The Effect of Aromatherapy with the Scent of Moist Soil on Anxiety and Concentration

INTERVENTION: Intervention 1: Intervention group: Participants in the intervention group are exposed to aromatherapy with the smell of moist soil before the examination. For this purpose a specified amount of moist soil scent extract is placed on a sterile absorbent pad positioned approximately 30 centimeters from the participant allowing the aroma to be inhaled naturally. The intervention is performed in a quiet and controlled environment for 10 minutes prior to the beginning of the examination. Participants remain seated and breathe normally during the exposure period. Intervention 2: Control group: Participants in the control group are exposed to a neutral smelling solution that is used as a placebo before the examination. For this purpose a specified amount of an inactive odorless solution is placed on a sterile absorbent pad positioned approximately 30 centimeters from the participant. The intervention is performed in a quiet and controlled environment for 10 minutes prior to the beginning of the examination. Participants remain seated and breathe normally during the exposure period. The environmental conditions, duration of exposure and procedure are identical to the intervention group and the only difference is the absence of the moist soil smell in the solution used for the control group. CONDITION: Condition 1: Generalized anxiety disorder. Condition 2: Adjustment disorders. ; Generalized anxiety disorder ; Adjustment disorders F41.1 F43.2 PRIMARY OUTCOME: Exam anxiety intensity measured using the Visual Analogue Scale for anxiety severity (VAS). Timepoint: Measured at two time points including before the intervention and immediately after the exam. Method of measurement: Visual Analogue Scale consisting of a 10 centimeter line on which the participant marks the perceived anxiety level ranging from zero meaning no anxiety to ten meaning the worst imaginable anxiety. Exam anxiety score according to the Depression, Anxiety and Stress Scale consisting of 21 items (DASS‐21) questionnaire. Timepoint: Measured at two time points including before the intervention and immediately after the exam. Method of measurement: Depression, Anxiety and Stress Scale consisting of 21 items with calculation of the anxiety subscale score. SECONDARY OUTCOME: Students academic performance score in the written course examination. Timepoint: The examination score at the end of the test. Method of measurement: Recording the written examination score of students according to the official university grading system. Students heart rate as a physiological indicator of stress. Timepoint: Measured at two time points including before the intervention and immediately after the examination. Method of measurement: Digital heart rate monitoring device. Students systolic and diastolic blood pressure as a physiological indicator of stress. Timepoint: Measured at two time points including before the intervention and immediately after the examination. Method of measurement: Digital blood pressure monitoring device. INCLUSION CRITERIA: Pharmacy students currently enrolled at the School of Pharmacy of Mashhad University of Medical Sciences Age between 20 and 40 years Participation in the specified pharmacotherapy course examination during the current semester Willingness to participate in the study and signing the written informed consent