Recommendations

The literature demonstrates that there are areas where there is evidence of the efficacy of aromatherapy and massage. This includes areas that benefit the sick child in the community. The areas that lack evidence do not necessarily point to a lack of efficacy, merely that more research is needed to provide a research base for practice. The complex nature of the therapies and the need to consider potential for harm has led me to conclude that minimum standards for training need to be implemented nationally and that managers must ensure issues such as safety and liability are covered before service implementation. One approach could be for nurses who are prescribing essential oils to undertake a form of nurse prescribing training.

There are implications in terms of cost and time to introducing this kind of service, but the benefits in terms of life quality for children with special needs or terminal illness raises the question of the ethics of not having treatments available that have proven beneficial. Other ethical issues will also need considering, such as equity of service provision and informed consent by the children, particularly those with communication problems. Issues of culture and diversity would also need addressing.

Conclusions

The breadth of evidence of the effectiveness of aromatherapy and massage is such that it is worthwhile facing the many challenges that successful service implementation will require. While realising that resources and service priorities may make this low down on a manager's list of priorities compared with other service needs, I would argue that there is evidence that children's nurses could usefully include these therapies within their practice for the benefit of the child and family. My recommendations for future practice would be to acknowledge and face the challenges to enable this service to develop, particularly within community children's nursing. I would specifically recommend the post of specialist practitioner in aromatherapy and massage in any team implementing this service to ensure that practice is research based, limitations are acknowledged and the necessary further research is undertaken.

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