BioMed Research International TABLE 1:Interventions of the aromatherapy programme. Week Teaching content(40 minutes) Activity (20 minutes) Self-administered aromatherapy (i)Introduction to pain: mechanism,assessment,effects of pain on physical and psychological health, pharmacological and Practical session on deep nonpharmacological approaches breathing exercises and (ii)Aromatherapy:introduction, aromatherapy history,and indications (iii)Deep breathing exercises: introduction and theory (i)Carried out at home by older persons Introducing different types of Practical session on deep 2 (ii)Aromatic spray given with essential oils and uses, breathing exercises and education on use and precautions indications for usage aromatherapy (i)Odour testing game Demonstration of how to make (ii)Practical session on deep an aromatherapy toolbox breathing exercises and aromatherapy (i)Practical session on deep Making an aroma decoration-a breathing exercises and towel rabbit aromatherapy (ii)Drinking of fruit tea the participants knew how to use the aromatic spray correctly. for the dependent variables when comparing the control and The aromatic spray was used externally,by inhalation (see intervention groups. Table 1). 3.Result 2.3.Procedure.The study took place at community elderly There were 44 participants in the intervention group (37 centres in a local area.The community elderly centres were females and 7 males)and 38 in the control group (30 females similar.A baseline assessment before the intervention was and 8 males),for a total of 82 participants in the study. conducted using a questionnaire to collect data on the demographics of the participants and their pain,depression, anxiety,and stress levels.The Geriatric Pain Assessment was 3.1.Demographic Data:Intervention Group versus Control adopted for assessing pain [38].The questionnaire included Group.Of the participants,27.3%and 34.2%were aged over 76 to 80 in the intervention and control groups,respectively. questions on pain measured using a 10-point scale,factors There was no significant difference in gender,age,marital that might alleviate and exacerbate the pain,and any activities that needed to be avoided in relation to the pain.The status,education level,personal health history,living status, Depression,Anxiety,and Stress Scale (DASS-21)was used financial status,and previous occupation (P 0.05)(see Table 2). to measure the negative emotional status of depression, anxiety,and stress [39].A total of 21 items were included in the questionnaire,with seven items in each subscale of 3.2.Pain Scores and Pain Sites:Baseline and Post-Intervention depression,anxiety,and stress.The negative emotional status Assessments.All of the participants from both groups had of depression,anxiety,and stress were graded as follows: had chronic pain for more than 3 months.They had different normal,mild,moderate,severe,and very severe.A postin- patterns and frequency of pain.No significant difference was tervention assessment was conducted after the conclusion of found when comparing the pain situations of the two older the four-week aromatherapy programme. groups at the baseline and postintervention assessments (P 0.05)(see Table 3). At the baseline,the pain score of the intervention group 2.4.Data Analysis.The Statistical Package for Social Science, was 4.75(SD 2.32)and that of the control group was 5.24(SD SPSS for Windows version 17.0,was used for the quantitative 2.14).After the aromatherapy programme,the pain score of data analysis.P<0.05 was considered the level of statistical the intervention group had decreased to 4.66(SD 2.56).In significance.The Chi-square test was used to measure the the control group,the pain score was 4.79(SD 2.19)at the demographic data of the control and intervention groups. postintervention assessment.No significant difference was The dependent variables were pain,depression,anxiety,and found in the between-group and within-group comparisons stress.The Wilcoxon's signed ranks test was used to examine (see Table 4). the dependent variables and compare the baseline data to the The most common sites of pain for the older persons at postintervention data.The Mann-Whitney U Test was used the baseline and postintervention assessments were the kneesBioMed Research International 3 Table 1: Interventions of the aromatherapy programme. Week Teaching content (40 minutes) Activity (20 minutes) Self-administered aromatherapy 1 (i) Introduction to pain: mechanism, assessment, effects of pain on physical and psychological health, pharmacological and nonpharmacological approaches (ii) Aromatherapy: introduction, history, and indications (iii) Deep breathing exercises: introduction and theory Practical session on deep breathing exercises and aromatherapy (i) Carried out at home by older persons (ii) Aromatic spray given with education on use and precautions 2 Introducing different types of essential oils and uses, indications for usage Practical session on deep breathing exercises and aromatherapy 3 Demonstration of how to make an aromatherapy toolbox (i) Odour testing game (ii) Practical session on deep breathing exercises and aromatherapy 4 Making an aroma decoration—a towel rabbit (i) Practical session on deep breathing exercises and aromatherapy (ii) Drinking of fruit tea the participants knew how to use the aromatic spray correctly. The aromatic spray was used externally, by inhalation (see Table 1). 2.3. Procedure. The study took place at community elderly centres in a local area. The community elderly centres were similar. A baseline assessment before the intervention was conducted using a questionnaire to collect data on the demographics of the participants and their pain, depression, anxiety, and stress levels. The Geriatric Pain Assessment was adopted for assessing pain [38]. The questionnaire included questions on pain measured using a 10-point scale, factors that might alleviate and exacerbate the pain, and any activities that needed to be avoided in relation to the pain. The Depression, Anxiety, and Stress Scale (DASS-21) was used to measure the negative emotional status of depression, anxiety, and stress [39]. A total of 21 items were included in the questionnaire, with seven items in each subscale of depression, anxiety, and stress. The negative emotional status of depression, anxiety, and stress were graded as follows: normal, mild, moderate, severe, and very severe. A postin￾tervention assessment was conducted after the conclusion of the four-week aromatherapy programme. 2.4. Data Analysis. The Statistical Package for Social Science, SPSS for Windows version 17.0, was used for the quantitative data analysis. 𝑃 < 0.05 was considered the level of statistical significance. The Chi-square test was used to measure the demographic data of the control and intervention groups. The dependent variables were pain, depression, anxiety, and stress. The Wilcoxon’s signed ranks test was used to examine the dependent variables and compare the baseline data to the postintervention data. The Mann-Whitney 𝑈 Test was used for the dependent variables when comparing the control and intervention groups. 3. Result There were 44 participants in the intervention group (37 females and 7 males) and 38 in the control group (30 females and 8 males), for a total of 82 participants in the study. 3.1. Demographic Data: Intervention Group versus Control Group. Of the participants, 27.3% and 34.2% were aged over 76 to 80 in the intervention and control groups, respectively. There was no significant difference in gender, age, marital status, education level, personal health history, living status, financial status, and previous occupation (𝑃 > 0.05) (see Table 2). 3.2. Pain Scores and Pain Sites: Baseline and Post-Intervention Assessments. All of the participants from both groups had had chronic pain for more than 3 months. They had different patterns and frequency of pain. No significant difference was found when comparing the pain situations of the two older groups at the baseline and postintervention assessments (𝑃 > 0.05) (see Table 3). At the baseline, the pain score of the intervention group was 4.75 (SD 2.32) and that of the control group was 5.24 (SD 2.14). After the aromatherapy programme, the pain score of the intervention group had decreased to 4.66 (SD 2.56). In the control group, the pain score was 4.79 (SD 2.19) at the postintervention assessment. No significant difference was found in the between-group and within-group comparisons (see Table 4). The most common sites of pain for the older persons at the baseline and postintervention assessments were the knees