Effect of Citrus Sinensis Aromatherapy on Pain and Anxiety Among Hemodialysis Patients: A Quasi-Experimental Study
DOI:
https://doi.org/10.55018/janh.v8i1.447Keywords:
citrus sinensis, aromatherapy, pain, anxiety, hemodialysisAbstract
Background: Pain is a common problem in hemodialysis patients and is often accompanied by anxiety. Aromatherapy is a simple, low-cost complementary intervention, but evidence in hemodialysis patients is still limited and inconclusive. Citrus sinensis essential oil is of particular interest because its major bioactive components are analgesic and anxiolytic agents. The purpose of this study was to determine the effect of citrus sinensis aromatherapy on pain and anxiety in hemodialysis patients.
Methods: A quasi-experimental design with a control group included 50 hemodialysis patients (25 control and 25 intervention) selected by purposive sampling at the Bangil Health Centre in Pasuruan City. Eligible patients were ≥ 18 years old, have good sense of smell, on routine hemodialysis. Pain was measured using the Numeric Rating Scale (NRS) and anxiety using the Generalized Anxiety Disorder-7 (GAD-7)—data analyzed with a paired t-test. The intervention was given twice a week for 30 minutes. Ethical clearance was obtained.
Results: In the intervention group, mean pain score decreased from 6.2 ± 1.1 to 3.4 ± 1.0, and anxiety scores decreased significantly (both p < 0.001), while changes in the control group were not significant. Between-group comparisons showed a greater reduction in pain and anxiety in the intervention group (p < 0.05).
Conclusion: The Citrus sinensis aromatherapy was effective to reduce on pain scale and anxiety level in chronic kidney disease patients undergoing hemodialysis. These findings suggest that citrus sinensis aromatherapy can be considered as a simple complementary nursing intervention to improve comfort and psychological well-being during hemodyalisis period.
Downloads
References
Barello, S., Anderson, G., Acampora, M., Bosio, C., Guida, E., Irace, V., Guastoni, C. M., Bertani, B., & Graffigna, G. (2023). The effect of psychosocial interventions on depression, anxiety, and quality of life in hemodialysis patients: a systematic review and a meta-analysis. International Urology and Nephrology, 55(4), 897–912. https://doi.org/10.1007/s11255-022-03374-3
Hsu, J. R., Mir, H., Wally, M. K., Seymour, R. B., Archer, K. R., Attum, B., Chad Coles, K. Y., Dumpe, J., Harvey, E., Higgins, T., Hoegler, J., Liu, J. Z., Lowe, J., Mamczak, C., Lawrence Marsh, J., Miller, A. N., Obremskey, W., Ransone, M., Ricci, W., … Shafiq, B. (2019). Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury. Journal of Orthopaedic Trauma, 33(5), E158–E182. https://doi.org/10.1097/BOT.0000000000001430
Kaya, A., Yeşildere Sağlam, H., Karadağ, E., & Gürsoy, E. (2023). The effectiveness of aromatherapy in the management of labor pain: A meta-analysis. European Journal of Obstetrics and Gynecology and Reproductive Biology: X, 20(August), 0–6. https://doi.org/10.1016/j.eurox.2023.100255
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, 2016. https://doi.org/10.1155/2016/8158693
Mailani, F., Muthia, R., Herien, Y., Huriani, E., Chan, C. M., & Abdullah, K. L. (2021). ORIGINAL RESEARCH The Fluid Management Experience in Patients with Chronic Kidney Disease Undergoing Hemodialysis in Indonesia: A Qualitative Study. Nurse Media Journal of Nursing, 11(3), 389–403. https://doi.org/10.14710/nmjn.v11i3.38838
Miller, M. A., Ye, L., Pelt, M. Van, & Pavone, K. J. (2025). Effects of Mindfulness on Postoperative Pain, Anxiety, and Opioid Use: An Integrative Review. Pain Management Nursing, 26(5), e425–e433. https://doi.org/10.1016/j.pmn.2025.04.004
Nascimento, J. C., Gonçalves, V. S. do. S., Souza, B. R. S., Nascimento, L. de C., Carvalho, B. M. R. d., Nogueira, P. C. L., Santos, J. P. S., Borges, L. P., Goes, T. C., Souza, J. B. de, Coutinho, H. D. M., & Guimarães, A. G. (2025). Effectiveness of aromatherapy with sweet orange oil (Citrus sinensis L.) in relieving pain and anxiety during labor. Explore, 21(1), 103081. https://doi.org/10.1016/j.explore.2024.103081
National Association for Holistic Aromatherapy. (2012). No Title. Safety Information.
Silalahi, E. D., Lister, I. N. E., & Fachrial, E. (2023). Analgesic and Antipyretic Activity of Sweet Orange Peel Methanol Extract. Biology, Medicine, & Natural Product Chemistry, 12(2), 577–584. https://doi.org/10.14421/biomedich.2023.122.577-584
Survey kesehatan indonesia (Ski). (2023). Survei Kesehatan Indonesia 2023 (SKI). Kemenkes, 235.
Tabatabaeichehr, M., & Mortazavi, H. (2020). The Effectiveness of Aromatherapy in the Management of Labor Pain and Anxiety: A Systematic Review. Ethiopian Journal of Health Sciences, 30(3), 449–458. https://doi.org/10.4314/ejhs.v30i3.16
Tiwouw, I. P., Robert, O., Umboh, H., & Awaludin, M. (2024). Gangguan cemas pada pasien penyakit ginjal kronik yang menjalani hemodialisis : literatur review. J Kedokt Kom Tropik, 12(1), 525–530.
Wilkinson, T. J., Nixon, D. G. D., Palmer, J., Lightfoot, C. J., & Smith, A. C. (2021). Differences in physical symptoms between those with and without kidney disease: a comparative study across disease stages in a UK population. BMC Nephrology, 22(1), 1–10. https://doi.org/10.1186/s12882-021-02355-5
Yang, H., Qi, L., & Pei, D. (2024). Effect of psychosocial interventions for depression in adults with chronic kidney disease: a systematic review and meta-analysis. BMC Nephrology, 25(1), 1–12. https://doi.org/10.1186/s12882-023-03447-0
Zhao, Q., Zhu, L., Wang, S., Gao, Y., & Jin, F. (2023). Molecular mechanism of the anti-inflammatory effects of plant essential oils: A systematic review. Journal of Ethnopharmacology, 301(July 2022), 115829. https://doi.org/10.1016/j.jep.2022.115829
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Rustiana Tasya Ariningpraja, Endah Panca Lydia Fatma, Retno Lestari
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
