Division of Pediatric Palliative Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE, USA.
Division of Biostatistics, Department of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
Palliat Support Care. 2020 Apr;18(2):158-163. doi: 10.1017/S1478951519000555.
The role of aromatherapy in supportive symptom management for pediatric patients receiving palliative care has been underexplored. This pilot study aimed to measure the impact of aromatherapy using validated child-reported nausea, pain, and mood scales 5 minutes and 60 minutes after aromatherapy exposure.
The 3 intervention arms included use of a symptom-specific aromatherapy sachet scent involving deep breathing. The parallel default control arm (for those children with medical exclusion criteria to aromatherapy) included use of a visual imagery picture envelope and deep breathing. Symptom burden was sequentially assessed at 5 and 60 minutes using the Baxter Retching Faces scale for nausea, the Wong-Baker FACES scale for pain, and the Children's Anxiety and Pain Scale (CAPS) for anxious mood. Ninety children or adolescents (mean age 9.4 years) at a free-standing children's hospital in the United States were included in each arm (total n = 180).
At 5 minutes, there was a mean improvement of 3/10 (standard deviation [SD] 2.21) on the nausea scale; 2.6/10 (SD 1.83) on the pain scale; and 1.6/5 (SD 0.93) on the mood scale for the aromatherapy cohort (p < 0.0001). Symptom burden remained improved at 60 minutes post-intervention (<0.0001). Visual imagery with deep breathing improved self-reports of symptoms but was not as consistently sustained at 60 minutes.
Aromatherapy represents an implementable supportive care intervention for pediatric patients receiving palliative care consults for symptom burden. The high number of children disqualified from the aromatherapy arm because of pulmonary or allergy indications warrants further attention to outcomes for additional breathing-based integrative modalities.
芳香疗法在姑息治疗中儿科患者支持性症状管理中的作用尚未得到充分探索。本初步研究旨在使用经过验证的儿童报告的恶心、疼痛和情绪量表，在芳香疗法暴露后 5 分钟和 60 分钟测量芳香疗法的影响。
3 个干预组包括使用涉及深呼吸的特定症状芳香疗法香包气味。平行的默认对照组（对于那些有芳香疗法医学排除标准的儿童）包括使用视觉意象图片信封和深呼吸。使用 Baxter 恶心面部量表、Wong-Baker FACES 疼痛量表和儿童焦虑和疼痛量表（CAPS）分别在 5 分钟和 60 分钟评估症状负担。在美国一家独立儿童医院的 90 名儿童或青少年（平均年龄 9.4 岁）被纳入每个组（每组总 n = 180）。
在 5 分钟时，芳香疗法组的恶心评分平均改善 3/10（标准差 [SD] 2.21）；疼痛评分改善 2.6/10（SD 1.83）；情绪评分改善 1.6/5（SD 0.93）（p < 0.0001）。干预后 60 分钟时，症状负担仍有改善（<0.0001）。深呼吸的视觉意象改善了自我报告的症状，但在 60 分钟时没有持续那么久。
芳香疗法代表了一种可实施的姑息治疗中儿科患者支持性症状管理的干预措施。由于肺部或过敏指征而被排除在芳香疗法组之外的大量儿童需要进一步关注其他呼吸为基础的综合模式的结果。
