Effects of sweet orange aromatherapy on pain and anxiety during needle insertion among patients undergoing hemodialysis: A quasi-experimental study

Nurs Forum. 2020 Jul;55(3):425-432. doi: 10.1111/nuf.12447. Epub 2020 Mar 17.


Purpose: Patients undergoing hemodialysis experience pain and anxiety during needle insertion, and the scientific interest in aromatherapy in reducing pain and anxiety is increasing. Thus, this study aimed to determine the effects of sweet orange aromatherapy on pain and anxiety during needle insertion in hemodialysis.

Design: Quasi-experimental, pretest, and posttest.

Methods: This study was carried out among 50 patients with chronic kidney disease who were non-randomly assigned to either sweet orange aromatherapy or calm breathing in three outpatient hemodialysis centers in the Philippines between July and August 2015. The numeric rating scale and adapted state-trait anxiety inventory were utilized to measure pain and anxiety.

Results: After the intervention, both the pain and anxiety scores were significantly lower for patients who received sweet orange aromatherapy than those who received calm breathing. The results obtained modest effect sizes that imply high practical significance.

Conclusion: The sweet orange aromatherapy can be effective in reducing pain and anxiety. Thus, this can be used by nurses as an alternative and complementary approach to reduce both pain and anxiety in painful procedures like needle insertion.

Keywords: anxiety; aromatherapy; hemodialysis; needle insertion; pain.

MeSH terms

  • Adult
  • Anxiety / psychology
  • Anxiety / therapy*
  • Aromatherapy / methods
  • Aromatherapy / standards*
  • Aromatherapy / statistics & numerical data
  • Citrus sinensis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / etiology
  • Pain Management / methods
  • Pain Management / standards*
  • Pain Management / statistics & numerical data
  • Philippines
  • Punctures / adverse effects
  • Punctures / methods
  • Renal Dialysis / adverse effects*
  • Renal Dialysis / psychology