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_b = 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.

中文翻译：

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芳香疗法对癌症患者焦虑的影响：随机对照试验的系统回顾和荟萃分析

 介绍

癌症患者在癌症诊断和治疗过程中经常会感到焦虑，这会对他们的治疗结果产生负面影响。尽管芳香疗法被认为可以有效减少癌症患者的焦虑，但证据有限。本综述旨在研究芳香疗法在减少癌症患者焦虑方面的有效性，并确定干预效果的潜在调节因素。

 方法

本综述使用的数据来自 PubMed、Embase、护理和联合健康文献累积索引 (CINAHL)、MEDLINE、Cochrane 图书馆和 Web of Science、区域信息共享系统 (RISS)、韩国信息服务系统 (KISS)、KoreaMed 、和 DBpia 截止日期为 2023 年 3 月 16 日。最终分析包括对 18 岁或以上癌症患者进行芳香疗法的 10 项研究的 11 项比较。通过标准化均差（SMD）计算干预效果，并使用亚组、方差荟萃分析和荟萃回归分析进行调节分析。使用修订后的随机试验 Cochrane 偏倚风险工具评估偏倚风险。

 结果

芳香疗法对癌症患者焦虑减轻的总体影响表明效果很大（SMD = -0.97，95% 置信区间：-1.60 – -0.35，I ² = 94%）。在亚组分析中，未发现给药方法的类型和干预持续时间是导致试验之间效应大小异质性的调节因素。然而，已证实精油的类型会减弱这种影响（Qb = 7.80，df = 2，p _b = 0.020）。此外，没有发现连续调节剂可以显着调节干预效果。

 结论

这篇综述表明芳香疗法可以减少癌症患者的焦虑，表明其在临床和社区环境中应用的可能性。然而，考虑到可用于亚组分析的随机对照试验（RCT）数量有限，这可能会影响研究结果的准确性，因此有必要纳入额外的随机对照试验来进行进一步的研究。