The Effects of Simple Inhalation using Mint (Mentha Piperita)

Aromatherapy on Decreased Shortness of Breath in Lung

Tuberculosis Patients

Siti Marlina, Novrika Silalahi, Septa Dwi Insani, Herri Novita Tarigan, Friska Ernita Sitorus

InstitutKesehatan DELI HUSADA Delitua

Alamat: JalanBesar No.77 Delitua Deli Serdang

Keyword: Mint Leaf, Shortness of Breath, and Tuberculosis.

Abstract: According to the World Health Organization (WHO), tuberculosis is a disease of global concern. Pulmonary

tuberculosis is estimated to still attack 9.6 million people and cause 1.2 million deaths in 2014. Pulmonary

TB symptoms that have similarities with other diseases are shortness of breath. Efforts to reduce shortness

of breath can use medical and non-medical drugs. One way that can reduce shortness of breath is by giving

the aroma of mint leaf therapy with a simple inhalation or evaporation method. The most important

ingredient in mint is menthol. Mint leaves contain 30-45% menthol, 17-35% menthone, 5-13% menthyl

acetate, 2-5% limonene and 2.5-4% neomenthol. This type of research is analytic observation research, with

case control design. The sampling technique in this study was consecutive sampling with a total of 29

respondents using the Wilcoxon statistical test. The results obtained p value 0.002 <(α) 0.05 then H0 is

rejected and H1 is accepted, which means that there is a simple inhalation effect using aromatherapy mint

leaves (menthapiperita) to decrease breathlessness in pulmonary tuberculosis patients. The results of this

study can provide input for nurses in providing services to patients with tuberculosis in the community that

the use of mint is one of the efforts to reduce shortness of breath without consuming pharmacological

therapy.

1 INTRODUCTION

According to WHO (World Health Organization,

2015), tuberculosis is a disease of global concern.

With the control efforts taken, the incidence of deaths

from tuberculosis has decreased, but pulmonary

tuberculosis is estimated to still attack 9.6 million

people and cause 1.2 million deaths in 2014.

Indonesia, India, and China are the countries with the

most pulmonary tuberculosis sufferers, respectively

10%, 23%, and 10% of all patients in the world.

According to the WHO Global Tubercolosis

Report (2016), it is estimated that Lung Tuberculosis

in Indonesia in 2015 amounted to 395 cases /

100,000 population, the death rate was 40 / 100,000

population. In Indonesia in 2016 the number of cases

of Pulmonary TB was 351,893 cases, an increase

compared to 2015 which was found at 330,729 cases

(Indonesian Ministry of Health, 2016). The

prevalence of pulmonary TB in Indonesia is grouped

into three regions namely Sumatra 33%, Java and

Bali 23% and Eastern Indonesia 44% (Departement

Of Health). North Sumatra is one of the provinces in

Indonesia where the TB incidence rate is quite high.

The definition of tuberculosis is a disease that can

be transmitted directly caused by TB germs, namely

Mycobacterium Tuberculosis. Diffusion of oxygen

will be disrupted due to the presence of nodules or

inflammation of the alveolar wall. If the attacked

lung expands, the cells will die and the lungs will

shrink. As a result, the patient's breath will be

breathless. Symptoms of shortness of breath are

found when the patient's lung parenchymal damage is

widespread. In mild pulmonary TB patients have not

felt any shortness of breath, shortness of breath

suffered will occur if the infiltration has reached half.

Pulmonary TB patients with symptoms experienced

like this need to be taught a simple method with the

method of evaporation or simple steam inhalation

which can be done at any time at home at their

respective homes.

According to Wahid (2013), complaints that are

felt by pulmonary TB patients vary or are also found

to be no complaints at all when a health check is

286

Marlina, S., Silalahi, N., Insani, S., Tarigan, H. and Sitorus, F.

The Effects of Simple Inhalation using Mint (Mentha Piperita) Aromatherapy on Decreased Shortness of Breath in Lung Tuberculosis Patients.

DOI: 10.5220/0009488402860292

In Proceedings of the International Conference on Health Informatics and Medical Application Technology (ICHIMAT 2019), pages 286-292

ISBN: 978-989-758-460-2

conducted. Pulmonary TB can also be called "the

great iminator" which is a disease that has many

similarities with other diseases that also give unclear

symptoms. The clinical picture of pulmonary TB is

divided into two groups namely respiratory

symptoms such as coughing up blood, shortness of

breath, coughing, chest pain. And systemic

symptoms include malaise, fever, weight loss.

