Aromatherapy and Nurse Fatigue

Aromatherapy with Lavender on Nurses' Fatigue

Abstract

• Nurse fatigue is caused by long hours, night shifts, staff shortages, stress, and patient interactions.
• Aromatherapy is beneficial for physical and mental well-being.
• The study assesses lavender aromatherapy's impact on nurse fatigue.
• 70 nurses were randomly assigned to intervention or control groups.
• The Chalder Fatigue Questionnaire was the primary data collection tool.
• Data analysis was with SPSS version 16.
• Fatigue levels in the intervention group:
  • Pre-intervention: 14.32 (SD=8.18)
  • Post-intervention: 5.72 (SD=4.08)
  • Significant reduction (P<0.01) via paired t-test.
• Control group:
  • Pre-intervention: 12.86 (SD=4.20)
  • No significant change post-intervention (P=0.280).
• Lavender essential oil inhalation helps reduce anxiety, improve sleep, and alleviate fatigue.
• It is a cost-effective, non-invasive intervention to promote relaxation and reduce nurse fatigue.
• Keywords: Aromatherapy, Lavender, Fatigue, Nurses, Nursing, Nursing Care.

Introduction

• Nursing is crucial for patient care and public health.
• Nurses face physical, emotional, and mental fatigue due to:
  • Long shifts
  • Night duties
  • Staff shortages
  • Workplace stress
  • Prolonged patient interactions
  • Rotating schedules
  • Mandatory overtime
  • Unexpected shifts
  • Additional job responsibilities.
• Aromatherapy is recognized for preventing and managing nurse fatigue.
  • Uses plant-based essential oils to improve physical and mental well-being.
  • Historically used to reduce stress, enhance sleep, and promote relaxation.
  • Recent research shows potential in reducing fatigue among nurses, office workers, and patients.
  • Natural fragrances like lavender, peppermint, citrus, and eucalyptus reduce stress, improve concentration, and boost energy.
• Aromatherapy influences the nervous system:
  • Enhances oxygen flow to the brain.
  • Promotes relaxation.
  • Reduces physical and mental fatigue.
• Aromatherapy is a non-invasive and natural option for high-stress work environments like hospitals and healthcare facilities.
  • Enhances employee well-being, reduces anxiety, and boosts productivity.
  • Integrating aromatherapy into wellness programs and workplace policies promotes mental health and reduces burnout.
• Lavender oil:
  • Calming and anti-anxiety properties.
  • Used to improve sleep, reduce anxiety, and alleviate fatigue.
  • Inhaling lavender decreases sympathetic nervous system activity, resulting in relaxation and lower stress.
• Aromatherapy blends traditional and modern medicine, providing a holistic approach to healthcare.
• Studies confirm positive effects of lavender on physical and mental health.
• Traditional and herbal medicine recommends aromatherapy as an affordable, non-invasive method with minimal side effects for reducing anxiety and promoting relaxation.
• Experts believe aromatherapy can influence the brain and nervous system similarly to pharmaceutical treatments.
• The study investigates the effect of lavender aromatherapy on nurse fatigue.

Methods

• Study Design: Randomized clinical trial in 2017.
  • Participants: 70 nurses working in ICUs in a hospital in northern Iran.
  • Objective: Investigate the effects of lavender aromatherapy on fatigue.
• Ethics Consideration:
  • Approved by the Research Council of the Faculty of Nursing at Arak University of Medical Sciences (approval number 3-171-93).
  • Registered with clinical trial code IRCT2015070110713N7.
  • Nurses received an explanation of the study objectives.
  • They were assured of confidentiality and safety.
  • Right to withdraw from the study without consequences.
  • Informed consent was obtained from all participants.
• Sample Size:
  • Calculated based on a study by Najafi et al., (2014).
  • Effect size: 0.97
  • Power: 95%
  • Confidence interval: 95%
  • Significance level: 0.05
  • Final sample: 70 nurses.
• Participants:
  • ICU nurses working in a hospital in northern Iran.
  • Inclusion criteria:
    • At least one year of nursing experience
    • Six months in an ICU
    • Informed consent.
  • Exclusion criteria:
    • History of asthma or allergies.
• Data Collection:
  • Participants were randomly assigned into two groups:
    • Intervention group: 35 nurses
    • Control group: 35 nurses
  • Simple random sampling.
  • The control group did not receive any intervention.
  • The intervention group underwent four weeks of lavender aromatherapy.
    • 2-3 drops of lavender essential oil (Barij Essence Pharmaceutical Company, Kashan, Iran) onto a cotton ball every other night before sleep.
    • Lavender oil: 10% concentration, derived from unopened flowers of Lavandula Stoechas species.
    • Cotton ball hung near the participant’s pillow for inhalation during the night and removed in the morning.
  • Fatigue levels were measured using the Chalder Fatigue Questionnaire:
    • 11 items scored on a 3-point Likert scale (0-3).
      • 0: no fatigue
      • 3: severe fatigue.
    • Total score range: 0 to 33 (higher scores indicate higher levels of fatigue).
    • Validity confirmed by ten university faculty members.
    • Reliability verified through Cronbach's alpha (0.85).
    • Test-retest reliability: correlation coefficient of 0.89.
    • Data collected twice: before and after the intervention, using self-reported questionnaires.
    • Questionnaire completion time: approximately 10-15 minutes.
    • The researcher was present during data collection to assist with any uncertainties.
• Statistical Analysis:
  • SPSS version 16.
  • Descriptive statistics: mean, standard deviation (SD), and frequency tables.
  • Inferential statistics: paired t-tests, independent t-tests, Chi-square tests, and Fisher’s exact tests.
  • Significance level: P<0.05

Results

• Participants: Chi-square test showed no significant difference in gender distribution between the intervention and control groups (P=0.070).
• Fisher’s test revealed no significant difference in age (P=0.210) and work experience (P=0.570) between the two groups.
• Effect of aromatherapy with Lavender on nurses' fatigue
  • Intervention group
    • Mean fatigue score pre-intervention: 14.32 (SD=8.18)
    • Mean fatigue score post-intervention: 5.72 (SD=4.08)
    • Significant reduction in fatigue following the intervention (P<0.01) via paired t-test.
  • Control group
    • Mean fatigue score pre-intervention: 12.86 (SD=4.20)
    • Mean fatigue score post-intervention: 10.80 (SD=4.90)
    • No significant difference (P=0.280) via paired t-test.
  • Independent t-test revealed no significant difference between the two groups prior to the intervention (P=0.350).
  • After the intervention, a significant difference was observed between the two groups (P<0.010).

Discussion

• Lavender aromatherapy significantly reduces fatigue among nurses.
• Inhalation of lavender essential oil reduces sympathetic nervous system activity, which may help alleviate anxiety and stress.
• Lavender helps regulate sleep and improve sleep quality, leading to mental relaxation and a reduction in both psychological and physical fatigue.
• Lavender aromatherapy is an effective and non-invasive method for managing fatigue and enhancing mental well-being.
• Natural essential oils have anti-stress, anti-anxiety, analgesic, and cognitive-enhancing properties.
• They can influence neurotransmitter receptors, contributing to:
  • Enhanced cognitive function
  • Improved emotional regulation
  • Altered feeding behavior
  • Better sleep
  • Reduced stress
  • Overall improved quality of life.
• Some essential oils promote neurite outgrowth, thereby reducing pain, depression, and mental fatigue.
• Hung et al., (2023) found that aromatherapy did not significantly affect nurses with heavy shifts but reduced stress and fatigue in those with lighter shifts.
• Yalcin et al., (2025) reported that lavender aromatherapy enhances relaxation and improves sleep quality.
• A meta-analysis study also confirmed that lavender aromatherapy has anxiolytic properties, which contribute to fatigue reduction.
• Musarezaie et al., (2024) found that aromatherapy, as a complementary therapy, improves focus and concentration.
• Ji-Yeon & Keum-Soon (2002) reported that lavender aromatherapy increases relaxation and reduces fatigue in nursing students.
• Emadikhalaf et al., (2023) showed that aromatherapy can reduce burnout and occupational stress in nurses.
• Farsi et al., (2021) concluded that essential oil-based aromatherapy effectively reduces occupational stress in nurses, suggesting its potential use for enhancing work efficiency and performance.
• Madadkar Dehkordi (2022) found that lavender aromatherapy improves physiological function and reduces fatigue and anxiety in patients.
• Jafari-Koulaee & Ilali (2020) reported that inhalation-based lavender aromatherapy effectively reduces patient anxiety, making it a helpful intervention in ICUs, surgical units, burn units, and other high-stress medical environments.

Limitations

• Small sample size affects the generalizability of the results. Future studies should involve larger sample sizes.
• The short duration of the aromatherapy intervention may have limited its long-term effectiveness, suggesting longer interventions should be investigated in future research.

Conclusion

• Lavender aromatherapy can be used as a non-invasive and natural method to reduce nurse fatigue.
• Inhaling lavender essential oil can help alleviate anxiety, improve sleep quality, and reduce feelings of exhaustion.
• These calming and anti-anxiety effects are particularly beneficial in high-stress hospital environments, where nurses experience significant physical and psychological pressure.