Lemon Oil Aromatherapy Intervention on Anxiety in Children with Chemotherapy through a Combination Assessment of ZSAS and AI-Based Emotimeter

Abstract

Each year, 176.000 children are diagnosed with cancer. Chemotherapy is a common treatment. Chemotherapy has both physical and psychological effects. One psychological impact is anxiety. Anxiety in children increases an exaggerated response to painful stimuli and can lead to refusal of treatment, thus impacting the treatment. Anxiety in children can be treated with lemon oil aromatherapy. Lemon oil aromatherapy is a non-pharmacological technique aimed at preventing anxiety in children. The aim of this study was to determine the effect of lemon oil aromatherapy intervention on the anxiety of school-aged children undergoing chemotherapy at a private hospital in Bandung. The study used a quasi-experimental design. The sample consisted of school-aged children. Consecutive sampling was used, with 21 children selected. Data collection involved administering aromatherapy through a diffuser as much as 2 drops of lemon oil dissolved in 100 ml of water, given once before and after chemotherapy for 15 minutes. Anxiety was measured before and after the intervention using the Zung Self-Anxiety Rating Scale (ZSAS) questionnaire, combined with an artificial intelligence based emotimeter to analyze facial expressions more accurately. Data analysis used marginal homogeneity test, found that anxiety before the intervention was mostly severe anxiety (60-74) and after the intervention changed to normal (<45). The statistical test yielded a p-value of 0.001, indicating that the lemon oil aromatherapy intervention had an effect on children's anxiety. Pediatric nurse should provide non-pharmacological interventions, such as aromatherapy, to treat anxiety in children undergoing chemotherapy and using appropriate measurement tools to assess anxiety.