Pulmonary TB is a disease that can be transmitted

through the air (airborne disease). TB germs are

spread from person to person through sputum sprays

(droplets) when active pulmonary TB sufferers

cough, sneeze, talk or laugh. TB germs die quickly

with direct sunlight, but can survive several hours in

a dark and damp place. In body tissues, these germs

can sleep for a long time (domaint) for several years

(RI Ministry of Health, 2012).

Pulmonary tuberculosis is a direct infectious

disease caused by TB (Mycobacterium Tuberculosis)

bacteria. Most TB germs attack the lungs but also

affect other organs (MOH, 2007). Factors that

influence the occurrence of pulmonary TB disease

include socioeconomic conditions, age, sex,

nutritional status and smoking habits. Although

smoking is not a major cause of pulmonary TB

disease, smoking can damage the pulmonary defense

mechanism thereby facilitating the entry of germs

such as TB germs.

Plus, the phenomenon of smoking in Indonesia is

still considered normal, even considered a lifestyle.

Smoking behavior is common for most Indonesian

people, especially adult men. In the last ten years,

cigarette consumption in Indonesia has increased by

44.1% and the number of smokers reaches 70% of

Indonesia's population. (Fatmawati, 2006).

Tuberculosis (TB), is a lung disease caused by the

attack of the bacterium Mycobacterium Tuberculosis.

Diffusion of oxygen will be disrupted due to the

presence of nodules or inflammation of the alveolar

wall. If the attacked lung expands, the cells will die

and the lungs will shrink. As a result, the patient's

breath will be breathless. Shortness of breath this

symptom is found when the damage to the lung

parenchyma sufferer has spread.

In mild pulmonary TB patients have not felt any

shortness of breath, shortness of breath suffered will

occur if the infiltration has reached half a part, in

pulmonary TB patients with symptoms experienced

like this need to be taught a simple way with the

method of evaporation or simple inhalation of steam

which when time can relapse can be done at their

respective homes. Boiled water vapors that are

inhaled to reduce shortness of breath usually use

natural ingredients such as mint leaves which will

produce menthol vapors for the inhalation process

(Yessie&Andra, 2013)

Efforts to reduce shortness of breath can use

medical drugs and use non-medical drugs. One way

that can reduce shortness of breath is by giving the

aroma of mint leaf therapy with a simple inhalation

or evaporation method. The most important

ingredient in mint is menthol. Mint leaves contain

30-45% menthol, 17-35% menthone, 5-13% menthyl

acetate, 2-5% limonene and 2.5-4% neomenthol

(Elshabrina, 2015). Mint leaves contain menthol so

they are often used as raw materials for cold

medicines (Jefry, 2014). The aroma of menthol found

in mint leaves has anti-inflammatory properties, so

that later it will open the respiratory tract.

In addition, mint leaves will also help treat

infections caused by bacterial attacks. Because mint

leaves have antibacterial properties. Mint leaves will

loosen the bronchi so that it will launch breathing.

To relieve breathing can be to inhale mint leaves

directly. Whereas a simple inhalation is to breathe

warm steam from boiling water mixed with

aromatherapy as a warmer, for example mint leaves.

Essential oil diffuser is a tool to convert essential oil

into small granules to then blend (spread / diffuse)

throughout the room.

In patients with pulmonary TB who experience

clinical symptoms is one of shortness of breath,

usually the patient's family panic in what ways to do

or reduce shortness of breath symptoms other than

using oxygen when at home with pulmonary TB

patients do not have oxygen equipment then these

patients need to be taught simple ways with a simple

evaporation or inhalation method.

The benefits of aromatherapy include overcoming

insomnia and depression, relieve anxiety, reduce

feelings of tension, improve the health and well-

being of the body, mind, and soul that are often

combined with alternative medical practices.

