Tong Po Yee

85 Pages·2015·1.01 MB·English

Abstract of thesis entitled
“An Evidence Based Guideline of Aromatherapy in Pain Relief for
Dysmenorrhea Patient in Gynecology Ward”
Submitted by
Tong Po Yee
For the degree of Master of Nursing
at The University of Hong Kong
in July 2015

Dysmenorrhea is a typical gynecology problem that women experienced during
menstruation. It is presented with pain and cramp over lower abdomen, sometimes it
is accompanied by headache, nausea, vomiting or diarrhea. It is an unpleasant
experience which results in a negative impact on women’s physical health and daily
life. The prevalence of dysmenorrhea is not rare to see. As reported by World Health
Organization (WHO) in 2006, dysmenorrhea prevalence is up to 81% in 20 high
quality studies. In Hong Kong, local surveys show that around 68.7 % to 80 % among
the studying subjects experienced dysmenorrhea.
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Traditional pharmacological therapy is associated with medication dependence
and side effects. Recent studies suggested aromatherapy as an effective
non-pharmacological therapy for dysmenorrhea in pain relief. Yet it is not a common
alternative chosen by patients in Hong Kong local hospital, including the target
gynecology ward. Thus, a translational study is conducted to formulate an
evidence-based guideline of aromatherapy in pain relief for dysmenorrhea patients, to
assess its transferability and feasibility and to develop the implementation plan and
the evaluation plan.
Five relevant studies were identified from five different electronic bibliographic
databases under a systematic search. According to the recommendation from Scottish
Intercollegiate Guidelines Network (SIGN) grading system, critical appraisal and
level of evidence were conducted on the five identified studies for the quality
assessment. Table of evidence was developed to summarize the findings. All of the
five identified studies support the use of aromatherapy is effective in pain relieve for
dysmenorrhea patients with statistical significant shown.
The implementation potential in the target ward was examined. It was feasible
and transferable to be implemented in the target ward. Also, benefits outweighed the
costs. Then, implementation plan was planned including communication plan with
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different stakeholders and a two-month pilot test. Revision of the proposed guideline
could be carried out before a full-scale program is implemented.
Lastly, evaluation plan was develop for assessing the effectiveness of the
proposed program. Reduction in pain, staff and patients’ satisfactory level, staff
knowledge and cost of the program will be measured. Further modification of the
program guideline would be considered to yield a better outcome in the future.

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An Evidence Based Guideline of Aromatherapy in Pain Relief for
Dysmenorrhea Patient in Gynecology Ward
By
Tong Po Yee
B.Nurs. H.K.U.

A thesis submitted in partial fulfillment of the requirement for
the Degree of Master of Nursing
at the University of Hong Kong
July 2015

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Declaration

I declare that this dissertation represents my own work, except where due
acknowledgement is made, and that it has not been previously included in a theses,
dissertation or report submitted to this University or to any other institution for a
degree, diploma or other qualification.

Signed _________________________________
Tong Po Yee

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Acknowledgements

I would like to express my sincere gratitude to my dissertation supervisor Ms.
Polly Chan for her inspirations and patient guidance throughout my two-year
dissertation journey. Her suggestion and help makes this dissertation completed.

Besides, I would like to deeply thank my family and fiancé for their love and
caring. With their contribution and backup in my life, I could complete this
dissertation and master program without worries.

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Table of Contents
Declaration...……………………...…..……………………….…………… v
Acknowledgements…………………...…..……………………….…..…… vi
Table of Contents…………………...…..……………………….…..…...… vii
List of Appendices…………………...…..……………………………..…... ix
Abbreviations…………………...…..…………………………………..…... x

CHAPTER 1: INTRODUCTION PAGE
1.1 Background...…………………..…..……………………………… 1
1.2 Affirming the Needs………………………………………………. 3
1.3 Objectives and Significance……………………………………….. 5

