Practical Feasibility and Implementation of an Aromatherapy Inhalation Program in Palliative Care setting

This abstract has open access
Abstract Description
Submission ID :
HAC14
Submission Type
Authors (including presenting author) :
Chau YK(1), Kwan WM(1), Chuk CY(1), Cheng SY(1), Leung CS(1)
Affiliation :
(1)Palliative Care, Bradbury Hospice
Introduction :
In palliative care, implementing complementary therapies faces challenges regarding resources, workload, and feasibility. While conventional symptom management remains fundamental, interest grows in simple, cost-effective complementary interventions. Aromatherapy with essential oils is effective but believed time-consuming in clinical settings. This study explores inhalation aromatherapy for its effectiveness and practicality, requiring minimal setup and easy administration. Current literature focuses on clinical effectiveness rather than implementation challenges in real-world settings. Limited attention addresses operational considerations like delivery methods, resources, staff acceptance, and integration into care routines. This knowledge gap is significant in Hong Kong's palliative care context, where high patient volumes and limited resources necessitate interventions that are effective, feasible, and sustainable. Successful integration requires consideration of cost-effectiveness, administration ease, training requirements, and compatibility with existing protocols.
Objectives :
This study assessed both patient outcomes and operational feasibility of an aromatherapy inhalation program in palliative care. Primary objectives included evaluating effectiveness for symptom management (pain, anxiety, fatigue, sleep quality) and patient acceptance. Secondary objectives examined healthcare providers' perspectives, operational challenges, staff training requirements, time management implications, and resource requirements.
Methodology :
A pre-post-test interventional, mixed-methods study was conducted from June to October 2023 in a Hong Kong palliative care ward with ethics approval and written consent from participants. The study included 37 advanced cancer patients (32 completing the intervention; 15 males, 17 females; mean age 74.5 years) and 18 healthcare staff. The intervention used ventilated plastic boxes with gauze. Patients chose from lavender, bergamot, or chamomile essential oils. Five drops were applied to the gauze inside the box, positioned near the patient's pillow, and replenished every three days. Symptoms were evaluated on days one and four using the Palliative Care Outcome Scale (POS), patient satisfaction surveys (5-point Likert scale), and staff feedback questionnaires. Statistical analysis used SPSS version 27.0, including descriptive statistics and the Wilcoxon signed-rank test (p<0.05). Qualitative staff feedback was analysed thematically.
Result & Outcome :
Analysis revealed significant improvements in sleep disturbance (1.71±0.99 to 0.96±0.79; Z=-3.082, p=0.002) and pain scores (1.74±0.94 to 1.26±0.81; Z=-2.504, p=0.012). Subgroup analysis showed lavender and bergamot improved sleep quality (p=0.034 and p=0.024), while bergamot significantly reduced pain (p=0.035). Staff reported high feasibility ratings: 88.89% found the intervention easy to apply, 94.44% considered it applicable in ward settings, and 77.78% reported improved patient comfort. Time consumption was minimal (mean 2.11±0.83/5), with limited impact on workload. Patient satisfaction was high (mean 3.78±0.91/5), with 90.62% reporting neutral to high satisfaction. No adverse events occurred. Cost analysis showed economic feasibility at 3.70 HKD per application (1.23 HKD daily). Aromatherapy inhalation proves effective for managing sleep disturbance and pain in palliative care, with high patient and staff acceptance. Its low cost, minimal resource requirements, and simple standardized delivery make it suitable for resource-conscious healthcare settings with heavy nursing workloads. The non-pharmacological nature presents no drug interaction risks, making it appropriate for complex palliative cases. Despite limitations of single-center design and sample size, findings support aromatherapy inhalation as a practical, effective complementary intervention in palliative care settings.
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