PICOT: For adult surgical oncology patients at White Plains Hospital Center for Cancer Care, does the implementation of aromatherapy in the preoperative setting, compared to current practice, impact anxiety in 8-10 weeks?

Literature Search Strategy

Many articles were identified to highlight the impact aromatherapy has on preoperative anxiety. It is imperative to identify strong, supportive, high-quality literature to support the practice problem and intended intervention. By doing so, the hope is to produce positive patient outcomes in our surgical oncology population. Keywords were used to search the most recent, peer-reviewed articles for the most relevant material regarding anxiety in the surgical oncology patient. The keywords used were preoperative anxietyaromatherapysurgical oncology, AND adults. In addition, the Chamberlain library search engine was the sole source of research. Databases utilized included CINHAL, Medline, and PubMed. Approximately 20 peer-reviewed articles were identified and strongly support the evidence-based intervention of utilizing lavender aromatherapy in the preoperative setting for the management of anxiety. All articles vary in evidence type and will be used to show the importance of this proposed intervention.

Literature to Synthesis

Lavender aromatherapy is one of the most widely used, well-recognized, complementary, and alternative medicine (CAM) that promotes relaxation and calmness (Beyliklioglu & Arslan, 2019; Koehler, 2021; Shady et al., 2019; Wotman et al., 2017). In recent times, aromatherapy has been successfully utilized in combination with modern day medicine to cure, manage, and treat a litany of aliments. Being able to safely manage symptoms, with a non-pharmacological approach is ideal, especially in the preoperative setting.

Bedaso and Ayalew (2019) conducted a study that revealed a 47.0% prevalence of preoperative anxiety among individuals undergoing elective surgeries. Given the commonality of this overwhelming feeling, the need to establish a safe, cost-effective, non-pharmacologic management approach is monumental. Studies have found that aromatherapy, more specifically lavender aromatherapy, when implemented, significantly decreases preoperative anxiety (Abdelhakim, et al., 2019; Franco, et al., 2016; Guo et al., 2020; Koehler, 2021; Trambert et al., 2017; Wotman, et al., 2017). By decreasing preoperative anxiety, the overall health status of the surgical patient is inadvertently optimized, and will therefore, produce positive patient outcomes.   


My DNP project has qualified for expedited review; therefore, it takes about 10-14 days for them to review the material and approve the project once fully submitted. Currently, there are a few little things to fix (mostly the wrong boxes clicked in the application) and then I can resubmit for approval. I am finally happy it is moving in the right direction and I now have a contact person who reviews the information in the iRIS database prior to submission.  


Abdelhakim, A.M., Hussein, A.S., Doheim, M.F., & Sayed, A.K. (2020). The effect of inhalation aromatherapy in patients undergoing cardiac surgery: A systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Medicine, 48, 1-8. https://doi.org/10.1016/j.ctim.2019.102256 (Links to an external site.)

Bedaso, A. & Ayalew, M. (2019). Preoperative anxiety among adult patients undergoing elective surgery: a prospective survey at a general hospital in Ethiopia. Patient Safety in Surgery, 13(18), 1-8. https://doi.org/10.1186/s13037-019-0198-0 (Links to an external site.)

Beyliklioglu, A. & Arslan, S. (2019). Effect of lavender oil on the anxiety of patients before breast surgery. Journal of PeriAnesthesia Nursing, 34(3), 587-593. https://doi.org/10.1016/j.jopan.2018.10.002 (Links to an external site.)

Franco, L., Blanck, T.J.J., Dugan, K., Kline, R., Shanmugam, G., Galotti, A., Granell, A.V.B., & Wajda, M. (2016). Both lavender fluer oil and unscented oil aromatherapy reduce postoperative anxiety in breast surgery patients: a randomized trial. Journal of Clinical Anesthesia, 33, 243-249. http://dx.doi.org/10.1016/j.jclinane.2016.02.032 (Links to an external site.) 

Guo, P., Li, P., Zhang, X., Liu, N., Wang, J., Yang, S., & Yu, L. (2020). The effectiveness of aromatherapy on preoperative anxiety in adults: A systematic review and meta-analysis of randomized controlled trials. International Journal of Nursing Studies, 111, 1-19. https://doi.org/10.1016/j.ijnurstu.2020.103747 (Links to an external site.)

Koehler, T. (2021). Lavender aromatherapy as a nurse-driven intervention for preoperative anxiety. Nursing for Women’s Health Journal, 25(4), 286-295. https://doi.org/10.1016/j.nwh.2021.05.005 (Links to an external site.)

Shady, K., Nair, J.M., & Crannell, C. (2019). Lavender aromatherapy. Examining the effects of lavender oil patches on patients in the hematology-oncology setting. Clinical Journal of Oncology Nursing, 23(5), 502-508. https://doi.org/10.1188/19.CJON.502-508 (Links to an external site.)

Trambert, R., Kowalski, M.O., Wu, B., Mehta, N., & Friedman, P. (2017). A randomized controlled trial provides evidence to support aromatherapy to minimize anxiety in women undergoing breast biopsy. Worldviews on Evidence Based Practice, 14(5), 394-402. https://doi.org/10.1111/wvn.12229 (Links to an external site.)

Wotman, M., Levinger, J., Leung, L., Kallush, A., Mauer, E., & Kacker, A. (2017). The efficacy of lavender aromatherapy in reducing preoperative anxiety in ambulatory surgery patients undergoing procedures in general otolaryngology. Laryngoscope Investigative Otolaryngology, 2, 437-441. https://doi.org/10..1002/lio2.121