A Scoping Review of Aromatherapy Evidence for Test Anxiety in Nursing Education

Abstract

Background: Aromatherapy is a holistic intervention that is purported to relax or stimulate cognitive performance in nursing students and improve sleep disturbances depending upon the essential oil and the method of delivery. Test anxiety is a prevalent educational issue for nursing students that can lead to poor outcomes during the course of their nursing education. Test anxiety can have adverse consequences for students such as poor performance, failure, and attrition in the nursing program. Objective: The aims of this scoping review were to identify, summarize, and synthesize aromatherapeutic evidence implemented and evaluated in nursing education to decrease anxiety and test anxiety and improve test taking and sleep among nursing students. It also aims to propose methodologies that best utilize aromatherapy in nursing education. Methodology: A scoping review of the research evidence was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (2021). Results: Nine studies (2008-2019) were identified from the United States, the Philippines, and Turkey. The majority of designs were reported as RCTs (random control trials), with small non-diverse samples reported. Lavender, rosemary and lemon oil were administered via inhalation and hand massage methods. Anxiety and test anxiety were evaluated using scales (Cognitive Test Anxiety, Westside Test Anxiety Scale, State Trait Anxiety Inventory) and vital sign data. Test anxiety decreased with aromatherapy hand massage, and lavender and rosemary scents. Pulse rate decreased while blood pressure was non-significant. Studies did not use sleep disturbances as a variable. Conclusions and Recommendations: Various essential oils and delivery methods were used to mitigate anxiety and test anxiety among nursing students; however, there is limited data available to understand the design, chemistry and concentration of the essential oils used in the studies. There should be comprehensive reports of the design and evidence for use in nursing education.