The effects of aromatherapy with lavender essential oil on fatigue levels in haemodialysis patients: A randomized clinical trial

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Abstract

Objective

This study was intended to examine the efficacy of lavender essential oil for the alleviation of fatigue in haemodialysis patients.

Methods and materials

This randomized clinical trial was conducted on 59 haemodialysis patients in two groups. The routine care group received the routine care, but the experimental group inhaled lavender essence 5% for 10 min, three times a week for 4 consecutive weeks. The Fatigue Severity Scale was used to assess fatigue before the intervention and after the last intervention in the second and fourth weeks.

Results

No statistically significant differences were observed between the two groups in terms of the fatigue scores before, and after the last intervention in the second and fourth weeks.

Conclusion

Our result does not support other studies suggesting that lavender essential oil is effective on fatigue in haemodialysis patients. This conflicting result can mostly be ascribed to a variety of factors such as duration of aromatherapy and differences in concentrations of lavender essential oil.

Introduction

The number of patients with end stage renal failure is on the rise [1]. These patients suffer from many other medical conditions and different problems. Fatigue is one of the most common side effects in haemodialysis patients and it adversely affects the patients' quality of life [2], [3], [4], [5]. Most haemodialysis patients suffer from high scores of fatigue [4]. According to a research study by Gordon et al., one third of the patients reported that they feel worse in the first hour of haemodialysis. Furthermore, one quarter of the patients reported suffering from severe or very severe fatigue after haemodialysis [6]. In haemodialysis patients fatigue is thought to be caused by a combination of factors such as poor nutritional status [5], ageing, length of dialysis treatment [4] and reduced motivation [2]. It has been shown that fatigue is associated with symptoms such as sleep disturbances, depression, poor physical and health status in patients with renal failure requiring maintenance haemodialysis treatment [7]. A review of literature revealed several treatment options that can help relieve the symptoms of dialysis-related fatigue, including oral vitamin C [8] and non-pharmacological methods such as back massage [9], exercise training [10] and yoga-based exercise [11]. A randomized controlled trial conducted on 106 participants examined the effectiveness of acupressure on fatigue in patients with end-stage renal-disease. Fatigue was measured using the revised Piper Fatigue Scale (PFS) and the Visual Analogue Scale for Fatigue (VAS-F). The study revealed the experimental group to have experienced less fatigue after the intervention compared to the control group [12].

Essential oil aromatherapy is another way to help alleviate fatigue. Essential oils are often extracted by steam distillation from aromatic plants [13]. Lavandula is a genus of over 30 species of flowering plants, including Lavandula angustifolia, Lavandula latifolia and Lavandula x intermedia [14]. Lavender essential oil originates from an herb and is used in various forms, including aromatherapy oil, gel, cream, lotion, infusion, and soap. In a randomized, double-blind, placebo controlled trial, patients were orally given 80 mg/day a preparation from Lavandula species or placebo for the treatment of subsyndromal anxiety disorder. Results showed the efficacy and safety of lavandula oil preparation for the relief of anxiety disorder [15]. Lavender can also be used as a cream. A study showed that a 3% cream of lavender, marjoram, black pepper and peppermint essential oils reduced neck pain [16]. In addition, lavender is used as an analgesic in traditional medicine, for massage therapy [17] and for inhalation therapy [18].

Research has confirmed that lavender produces sedative effects, promotes deep sleep [19], improves sleep quality [20], provides relaxing effects [21] and relives anxiety [22], which may offer relief from fatigue. Several studies have examined the fatigue-reducing effect of inhaling lavender essential oil. Kohara et al. (2004) found that combined modality treatment including aromatherapy, footsoak and reflexology can relieve fatigue in terminally ill cancer patients [23]. Furthermore, Lee (2000) examined the psychoneuroimmunology effect of aromatherapy massage and explored a significant decrease in fatigue scores following aromatherapy massage with 2% jojova oil mixed with lavender and rosemary oil for 20 min [24]. It has been also reported that lavender and eucalyptus inhalation can reduce fatigue in postpartum mothers [25].

As essential oils are fast-acting when inhaled and since patients are more receptive to trying natural therapies than traditional allopathic therapies, the present study was designed to help reduce fatigue in haemodialysis patients. To the best of our knowledge, no published study has explored the effects of lavender essential oil on fatigue in haemodialysis patients, so this study was intended to examine the efficacy of lavender essential oil for the alleviation of fatigue in haemodialysis patients.

Section snippets

Sample and sampling method

This randomized clinical trial was conducted in two hospitals affiliated to the Mazandaran University of Medical Sciences, Sari, Iran. Haemodialysis patients who met the following inclusion criteria were sampled: be willing to participate in the study, be treated with dialysis three times a week, be undergoing dialysis for at least six months [26], be of 18 years old and over, be conscious, have the ability to verbally communicate, and have an uncompromised sense of smell [27]. The exclusion

Results

Only one patient from the experimental group was excluded because of an infection, resulting in 29 patients in the experimental group and 30 patients in the routine care group (See Fig. 1). The results showed that 17 (58.6%) of the experimental group and 21 (70%) of the routine care group were male. The mean age of patients was 62.31 ± 14.46 (range 31–88 years) and 59.33 ± 12.80 (range 30–85 years) in the experimental and routine care groups, respectively. The demographic and medical data of

Discussion

This study found that the fatigue score did not differ significantly between the experimental and routine care groups before, two, and four weeks after the intervention. Bahraini et al. (2011) investigated the effects of effleurage massage with aromatic oil and non-aromatic oil on fatigue in patients with multiple sclerosis. Women with multiple sclerosis were divided into two massage therapy groups –one group with aromatic oil (10 ml of lavender essential oil 2.5%) and the other with

Conclusion

Although a few previous studies have demonstrated that lavender aromatherapy is an effective way to alleviate fatigue in dialysis patients, we found that lavender essential oil at a concentration of 5% does not positively affect fatigue levels in haemodialysis patients. This conflicting result can mostly be ascribed to multiple factors such as nature of the samples, duration of aromatherapy, differences in doses and concentrations of lavender essential oil, various routes of essential oil

Conflicts of interest

The authors have no conflict of interest to declare.

References (34)

  • B. Farmahini et al.

    The effect of oral vitamin C on fatigue in hemodialysis patients in selected hospitals of the Army University of Medical Sciences in 2009

    J. Mil. Health Sci. Res.

    (2009)
  • H. Hasankhani et al.

    The effect of the slow-stroke back massage on fatigue of dialyzed patients

    Int. Res. J. Appl. Basic Sci.

    (2013)
  • T.W. Storer et al.

    Endurance exercise training during haemodialysis improves strength, power, fatigability and physical performance in maintenance haemodialysis patients

    Nephrol. Dial. Transplant.

    (2005)
  • R.A. Stein et al.

    Complementary and Alternative Cardiovascular Medicine

    (2004)
  • C.E. Beus

    Growing and Marketing Lavender

    (2006)
  • S. Kasper et al.

    Silexan, an orally administered Lavandula oil preparation is effective in the treatment of subsyndromal anxiety disorder: a randomized, double-blind, placebo controlled trial

    Int. Clin. Psychopharmacol.

    (2010)
  • M.C. Ou et al.

    The effectiveness of essential oils for patients with neck pain: a randomized controlled study

    J. Altern. Complement. Med.

    (2014)
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