精油嗅吸於急重症單位護理人員頭痛相關生活品質之成效

Effects of Inhaling Essential Oil on Headache-Related Quality of Life Among Nurses Working in Emergency and Critical Care Units

10.6224/JN.202110_68(5).08

陳思柔(Shih-Jou CHEN)；陳志昊(Chih-Hao CHEN)；張皓媛(Hao-Yuan CHANG)

頭痛相關失能 ； 生活品質 ； 護理人員 ； 精油嗅吸 ； headache-related disability ； quality of life ； nurses ； inhaling essential oil

護理雜誌

68卷5期（2021 / 10 / 01）

51 - 64

繁體中文

背景：頭痛是急重症單位護理人員常見困擾，文獻顯示精油具有止痛的療效，但實證文獻較少探討精油於頭痛的成效，若精油有緩解頭痛的效果，亦可能改善生活品質與照護品質。目的：本研究目的為檢驗精油吸嗅改善具頭痛之急重症護理人員（1）頭痛相關失能、（2）頭痛相關生活品質與（3）自覺照護品質之效果。方法：採群集隨機分派臨床試驗與交叉實驗設計，以北部某醫學中心急重症單位患有頭痛的49位護理人員為對象，分成A、B兩組，A組佩戴精油項鍊28天後（100% Lavandula angustifolia 0.1 ml + 100% citrus bergamia 0.1 ml），經7天洗滌期，則不佩戴項鍊28天，B組與A組時序相反。在第0、28、63天以問卷收集資料，研究工具包含：人口學與頭痛相關資料、頭痛日誌、頭痛失能指標、偏頭痛特定族群生活品質量表、照護品質量表、憂鬱、焦慮與壓力量表、哥本哈根疲勞量表。以重複測量變異數分析與廣義估計模式進行分析。結果：兩組於生活品質角色功能受限（β=9.77,p=.008）及角色功能妨礙（β=10.03,p=.018）改變幅度達顯著差異。頭痛相關失能及照護品質則無顯著差異（p＞.05），顯示精油嗅吸能改善生活品質分數。結論：佩戴薰衣草與佛手柑等精油項鍊28天後可改善急重症單位頭痛護理人員角色功能方面之生活品質，建議日後能發展更多實證研究，推廣精油止痛的效益。

Background: Headache attacks are prevalent symptoms in emergency and critical care nurses. Prior evidence supports the analgesic effects of essential oils on headache symptoms. However, few empirical studies have examined how essential oil may further improve the relief of related symptoms. If essential oils are effective in headache relief, nurses' quality of life and care quality may also be improved. Purpose: This study was designed to examine the effects of inhaling essential oil on (1) headache-related disability, (2) headache-related quality of life, and (3) perceived care quality in emergency and critical care nurses. Methods: A cluster randomized control trial and crossover experimental design were adopted. The participants, all nurses with headaches working in emergency and critical care units (N = 49) in a medical center in northern Taiwan, were cluster randomized to Group A and B. Group A wore a necklace with essential oil (100% Lavandula angustifolia 0.1 ml + 100% citrus bergamia 0.1 ml) for 28 days (intervention period), stopped wearing the necklace for 7 days (wash-out), and then wore the necklace without essential oil for 28 days (control period). Group B underwent the control period (28 days) first, followed by the wash-out (7 days) and then the intervention period (28 days). Data were collected using a self-administered questionnaires that was administered three times (at day 0, day 28, day 63). The questionnaire included a demographic and headache-related datasheet, headache diary, Headache Disability Index, Migraine-Specific Questionnaire version 2.1 (role restrictive, role preventive, and emotion function), SERVQUAL (Service Quality), DASS-21, and Copenhagen Burnout Inventory. Repeated measures ANOVA (RM-ANOVA) and generalized estimating equations (GEEs) were used to analyze data. Results: Headache-related quality of life showed significant improvement in the role restrictive (β = 9.77, p = .008) and role preventive (β = 10.03, p = .018) domains. However, headache-related disability and care quality showed no significant differences (p ＞ .05), indicating that inhaling essential oil had a positive effect on quality of life. Conclusion: The findings of this study support that using a necklace with essential oil (Lavandula angustifolia and citrus bergamia 1:1) for 28 days effectively improves quality of life, especially in the domain of role function, in nurses working in emergency and critical care units. Additional empirical studies may be developed in the future to promote the benefits of using essential oils to ease pain.

