Purpose: Although lavender is purported to possess anxiolytic and sedative properties and is often recommended for relieving anxiety, the efficacy of lavender has not been well established. Thus, this review aimed to evaluate the anxiolytic effects of lavender aromatherapy. Methods: Ten data bases were searched for studies published between 2000 and 2018. Randomized controlled trials investigating the anxiolytic effects of lavender aromatherapy with any type of application for persons with or without clinical anxiety were included. The outcome variables included selfrated anxiety, vital signs, and salivary cortisol and chromogranin A (CgA) levels. In the meta-analysis, standardized mean difference and 95% confidence interval were calculated as effect measures by applying the random effect model and inverse variance method. Results: Twenty-two trials met our inclusion criteria. Lavender aromatherapy was found to have favorable effects in relieving anxiety (Hedges'ĝ ¼ À0.65; 95% CI, À0.84 to À0.46) and decreasing systolic blood pressure (ĝ ¼ À0.22; 95% CI, À0.43 to À0.02), heart rate (ĝ ¼ À0.53; 95% CI, À0.74 to À0.32), and salivary cortisol (ĝ ¼ À1.29; 95% CI, À2.23 to À0.35) and CgA (ĝ ¼ À2.29; 95% CI, À3.24 to À1.34) levels. However, the meta-analysis did not reveal any significant effects of lavender on diastolic blood pressure (effect size: À0.17; 95% CI, À0.37e0.04). Conclusion: Aromatherapy using lavender oil might have favorable effects on anxiety and its physiological manifestations. Future studies are recommended with an emphasis on methodological quality. In nursing practice, it is suggested that lavender aromatherapy be included in programs intended to manage anxiety in patients across diverse healthcare settings.

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Purpose: The purpose of this study was to obtain a more comprehensive understanding of critical thinking within the clinical nursing context. In this review, we addressed the following specific research questions: what are the levels of critical thinking among clinical nurses?; what are the antecedents of critical thinking?; and what are the consequences of critical thinking? Methods: A narrative literature review was applied in this study. Thirteen articles published from July 2013 to December 2019 were appraised since the most recent scoping review on critical thinking among nurses was conducted from January 1999 to June 2013.Results: The levels of critical thinking among clinical nurses were moderate or high. Regarding the antecedents of critical thinking, the influence of sociodemographic variables on critical thinking was inconsistent, with the exception that levels of critical thinking differed according to years of work experience. Finally, little research has been conducted on the consequences of critical thinking and related factors.Conclusion: The above findings highlight the levels, antecedents, and consequences of critical thinking among clinical nurses in various settings. Considering the significant association between years of work experience and critical thinking capability, it may be effective for organizations to deliver tailored education programs on critical thinking for nurses according to their years of work experience.

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