 23];34(3):587-93. Available from: https://doi.org/10.1016/j.jopan.2018.10.002 https://doi.org/10.1016/j.jopan.2018.10....	80 participants divided into 2 groups of 40 each.	Gaze with three to four drops of lavender EO§ was used for inhalation.	20 minutes	There was a statistically significant difference in IG† (p<0.05), while in CG* there was no statistically significant difference (p>0.05).
S21010. Xiao Y, Li L, Xie Y, Xu J, Liu Y. Effects of aroma therapy and music intervention on pain and anxious for breast cancer patients in the perioperative period. Zhong Nan [Internet]. 2018 [cited 2022 Apr 26];43(6):656-61. Available from: https://doi.org/10.11817/j.issn.1672-7347.2018.06.013 https://doi.org/10.11817/j.issn.1672-734...	100 participants divided into 4 groups.	Aromatherapy was prepared according to the proportions 1:2:3, choosing three types of EO§: lavender, bergamot and geranium.	30 minutes	During anesthetic recovery, the anxiety of patients in IG†, post-surgery at T2 and T3, decreased significantly, compared to CG* (p<0.05).
S31717. Clemo-Crosby AC, Day J, Stidston C, McGinley S, Powell RJ. Aromatherapy massage for breast cancer patients: a randomized controlled trial. J Nurs Womens Health [Internet]. 2018 [cited 2022 Mar 23];3:144. Available from: https://www.gavinpublishers.com/article/view/aromatherapy-massage-for-breast-cancer-patients-a-randomized-controlled-trial https://www.gavinpublishers.com/article/...	284 participants divided into 135 in the IG† and 149 in the CG*.	Individualized mixture of 1% of EO§ (lavender, lemongrass, neroli, grapefruit, bergamot, frankincense, sandalwood) for each patient.	1 hour	Mean anxiety scores improved in IG† to 5.2 (95% CI‡: 4.41 to 5.99), remaining relatively unchanged in CG (7.07) (95% CI‡: 6.27 to 7.87).
S41818. San Juan MNC, San Andres JS, Sanchez EMV, Sanchez GFS, Sales MKA, Salud SPM, et al. Effectiveness of Cananga odorata (ylang-ylang) vapor aromatherapy in chemotherapy-induced state anxiety reduction among breast cancer patients: a randomized controlled trial. UERM [Internet]. 2014 [cited 2022 Mar 26];3(1):31-5. Available from: https://registry.healthresearch.ph/index.php?view=research&cid=56858 https://registry.healthresearch.ph/index...	34 participants, 17 in the IG† and 17 in the CG*.	EO§ ylang-ylang was placed only once in the diffuser, before the start of chemotherapy sessions.	30 minutes	A significant reduction in the state of anxiety was observed in IG†. While in CG*, only those who had moderate anxiety showed improvement.
S51919. Yun S, Cha JH, Yoo YS, Kim YI, Chung SM, Jeong HL. Effects of aromatherapy on depression, anxiety and the autonomic nervous system in breast cancer patients undergoing adjuvant radiotherapy. J Hosp Palliat Care [Internet]. 2012 [cited 2022 Mar 26];15(2):68-76. Available from: https://doi.org/10.14475/KJHPC.2012.15.2.68 https://doi.org/10.14475/KJHPC.2012.15.2...	33 participants were divided into three groups (IG†-1, IG†-2 and CG*).	IG†-1: three times a day for six weeks. Lemon, lavender, rosewood and rose EO§ were mixed and inhaled in a 1:1:1:1 ratio. IG†-2: once a day, lemon, lavender, rosewood and rose EO§ were mixed and inhaled for 2 minutes. CG*: inhaled tea tree oil once a day for two minutes.	2 minutes	There was statistical significance in the results of IG†-1 and IG†-2, in which the level of anxiety was lower than in patients in the control group.
S62020. Imanishi J, Kuriyama H, Shigemori I, Watanabe S, Aihara Y, Kita M, et al. Anxiolytic effect of aromatherapy massage in patients with breast cancer. eCAM [Internet]. 2009 [cited 2022 Mar 26];6(1):123-8. Available from: https://doi.org/10.1093/ecam/nem073 https://doi.org/10.1093/ecam/nem073...	12 participants in only one group.	Massage with jojoba oil associated with EO§ in the neck and chest, back, shoulders, arms, hands and thighs.	30 minutes	Anxiety level was gradually reduced over time and there were significant differences between anxiety scores one month before the massage and immediately before the eighth massage (p<0.05).
S72121. Sohn KJ, Choi YS, Kim MJ, Lee J, Lee JB, Kim SH, et al. The effects of aroma self massage in hands on pain, depressive mood and anxiety in breast cancer patients. J Hosp Palliat Care [Internet]. 2005 [cited 2022 Mar 26];8(1):18-29. Available from: https://www.e-jhpc.org/journal/view.html?volume=8&number=1&spage=18 https://www.e-jhpc.org/journal/view.html...	32 participants , 15 in the IG† and 17 in the CG*.	Massage with frankincense, bergamot and lavender EO§, in a 1:1:2 ratio, mixed at 4% with jojoba, a carrier oil. Hand massage was performed.	10 to 20 minutes	There was statistical significance (p=0.008) in the degree of anxiety in patients with breast cancer. Number of associated symptoms and degree of depression decreased significantly after two weeks, but in CG* increased.

Studies	Risks of bias
Studies	Random sequence generation	Allocation concealment	Blinding of participants and professionals	Blinding of evaluators	Incomplete outcomes	Selective outcome reporting	Risk of other biases
S1	Low risk	High risk	High risk	Uncertain risk	Uncertain risk	Low risk	Low risk
S2	Uncertain risk	Uncertain risk	Uncertain risk	Uncertain risk	Low risk	Low risk	Low risk
S3	Low risk	Low risk	High risk	Uncertain risk	Low risk	Low risk	Low risk
S4	High risk	Uncertain risk	High risk	High risk	Low risk	Low risk	Low risk
S5	Low risk	High risk	High risk	High risk	Uncertain risk	Low risk	Low risk
S6	Uncertain risk	Uncertain risk	High risk	High risk	Uncertain risk	Low risk	High risk
S7	Low risk	Uncertain risk	Low risk	High risk	Low risk	Low risk	Low risk

[1] CORRESPONDING AUTHOR
Cristina da Silva Fernandes cristina.sednanref@gmail.com

Brasil

Brasil

EFFECTS OF AROMATHERAPY ON ANXIETY SYMPTOMS IN WOMEN WITH BREAST CANCER: A SYSTEMATIC REVIEW

EFECTOS DE LA AROMATERAPIA SOBRE LOS SÍNTOMAS DE ANSIEDAD EN MUJERES CON CÁNCER DE MAMA: UNA REVISIÓN SISTEMÁTICA

ABSTRACT

Objective:

Method:

Results:

Conclusion: