Journal of Korean Biological Nursing Science

Korean society of Biological Nursing Science (한국기초간호학회)
권호 표지
DOI QR코드

DOI QR Code

Inhalation of Clary Sage Oil before Chemotherapy Alleviates Anxiety and Stress without Changing Blood Pressure: A Randomized Controlled Trial

  • Kim, Moonsuk (Department of Basic Nursing Science, College of Nursing, Korea University) ;
  • Shin, You Kyoung (Department of Basic Nursing Science, College of Nursing, Korea University) ;
  • Seol, Geun Hee (Department of Basic Nursing Science, College of Nursing, Korea University)
  • Received : 2021.08.26
  • Accepted : 2021.11.17
  • Published : 2021.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to evaluate the effects of inhaled clary sage (Salvia sclarea L.) oil or linalyl acetate on patients' anxiety and stress levels before undergoing chemotherapy. Methods: Forty-five eligible participants were randomly assigned to inhale clary sage oil, or linalyl acetate, each at concentrations of 5% vol/vol in almond oil or pure almond oil (control). State-trait anxiety inventory (STAI), Stress rating scale, anxiety-visual analog scale (Anxiety-VAS), stress-visual analog scale (Stress-VAS), blood pressure, and heart rate were measured before and after the inhalation prior to undergoing chemotherapy. Results: Anxiety-VAS and Stress-VAS were significantly lower after than before inhalation of clary sage oil (p< .01 and p< .05, respectively) and linalyl acetate (p< .05 and p< .05, respectively), despite having no significant difference in the three groups compared with control group. Systolic (p< .05) and diastolic (p< .01) blood pressure before undergoing chemotherapy were significantly lower after than before inhalation of linalyl acetate, while there was no significant difference in after than before inhalation of clary sage oil, despite both reducing levels of anxiety and stress. Conclusion: These findings suggest that linalyl acetate inhalation may be inappropriate in lowering anxiety and stress in patients undergoing chemotherapy, despite its anxiolytic and antistress effects, while clary sage oil inhalation may be useful in reducing anxiety and stress in patients undergoing chemotherapy, which has a risk of hypotensive side effects.

Keywords

Acknowledgement

This work was supported by a grant from the Basic Science Research Program through the National Research Foundation of Korea (NRF-2021R1A2C2004118) and the Institute of Nursing Research, Korea University Grant. This manuscript is a revision of MK's master's thesis from Korea University.

References

  1. Pitman A, Suleman S, Hyde N, Hodgkiss A. Depression and anxiety in patients with cancer. BMJ. 2018;361:k1415. https://doi.org/10.1136/bmj.k1415
  2. Rao WW, Yang MJ, Cao BN, You YY, Zhang YY, Liu YY, et al. Psychological distress in cancer patients in a large Chinese cross-sectional study. Journal of Affective Disorders. 2019;245:950-956. https://doi.org/10.1016/j.jad.2018.11.089
  3. Choi JW, Park EC, Kim TH, Han E. Mental disorders and suicide risk among cancer patients: a nationwide cohort study. Archives of Suicide Research. 2020;1-12. https://doi.org/10.1080/13811118.2020.1779156
  4. Heo J, Noh OK, Chun M, Oh YT, Kim L. Psychological distress among prostate cancer survivors in South Korea: a nationwide population-based, longitudinal study. Asia-Pacific Journal of Clinical Oncology. 2020;16(2):e125-e130. https://doi.org/10.1111/ajco.13160
  5. Tuinman MA, Hoekstra HJ, Sleijfer DT, Fleer J, Vidrine DJ, Gritz ER, et al. Testicular cancer: a longitudinal pilot study on stress response symptoms and quality of life in couples before and after chemotherapy. Supportive Care in Cancer. 2007;15(3):279-286. https://doi.org/10.1007/s00520-006-0119-5
  6. Yusufov M, Grebstein L, Rossi JS, Redding CA, Ferszt GG, Prochaska JO. Development and implementation of a psychological service for patients with cancer. Cognitive and Behavioral Practice. 2020;27(3):290-305. https://doi.org/10.1016/j.cbpra.2020.05.001
  7. Meggiolaro E, Berardi MA, Andritsch E, Nanni MG, Sirgo A, Samori E, et al. Cancer patients' emotional distress, coping styles and perception of doctor-patient interaction in European cancer settings. Palliative & Supportive Care. 2016;14(3):204-211. https://doi.org/10.1017/S1478951515000760
  8. Lee KM, Jung D, Hwang H, Son KL, Kim TY, Im SA, et al. Pre-treatment anxiety is associated with persistent chemotherapy-induced peripheral neuropathy in women treated with neoadjuvant chemotherapy for breast cancer. Journal of Psychosomatic Research. 2018;108:14-19. https://doi.org/10.1016/j.jpsychores.2018.02.012
  9. Grassi L, Berardi MA, Ruffilli F, Meggiolaro E, Andritsch E, Sirgo A, et al. Role of psychosocial variables on chemotherapy-induced nausea and vomiting and health-related quality of life among cancer patients: a European study. Psychotherapy and Psychosomatics. 2015;84(6):339-347. https://doi.org/10.1159/000431256
  10. Shin KJ, Lee YJ, Ryoul Yang Y, Park S, Suh PG, Yung Follo M, et al. Molecular mechanisms underlying psychological stress and cancer. Current Pharmaceutical Design. 2016;22(16):2389-2402. https://doi.org/10.2174/1381612822666160226144025
  11. Su F, Ouyang N, Zhu P, Ouyang N, Jia W, Gong C, et al. Psychological stress induces chemoresistance in breast cancer by upregulating mdr1. Biochemical and Biophysical Research Communications. 2005;329(3):888-897. https://doi.org/10.1016/j.bbrc.2005.02.056
  12. Kostic M, Kitic D, Petrovic MB, Jevtovic-Stoimenov T, Jovic M, Petrovic A, et al. Anti-inflammatory effect of the Salvia sclarea L. ethanolic extract on lipopolysaccharide-induced periodontitis in rats. Journal of Ethnopharmacology. 2017;199:52-59. https://doi.org/10.1016/j.jep.2017.01.020
  13. Yu JH, Kim MY, Moon HK, Min SS, Seol GH. Effect of clary sage-inhalation on pain and stress during the treatment of periodontitis. Journal of Korean Academy of Oral Health. 2011;35(1):32-40.
  14. Seol GH, Shim HS, Kim PJ, Moon HK, Lee KH, Shim I, et al. Antidepressantlike effect of Salvia sclarea is explained by modulation of dopamine activities in rats. Journal of Ethnopharmacology. 2010;130(1):187-190. https://doi.org/10.1016/j.jep.2010.04.035
  15. Mahboubi M. Clary sage essential oil and its biological activities. Advances in Traditional Medicine. 2020;20:517-528. https://doi.org/10.1007/s13596-019-00420-x
  16. Gross M, Nesher E, Tikhonov T, Raz O, Pinhasov A. Chronic food administration of Salvia sclarea oil reduces animals' anxious and dominant behavior. Journal of Medicinal Food. 2013;16(3):216-222. https://doi.org/10.1089/jmf.2012.0137
  17. Yang HJ, Kim KY, Kang P, Lee HS, Seol GH. Effects of Salvia sclarea on chronic immobilization stress induced endothelial dysfunction in rats. BMC Complementary and Alternative Medicine. 2014;14(1):396. https://doi.org/10.1186/1472-6882-14-396
  18. Seol GH, Lee YH, Kang P, You JH, Park M, Min SS. Randomized controlled trial for Salvia sclarea or Lavandula angustifolia: differential effects on blood pressure in female patients with urinary incontinence undergoing urodynamic examination. The Journal of Alternative and Complementary Medicine. 2013; 19(7):664-670. https://doi.org/10.1089/acm.2012.0148
  19. Buchbauer G, Jirovetz L, Jager W. Aromatherapy: evidence for sedative effects of the essential oil of lavender after inhalation. Zeitschrift fur Naturforschung C. 1991;46(11-12):1067-1072. https://doi.org/10.1515/znc-1991-11-1223
  20. Yu SH, Seol GH. Lavandula angustifolia Mill. Oil and its active constituent linalyl acetate alleviate pain and urinary residual sense after colorectal cancer surgery: a randomised controlled trial. Evidence-Based Complementary and Alternative Medicine. 2017;2017:3954181. https://doi.org/https://doi.org/10.1155/2017/3954181
  21. Spielberger CD. Anxiety: State-trait-process. In: Spielberger CD, Sarason IG, editors. Stress and anxiety. 1st ed. New York: Wiley; 1975. p. 115-143.
  22. Kim J, Shin D, Kim J, Kim JT, Shin DK, Kim J, et al. A study based on the standardization of the STAI for Korea. The Newest Medical Journal. 1978;21(11): 69-75.
  23. Volicer BJ, Bohannon MW. A hospital stress rating scale. Nursing Research. 1975;24(5): 352-359.
  24. Kim E. Hospitalization-related stress and coping strategies of colon cancer patients [master's thesis]. Seoul: Ewa Womans University; 2007. p. 49-50.
  25. Salvo N, Zeng L, Zhang L, Leung M, Khan L, Presutti R, et al. Frequency of reporting and predictive factors for anxiety and depression in patients with advanced cancer. Clinical Oncology. 2012;24(2):139-148. https://doi.org/10.1016/j.clon.2011.05.003
  26. Andersen BL, DeRubeis RJ, Berman BS, Gruman J, Champion VL, Massie MJ, et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. Journal of Clinical Oncology. 2014;32(15):1605-1619. https://doi.org/10.1200/JCO.2013.52.4611
  27. Won Em, Kim Y-K. Neuroinflammation-associated alterations of the brain as potential neural biomarkers in anxiety disorders. International Journal of Molecular Sciences. 2020;21(18):E6546. https://doi.org/10.3390/ijms21186546
  28. Bower JE. Cancer-related fatigue-mechanisms, risk factors, and treatments. Nature Reviews Clinical Oncology. 2014;11(10):597-609. https://doi.org/10.1038/nrclinonc.2014.127
  29. Simo M, Rifa-Ros X, Rodriguez-Fornells A, Bruna J. Chemobrain: a systematic review of structural and functional neuroimaging studies. Neuroscience & Biobehavioral Reviews. 2013;37(8):1311-1321. https://doi.org/10.1016/j.neubiorev.2013.04.015
  30. Piombo SE, Miller KA, Alderete K, Egan A, Golingay S, Valente TW. Evaluation of a nurse-delivered pre-chemotherapy educational intervention to increase knowledge and reduce anxiety among ethnically diverse patients. Journal of Cancer Education. 2021;36(4):728-734. https://doi.org/10.1007/s13187-020-01695-4
  31. Chirico A, Maiorano P, Indovina P, Milanese C, Giordano GG, Alivernini F, et al. Virtual reality and music therapy as distraction interventions to alleviate anxiety and improve mood states in breast cancer patients during chemotherapy. Journal of Cellular Physiology. 2020;235(6):5353-5362. https://doi.org/10.1002/jcp.29422
  32. Holmes P. Aromatica Volume 1: a clinical guide to essential oil therapeutics. 1st ed. London: Jessica Kingsley Publishers; 2016. p. 400.
  33. Ohtsubo S, Fujita T, Matsushita A, Kumamoto E. Inhibition of the compound action potentials of frog sciatic nerves by aroma oil compounds having various chemical structures. Pharmacology Research & Perspectives. 2015;3(2):e00127. https://doi.org/10.1002/prp2.127
  34. Melliou E, Michaelakis A, Koliopoulos G, Skaltsounis AL, Magiatis P. High quality bergamot oil from Greece: chemical analysis using chiral gas chromatography and larvicidal activity against the West Nile virus vector. Molecules. 2009;14(2):839-849. https://doi.org/10.3390/molecules14020839
  35. Donelli D, Antonelli M, Bellinazzi C, Gensini GF, Firenzuoli F. Effects of lavender on anxiety: A systematic review and meta-analysis. Phytomedicine. 2019;65:153099. https://doi.org/10.1016/j.phymed.2019.153099
  36. Watanabe E, Kuchta K, Kimura M, Rauwald HW, Kamei T, Imanishi J. Effects of bergamot (Citrus bergamia (Risso) Wright & Arn.) essential oil aromatherapy on mood states, parasympathetic nervous system activity, and salivary cortisol levels in 41 healthy females. Complementary Medicine Research. 2015;22 (1):43-49. https://doi.org/10.1159/000380989
  37. Senkus E, Jassem J. Cardiovascular effects of systemic cancer treatment. Cancer treatment reviews. 2011;37(4):300-311. https://doi.org/10.1016/j.ctrv.2010.11.001
  38. Koto R, Imamura M, Watanabe C, Obayashi S, Shiraishi M, Sasaki Y, et al. Linalyl acetate as a major ingredient of lavender essential oil relaxes the rabbit vascular smooth muscle through dephosphorylation of myosin light chain. Journal of Cardiovascular Pharmacology. 2006;48(1):850-856. https://doi.org/10.1097/01.fjc.0000238589.00365.42
  39. Tadokoro Y, Horiuchi S, Takahata K, Shuo T, Sawano E, Shinohara K. Changes in salivary oxytocin after inhalation of clary sage essential oil scent in termpregnant women: a feasibility pilot study. BMC Research Notes. 2017;10(1):1-7. https://doi.org/10.1186/s13104-017-3053-3
  40. Li C, Wang W, Summer SN, Westfall TD, Brooks DP, Falk S, et al. Molecular mechanisms of antidiuretic effect of oxytocin. Journal of the American Society of Nephrology. 2008;19(2):225-232. https://doi.org/10.1681/ASN.2007010029