Aromatherapy does not only work when there is only

interference, but also can maintain the stability and

balance of the system contained in the body so that

the body becomes attractive. Therefore,

aromatherapy is a holistic treatment to balance all

bodily functions used was the American Thoracic

Sosiety (ATS) shortness of breath scale, using an

observation sheet. While the independent variable

instrument uses a diffuser, and is carried out only in

the treatment group. Simple inhalation research

procedure using aromatherapy of mint leaves

(menthapiperita) to reduce shortness of breath in

pulmonary tuberculosis patients the data collected

must first apply for a research permit at the Pon

Village Health Center in Sei Bamban District.

The Effects of Simple Inhalation using Mint (Mentha Piperita) Aromatherapy on Decreased Shortness of Breath in Lung Tuberculosis

Patients

287

After obtaining permission, data collection is

carried out by first explaining to respondents about

the objectives and benefits as well as the procedures

for conducting research, ask respondents to sign an

informed consent. Taking data in this study is an

observation sheet. For respondents, the technique of

giving mint aroma therapy with a simple inhalation

or using a diffuser is done by inserting into the

device 2-3 drops of essential oil containing mint

leaves for 3 times a day within 15 minutes in 1 week

is placed not far from the patient approximately

effective for inhalation.

2 RESEARCH METHODS

The type of research design used is Pre

Experimental with the design of One Pretest-Posttest

Design Group, namely the type of research that aims

to determine the effect of an action on the group

before training (pretest) and handling (posttest).

The sampling technique in this study was

consecutive sampling of 29 respondents. This study

aims to discuss how to use mint leaf aromatherapy

(menthapiperita) to reduce shortness of breath in

pulmonary tuberculosis patients in Puskesmas Desa

Pon, Sei Bamban District. In the dependent variable,

the measuring instrument used is the American

Thoracic Sosiety (ATS) shortness of breath scale,

using an observation sheet. While the independent

variable instrument uses a diffuser tool, and is

carried out only on the manager group.

Simple inhalation research procedure using mint

leaf aromatherapy (menthapiperita) for reduction of

shortness of breath in pulmonary tuberculosis

patients, data collected in advance apply for

permission to conduct research at Puskesmas Desa

Desa Pon Desa Sei Bamban District.

After obtaining permission, data collection is

carried out by first explaining to the respondent the

purpose and benefits and procedures for conducting

research, asking respondents to sign informed

consent.

Retrieval of data in this study is the observation

sheet. For respondents, the therapeutic treatment of

mint leaves with a simple inhalation or using a

diffuser is done by inserting into the device 2-3

drops of essential oil containing mint leaves for 3

times a day within 15 minutes in 1 week placed not

far from the patient which is roughly effective for

inhalation.

Planning

Apply for permission

research implementation

on Health Center

Data collection

Signed informed

consent.

Explain the benefits,

objectives, research procedures

The Technique of giving mint

aroma therapy to respondents

Action implementation

By Simple inhalation or

method using a diffuser tool

Put in put the tool 2-3 drops of

essential oil containing mint leaves

Put in For 3 times a day

within 15 minutes

Whitin 1 week placed not far from

the patient which is roughly

effective for inhalation

Figure 1: Flowchart of the Research.

ICHIMAT 2019 - International Conference on Health Informatics and Medical Application Technology

288

Figure 2: Image of a diffuser tool and how to open it.

Figure 3: The stage of using a diffuser.

3 RESULT

The results of observations of research respondents

before being given treatment are known to show

their breath short and short of breath and the use of

The Effects of Simple Inhalation using Mint (Mentha Piperita) Aromatherapy on Decreased Shortness of Breath in Lung Tuberculosis

Patients

289

respiratory muscles in respondents who are too short

of breath when leaving the house or take off and

dress or shortness of breath with a very heavy

degree. Shortness of breath experienced by

respondents resulted in psychological changes such

as anxiety, fear and feeling very uncomfortable

because of the ineffectiveness of breathing patterns.

while shortness of breath.

In patients with pulmonary tuberculosis that are

not treated immediately, the impact will be caused

by the extent of lung parenchymal damage and can

cause several complications. Given the severity of

lung parenchymal damage and complications that

will occur, patients should be treated to treat

shortness of breath. With this treatment it is hoped

that it will reduce the shortness of breath.