1. 葉婉榆, W.-Y.,鄭雅文, Y.-W.,陳美如, M.-J.,邱文祥, W.-H.(2008)。職場疲勞量表的編制與信效度分析。台灣公共衛生雜誌，27(5)，349-464。
   連結：
2. Abbaszadeh, R.,Tabari, F.,Taherian, K.,Torabi, S.(2017).Lavender aromatherapy in pain management: A review study.Pharmacophore,8(3),50-54.
3. Adhisty, K.(2020).Complementary therapy: Citrus aromatherapy for pain.Conference of Medical Sciences Dies Natalis Faculty of Medicine Universitas Sriwijaya,2(1),132-139.
4. Bakhtiari, S.,Paki, S.,Khalili, A.,Baradaranfard, F.,Mosleh, S.,Jokar, M.(2019).Effect of lavender aromatherapy through inhalation on quality of life among postmeno-pausal women covered by a governmental health center in Isfahan, Iran: A single-blind clinical trial.Complementary Therapies in Clinical Practice,34,46-50.
5. Black, A. K.,Fulwiler, J. C.,Smitherman, T. A.(2015).The role of fear of pain in headache.Headache: The Journal of Head and Face Pain,55(5),669-679.
6. Buckle, J.(2014).Clinical aromatherapy: Essential oils in healthcare.Elsevier.
7. Chang, H.-Y.,Jensen, M. P.,Yang, C.-C.,Lai, Y.-H.(2019).Migraine-Specific Quality of Life Questionnaire Chinese version 2.1 (MSQv2.1-C): Psychometric evaluation in patients with migraine.Health and Quality of Life Outcomes,17(1),Article 108.
8. Diener, H.-C.,Tassorelli, C.,Dodick, D. W.,Silberstein, S. D.,Lipton, R. B.,Ashina, M.,Becker, W. J.,Ferrari, M. D.,Goadsby, P. J.,Pozo-Rosich, P.,Wang, S. J.,Houle, T. T.,Hoek, T.,Martinelli, D.,Terwindt, G. M.,International Headache Society Clinical Trials Committee(2020).Guidelines of the International Headache Society for controlled trials of preventive treatment of migraine attacks in episodic migraine in adults.Cephalalgia,40(10),1026-1044.
9. Diggle, P. J.,Heagerty, P.,Liang, K.-Y.,Zeger, S. L.(2002).Analysis of longitudinal data.Oxford University Press.
10. Donatello, N. N.,Emer, A. A.,Salm, D. C.,Ludtke, D. D.,Bordignon, S.,Ferreira, J. K.,Salgado, A. S. I.,Venzke, D.,Bretanha, L. C.,Micke, G. A.,Martins, D. F.(2020).Lavandula angustifolia essential oil inhalation reduces mechanical hyperalgesia in a model of inflammatory and neuropathic pain: The involvement of opioid and cannabinoid receptors.Journal of Neuroimmunology,340,Article 577145.
11. French, D. J.,Holroyd, K. A.,Pinell, C.,Malinoski, P. T.,O’Donnell, F.,Hill, K. R.(2000).Perceived self-efficacy and headache-related disability.Headache: The Journal of Head and Face Pain,40(8),647-656.
12. Gensini, G. F.,Conti, A. A.,Conti, A.(2005).Past and present of "What will please the Lord": An updated history of the concept of placebo.Minerva Medica,96(2),121-124.
13. Giamberardino, M. A.,Affaitati, G.,Costantini, R.,Guglielmetti, M.,Martelletti, P.(2020).Acute headache management in emergency department. A narrative review.Internal and Emergency Medicine,15(1),109-117.
14. Gok Metin, Z.,Arikan Donmez, A.,Izgu, N.,Ozdemir, L.,Arslan, I. E.(2017).Aromatherapy massage for neuro-pathic pain and quality of life in diabetic patients.Journal of Nursing Scholarship,49(4),379-388.
15. Güneş, E.,Olguntürk, N.(2020).Color-emotion associations in interiors.Color Research & Application,45(1),129-141.
16. Hummel, T.,Olgun, S.,Gerber, J.,Huchel, U.,Frasnelli, J.(2013).Brain responses to odor mixtures with sub-threshold components.Frontiers in Psychology,4,Article 786.
17. Jacobson, G. P.,Ramadan, N. M.,Aggarwal, S. K.,Newman, C. W.(1994).The Henry Ford Hospital headache disability inventory (HDI).Neurology,44(5),837-842.
18. Korucu, O.,Atasoy, H. T.,Demiryürek, B. E.,Emre, U.,Taşçılar, F. N.,Barut, B. Ö.(2018).The use of complementary and alternative treatment in headache patients.Gazi Medical Journal,29(3),183-186.
19. Krøll, L. S.,Hammarlund, C. S.,Westergaard, M. L.,Nielsen, T.,Sloth, L. B.,Jensen, R. H.,Gard, G.(2017).Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain.The Journal of Headache and Pain,18(1),Article 46.