CHAPTER 2: CRITICAL APPRAISAL
2.1 Search and Appraisal Strategies………………………………….... 9
2.1.1 Translational Nursing Research Question…………………. 9
2.1.2 Identification of Studies……………………………………. 10
2.1.3 Inclusion Criteria…………………………………………… 11
2.1.4 Exclusion Criteria…………………………………………... 11
2.1.5 Data Extraction………………………………………….….. 12
2.1.6 Appraisal Strategies………………………………………… 12
2.2 Results…………………………….……………………………….. 13
2.2.1 Studies Characteristic………………………………………. 13
2.2.2 Methodology……………………………………………….. 14
2.2.3 Level of Evidence…………………………………….…….. 15
2.3 Summary and Synthesis……………………………………….…… 16
2.3.1 Summary……………………………………………….…… 16
2.3.1.1 Patients’ Characteristics……………………………… 16
2.3.1.2 Intervention and Comparison………………………… 16
2.3.1.3 Outcome Measure……………………………………. 18
2.3.2 Synthesis…………………………………………………….. 19

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CHAPTER 3: TRANSLATION AND APPLICATION PAGE
3.1 Target Setting and Population…………..…..……………………… 22
3.2 Implementation Potential……..…..…………………..……………. 23
3.2.1 Transferability…………..…..…………………..……………. 23
3.2.2 Feasibility…………..…..……………….……………………. 26
3.2.3 Cost-Benefit Ratio…………..…..……………………………. 30
3.3 Evidence-Based Guideline…………..…..…………….……………. 33
3.3.1 Title………………………………..…..……………………… 33
3.3.2 Objectives…………………………....…..……………………. 33
3.3.3 Target Population...………………..…..………………………. 33
3.3.4 Recommendations...………………..…..……………………… 34

CHAPTER 4: IMPLEMENTATION PLAN
4.1 Communication Plan…………..…..……………………….…….… 38
4.1.1 Stakeholder…………..…..……………………….……….… 38
4.1.2 Communication Progress………………………………….… 40
4.2 Pilot Test………….………………..…..……………..…………….. 44
4.2.1 Objectives……………..…..………………..……………….. 44
4.2.2 Duration and Setting……..…..……………..……………….. 45
4.2.3 Target Population……….…..……………..…..…………….. 45
4.2.4 Evaluation of Pilot Test…………….………..…………..….. 46
4.3 Evaluation Plan…………..…..……………………….…….…….… 47
4.3.1 Identifying Outcomes……………..…..……….……….…… 47
4.3.2 Characteristic and Number of Patients involved.…………… 49
4.3.3 Data Collection…………………..………………..………… 50
4.3.4 Data Analysis……....……….……..…..…………………….. 51
4.3.5 Criteria for Determining Guideline Effectiveness…...…..….. 51

APPENDICES……..…………………………….………........……..…..….. 55
REFERENCES……..…………………………….……...........……..…..….. 74

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List of Appendices

Appendix A Database Search Strategy and Results (Prisma Flow Diagram)
Appendix B Bibliographic citation of selected studies
Appendix C Table of Evidence
Appendix D SIGN Grading System 1999 – 2012
Appendix E Quality Assessment of Studies
Appendix F Estimated cost of implementing the 6-month pilot program
Appendix G Evidence based guideline of aromatherapy in pain relief for
dysmenorrhea patient in gynecology ward
Appendix H Staff Evaluation Questionnaire
Appendix I Patient Evaluation Questionnaire
Appendix J Estimated Timeframe of Implementation Plan
Appendix K Staff Audit Form on Aromatherapy Massage

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Abbreviations

AED Accident and Emergency Department
APN Advanced Practice Nurse
CNE Continuing Nursing Education
COS Chief of Service
DOM Departmental Operational Manager
EBP Evidence Based Practice
HCA Health Care Assistants
NRS Numeric Rating Scales
NSAID Non-Steroid Anti-Inflammatory drug
RCT Randomized Controlled Trial
RN Registered Nurse
SPSS Statistical Package for Social Sciences
VAS Visual Analogue Scale
VRS Verbal Rating Scale
WHO World Health Organization
WM Ward Manager

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