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      Aromatherapy with inhalation effectively alleviates the test anxiety of college students: A meta-analysis

      systematic-review

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          Abstract

          Objective

          Test anxiety is one of the common psychological and behavioral problems of college students, which can result in poor academic performance and even academic failure. Aromatherapy has been proposed as a promising method to reduce test anxiety in college students, but its precise efficacy has not been fully confirmed. This meta-analysis evaluated the effects of aromatherapy on the symptoms of test anxiety in college students to serve as a reference for future research and provide more scientific and exact evidence.

          Methods

          PubMed, The Cochrane Library, Web of Science, Embase, CINAHL, Science Direct, Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Full-Text Database (VIP), and Wanfang Data were electronically searched from inception to June 2022 to identify randomized controlled trials (RCTs) on aromatherapy for treating students’ test anxiety. The Cochrane Risk of Bias Assessment Tool for RCTs was used by two reviewers to critically and independently assess the methodological quality of the included studies. Review Manager 5.4 was used for the meta-analysis. Stata 17.0 was used for sensitivity analysis and Egger’s test.

          Results

          Seven RCTs included 425 patients, with a moderate risk of bias in the included studies. The meta-analysis found that aromatherapy effectively reduced test anxiety in college students (SMD = −0.67, p < 0.01), with high heterogeneity of results ( I 2 = 72%). The different types of essential oil devices used in the study are the source of inter-study heterogeneity. Subgroup analysis suggested that most effective methods were aromatherapy with compound essential oils (SMD = −0.91, p < 0.01), and using cloths or pads as the essential oil devices (SMD = −1.03, p < 0.01). There was no difference between aromatherapy and placebo control groups (SMD = −0.65, p = 0.25).

          Conclusion

          Aromatherapy with inhalation can help relieve test anxiety in college students, but more and higher-quality studies are needed. This study provides a reference for future research designs in terms of the selection of essential oil types and devices and the design of research groups.

          Systematic review registration

          [ https://www.crd.york.ac.uk/prospero/], identifier [CRD42022345767].

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          Most cited references50

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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            The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

            Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate
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              Evaluation of intranasal delivery route of drug administration for brain targeting

              The acute or chronic drug treatments for different neurodegenerative and psychiatric disorders are challenging from several aspects. The low bioavailability and limited brain exposure of oral drugs, the rapid metabolism, elimination, the unwanted side effects and also the high dose to be added mean both inconvenience for the patients and high costs for the patients, their family and the society. The reason of low brain penetration of the compounds is that they have to overcome the blood-brain barrier which protects the brain against xenobiotics. Intranasal drug administration is one of the promising options to bypass blood-brain barrier, to reduce the systemic adverse effects of the drugs and to lower the doses to be administered. Furthermore, the drugs administered using nasal route have usually higher bioavailability, less side effects and result in higher brain exposure at similar dosage than the oral drugs. In this review the focus is on giving an overview on the anatomical and cellular structure of nasal cavity and absorption surface. It presents some possibilities to enhance the drug penetration through the nasal barrier and summarizes some in vitro, ex vivo and in vivo technologies to test the drug delivery across the nasal epithelium into the brain. Finally, the authors give a critical evaluation of the nasal route of administration showing its main advantages and limitations of this delivery route for CNS drug targeting.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                06 January 2023
                2022
                : 13
                : 1042553
                Affiliations
                [1] 1School of Nursing, Hebei Medical University , Shijiazhuang, China
                [2] 2The Second Hospital of Hebei Medical University , Shijiazhuang, China
                Author notes

                Edited by: Mohamed Elsadek, Tongji University, China

                Reviewed by: Danilo Menicucci, University of Pisa, Italy; Zhe-an Shen, Xinjiang Institute of Technology, China

                *Correspondence: Haiying Chen, hychen1964@ 123456163.com

                This article was submitted to Educational Psychology, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2022.1042553
                9853416
                36687893
                cb614ff6-9fbf-4f66-9f15-95053db49a93
                Copyright © 2023 Luan, Yang, Zhao, Zang, Zhang and Chen.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 12 September 2022
                : 15 December 2022
                Page count
                Figures: 6, Tables: 1, Equations: 0, References: 50, Pages: 11, Words: 6288
                Funding
                Funded by: Hebei Provincial Department of Bureau of Science and Technology, doi 10.13039/501100008238;
                Categories
                Psychology
                Systematic Review

                Clinical Psychology & Psychiatry
                complementary therapy,essential oils,students,exam anxiety,systematic review

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