Based on the univariate table below, it can be

seen that in the pre-test or before the administration

of simple inhalation using mint leaf aromatherapy

(menthapiperita) to decrease breathlessness in

pulmonary tuberculosis patients, it shows that the

number of respondents before being carried out in

the experimental group found that most experienced

shortness of breath with a degree of severe shortness

of breath that is as many as 14 respondents or

around 48.3% and minor minorities as many as 3

people or around 10.3%, in the post-test majority of

minor people as many as 16 people or around 55.2%

and severe minority 1 person or around 3.4%.

Table 1: Pre_Test and Post_Test Data Distribution in the

Treatment Group of Lung Tuberculosis Patients.

Based on the table above after simple inhalation

administration using mint leaf aromatherapy for

decreased breathlessness in pulmonary tuberculosis

patients, showed that of the 29 respondents in the

experimental group it was found that most of them

experienced mild shortness of breath scale values of

16 respondents, with very heavy degrees of 4

respondents, with a moderate degree of 8

respondents, and those who experienced a severe

degree of 1 respondent.

There is a difference in the value of the shortness

of breath scale before being given a simple

inhalation and after being given a simple inhalation

using mint aromatherapy (MenthaPiperita). Simple

inhalation is a steam of warm water from boiling

water that has been mixed with aromatherapy as a

warmer, for example mint leaves.

After being given a simple inhalation using mint

leaf aromatherapy (menthapiperita) in the

experimental group, the respondent showed that

their breathing was not wheezing because the aroma

of menthol found in mint leaves has anti-

inflammatory properties, so it will open the

respiratory tract.

Table 2: The Influence of Simple Inhalation Using Mint

(MenthaPiperita) Aromatherapy Against Decreased

Shortness of Breath in Lung Tuberculosis Patients in

Puskesmas DesaDesaPon District of SeiBamban in 2019.

Pre Post Pre Post Pre Post

Mild Mild 3 16 10,3 55.2

Moderate Moderate 8 8 27.6 27.6

Heavy Heavy 14 1 48.3 3.4

Intense Intense

Heavy Heavy

Total Total 29 29 100 100

Shortness Of breath

Frequency

Percentage %

13.8

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290

Evidence:

Pre-Post Test:

1. Mild

2. Moderate

3. Heavy

4. Intense

Gender:

1. Male

2. Female

Occupation:

1. Farmer

2. Government

Employees

3. Entrepreuner

Age:

1. 26 Old- 30 Old

2. 31 Old- 35 Old

3. 36 Old- 40 Old

4. > 40 Old

Chart 1: Distribution of Pre_Test and Post_Test Datain

Groups Treatment of patients Lung Tuberculosis.

The Wilcoxon Test results show aromatherapy of

mint leaves (menthapiperita) on decreased

breathlessness in pulmonary tuberculosis patients in

the treatment group shows that H0 is rejected and

H1 is accepted, meaning that there is a significant

effect of decrease in shortness of breath in the

experimental group between before and after

intervention.

In the experimental group before being given a

simple inhalation using mint leaves aromatherapy

obtained a mild degree of 3 respondents, a heavy

degree of 14 respondents, a moderate degree of 8

respondents, and a very heavy degree of 4

respondents. Then after being given a simple

inhalation using aromatherapy mint leaves, 16

respondents experienced mild shortness of breath, 1

respondent with severe degree, 8 respondents with

moderate degree, 4 respondents with very severe

degree.

4 CONCLUSIONS

Shortness of breath scale values before being given a

simple inhalation using mint leaf aromatherapy in

the experimental group found 14 respondents

experienced shortness of breath with a severe

degree. Whereas in the dick group, it was found that

6 respondents experienced shortness of breath with a

very heavy degree. Shortness of breath scale value

after being given a simple inhalation using mint leaf

aromatherapy in the experimental group found 4

respondents experienced severe shortness of breath.

Whereas in the dick group, it was found that 6

respondents experienced shortness of breath with a

very heavy degree.

From the Wilcoxon Test results showed a simple

inhalation effect using aromatherapy of mint leaves

(menthapiperita), the technique of giving mint

aroma therapy with a simple inhalation or using a

diffuser device is done by inserting into the tool 2-3

drops of essential oil containing mint leaves for 3

times a day within 15 minutes a week is placed not

far from the patient which is approximately effective

for inhaled against decreased breathlessness in

patients with pulmonary tuberculosis .

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