20. Kuo, W.-Y.,Huang, C.-C.,Weng, S.-F.,Lin, H.-J.,Su, S.-B.,Wang, J.-J.,Guo, H.-R.,Hsu, C.-C.(2015).Higher migraine risk in healthcare professionals than in general population: A nationwide population-based cohort study in Taiwan.The Journal of Headache and Pain,16(1),Article 102.
21. Lakhan, S. E.,Sheafer, H.,Tepper, D.(2016).The effectiveness of aromatherapy in reducing pain: A systematic review and meta-analysis.Pain Research and Treatment
22. Lovibond, S. H.,Lovibond, P. F.(2004).Manual for the depression anxiety stress scale.Psychology Foundation Monograph.
23. Moloney, M. F.,Strickland, O. L.,DeRossett, S. E.,Melby, M. K.,Dietrich, A. S.(2006).The experiences of midlife women with migraines.Journal of Nursing Scholarship,38(3),278-285.
24. Moriarty, M.,Mallick-Searle, T.(2016).Diagnosis and treatment for chronic migraine.The Nurse Practitioner,41(6),18-32.
25. Moussa, M. T.,Lovibond, P. F.,Laube, R.(2001).Report for New South Wales Transcultural Mental Health CentreReport for New South Wales Transcultural Mental Health Centre,Sydney:Cumber-land Hospital.
26. Park, Y.-S.,Lee, M.-K.(2019).Meta-analysis of the effects of lavender aromatherapy on pain.Journal of the Korea Academia-Industrial Cooperation Society,20(5),300-310.
27. Parker, S. L.,Godil, S. S.,Zuckerman, S. L.,Mendenhall, S. K.,Tulipan, N. B.,McGirt, M. J.(2013).Effect of symptomatic pseudomeningocele on improvement in pain, disability, and quality of life following suboccipital decompression for adult Chiari malformation type I.Journal of Neurosurgery,119(5),1159-1165.
28. Peana, A. T.,Marzocco, S.,Popolo, A.,Pinto, A.(2006).(-)-Linalool inhibits in vitro NO formation: Probable involvement in the antinociceptive activity of this monoterpene compound.Life Science,78(7),719-723.
29. Powers, K. A.,Beasley, V. R.(1985).Toxicological aspects of linalool: A review.Veterinary and Human Toxicology,27(6),484-485.
30. Priya, S. M.,Jesudoss, M.,Snegalatha, D.,Bai, R. S.,Mathew, V.(2018).Headache among nursing staff.Indian Journal of Continuing Nursing Education,19(1),91-95.
31. Salvagioni, D. A. J.,Melanda, F. N.,Mesas, A. E.,González, A. D.,Gabani, F. L.,de Andrade, S. M.(2017).Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies.PLOS ONE,12(10),Article e0185781.
32. Sandoe, C. H.,Sasikumar, S.,Lay, C.,Lawler, V.(2019).The impact of shift work on migraine: A case series and narrative review.Headache: The Journal of Head and Face Pain,59(9),1631-1640.
33. Sobel, N.,Khan, R. M.,Hartley, C. A.,Sullivan, E. V.,Gabrieli, J. D. E.(2000).Sniffing longer rather than stronger to maintain olfactory detection threshold.Chemical Senses,25(1),1-8.
34. Teng, C.-I.,Ing, C.-K.,Chang, H.-Y.,Chung, K.-P.(2007).Development of service quality scale for surgical hospitalization.Journal of the Formosan Medical Association,106(6),475-484.
35. Welp, A.,Meier, L. L.,Manser, T.(2015).Emotional exhaustion and workload predict clinician-rated and objective patient safety.Frontiers in Psychology,5,Article 1573.
36. Wetmore, S.(Ed.),Rubin, A.(Ed.)(2015).Vestibular migraine.Springer.
37. Yuan, R.,Zhang, D.,Yang, J.,Wu, Z.,Luo, C.,Han, L.,Yang, F.,Lin, J.,Yang, M.(2021).Review of aromatherapy essential oils and their mechanism of action against migraines.Journal of Ethnopharmacology,265,Article 113326.
38. Zebenigus, M.,Tekle-Haimanot, R.,Worku, D. K.,Thomas, H.,Steiner, T. J.(2016).The prevalence of primary headache disorders in Ethiopia.The Journal of Headache and Pain,17,Article 110.
39. 台灣頭痛學會（2014）．國際頭痛疾病分類第三版中文版。https://reurl.cc/5r4kkv [Taiwan Headache Society. (2014). The international classification of headache disorders. https://reurl.cc/5r4kkv]
40. 許永居, Y.-C.,林高章, K. C.,台灣頭痛學會治療準則小組(2017)。偏頭痛急性發作藥物治療準則。台灣神經學雜誌，26(2)，78-96。
41. 陳思柔, S.-J.(2017)。國立臺灣大學=National Taiwan University。
42. 陳思柔, S.-J.,賴裕和, Y.-H.,楊智超, C.-C.,張皓媛, H.-Y.(2021)。頭痛症狀影響工作和生活：急重症護理人員之主觀經驗。台大護理，17(1)，140-153。
43. 盧玉嬴, Y.-Y.,陳瑞貞, J.-C.,梁淑媛, S.-Y.,吳淑芳, S.-F.(2014)。護理人員之工作壓力與職場疲勞之相關性探討。護理暨健康照護研究，10(4)，276-285。