Table 3. Non-pharmacological Intervention .
| Study ID | Authors & Year of Publication | Study Design | Sample Size & Groups | Intervention | Duration of Intervention | Tools | Results & Conclusion | Difference in Percentage/ Mean/Median Between Groups at the Final Measurement |
|---|---|---|---|---|---|---|---|---|
| 1 | Ezati-Soleiman et al22 | randomized clinical trial | Sample Size: n = 90 Lavender Essential Oil Group: n = 30 Placebo Group: n = 30 Acetaminophen Group: n = 30 |
Inhalation of Lavender (Three Drops) | Lavender Group: Inhalation of three drops of lavender essential oil on a cotton gauze 15 minutes before nitroglycerin IV infusion Control Group: routine care for headaches caused by nitroglycerin. This involved the administration of 500 mg of acetaminophen following the nitroglycerin infusion whenever the patient reported experiencing a headache. Acetaminophen Group: 500 mg of oral acetaminophen about 15 minutes prior to starting the IV nitroglycerin infusion. |
Visual Analog Scale (VAS) | At the 60-minute mark, the average headache intensity was 1.37 ± 1.10 in the lavender group and 2.50 ± 2.43 in the control group, whereas no headaches were reported in the acetaminophen group. Headache severity showed significant variation throughout the intervention minutes among the three groups (P < 0.001). |
Difference in the median headache scores between the lavender and control groups 60 minutes after the intervention: 1.63 |
| 2 | Uğurlu & Enc9 | Pretest-Posttest Without Control Group | Sample Size: n = 70 Group 1: n = 35 Group 2: n = 35 |
Cold Compress (Forehead) | Group 1: Application of a local cold compress for the first 20 minutes of NTG infusion Group 2: Application of a local cold compress for 20 minutes in patients experiencing a headache after NTG infusion (no cold compress applied at the start of the infusion) |
Visual Analog Scale (VAS) | Patients in the intervention group had significantly lower VAS scores before (5.75) and after (2.00) using the the cold compress (P = 0.000). The application of a local cold compress at the start of NTG infusion has a pain prophylactic role and reduces headache intensity in patients experiencing NTG-induced headaches. |
Difference in headache occurrence percentage between the groups after 12 hours: 27.5% |
| 3 | Fatai et al32 | Randomized Clinical Trial | Sample Size: n = 60 Intervention Group: n = 30 Control Group: n = 30 |
Foot Reflexology using the Ingham method on both feet. Control Group: Superficial Foot Touch |
intervention lasted 10 minutes (5 minutes per foot) and was followed by a second 10-minute reflexology intervention after a 15-minute interval. | McGill Pain Questionnaire Short-Form (MPQ-SF) | There was a significant difference after the intervention between the two groups (P < 0.001). Foot reflexology is a feasible intervention for reducing headaches in patients receiving NTG infusion and is associated with headache improvement. |
Difference in mean headache scores between the two groups after the second intervention (after 35 minutes): 5.43 |
| 4 | Imani et al36 | Randomized Clinical Trial | Sample Size: n = 75 Intervention Group: n = 25 Placebo Group: n = 25 Control Group: n = 25 |
Foot Reflexology using the Ingham method on both feet with the thumb of the right hand on the brain reflex points Placebo Group: an unrelated point on the heel (not associated with the brain) control group: did not receive any massage |
intervention lasted 20 minutes (10 minutes per foot) and was followed by a second 20-minute reflexology intervention after a 3 hours interval. | Numerical Rating Scale (NRS) | There was a significant difference among the three groups post-intervention (P = 0.000). Reflexology massage can reduce the intensity of NTG-induced headaches |
Pairwise comparisons of differences in the mean headache score between the three groups after the second intervention (after 3 hours and 40 minutes): Reflexology vs. Placebo: 3.4 Intervention vs. Control: 4.2 Placebo vs. Control: 0.8 |
| 5 | Zarifnejad et al14 | Clinical Trial | Sample Size: n = 135 Lavender Essential Oil Group: n = 45 Placebo Group: n = 45 Acetaminophen Group: n = 45 |
Inhalation of Lavender (Three Drops) | Lavender/placebo Group: Inhalation of three drops of lavender essential oil/ placebo on a cotton ball for 30 minutes Acetaminophen Group: Administration of a single dose of 325 mg acetaminophen tablet |
Visual Analog Scale (VAS) | Pairwise comparisons revealed a significant reduction in headache in the lavender group compared to the acetaminophen group (P = 0.001) and in the acetaminophen group compared to the placebo group (P = 0.001). Aromatherapy with lavender essential oil may effectively reduce headaches in patients receiving NTG infusion. |
Difference in the median headache scores between the lavender and placebo groups 60 minutes after the intervention: 4.4 |