Evidence map›Paper›PMID 41918582›Full record

SynthesisFrontiers in psychiatry2026

Enhancing wellness: a systematic review of biofeedback interventions for healthcare professionals.

Elisa Cantone, Antonio Urban, Alessandra Perra, Giulia Cossu, Massimo Tusconi, Serdar M Dursun, Mauro Giovanni Carta

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Elisa CantonePhD Course Capacities Building for Global Health, University of Cagliari, Cagliari, Italy.
Antonio UrbanPhD Course Capacities Building for Global Health, University of Cagliari, Cagliari, Italy.
Alessandra PerraDepartment of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Giulia CossuDepartment of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Massimo TusconiUniversity Hospital of Cagliari, Cagliari, Italy.
Serdar M DursunNeurochemical Research Unit, Department of Psychiatry University of Alberta, Edmonton, AB, Canada.
Mauro Giovanni CartaDepartment of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background/objectives: Healthcare professionals are routinely exposed to high psychosocial and physiological demands, placing them at elevated risk for stress-related disorders, including burnout, anxiety, and impaired autonomic regulation. Biofeedback has emerged as a promising non-pharmacological approach to enhance self-regulation and resilience. This systematic review aimed to evaluate the effectiveness of biofeedback-based interventions in improving psychological and physiological outcomes among healthcare workers. Methods: A systematic search was conducted across PubMed, Cochrane, Embase, PsycINFO, and grey literature (December 2023-January 2024), following PRISMA guidelines and a registered PROSPERO protocol (CRD42024544687). Eligible studies included randomized controlled trials, quasi-experimental designs, and pre-post studies involving adult healthcare workers exposed to work-related stress. Primary outcomes comprised stress, burnout, anxiety, depression, resilience, and physiological indices such as heart rate variability (HRV), respiratory rate, and skin conductance. Data were synthesized narratively due to methodological heterogeneity. Twelve studies met inclusion criteria. HRV-biofeedback and respiratory sinus arrhythmia training demonstrated. Results: consistent improvements in perceived stress, anxiety, depressive symptoms, emotional regulation, and resilience. Physiological benefits included increased HRV, decreased sympathetic arousal, and improved autonomic balance. Interventions integrating breathing or mindfulness techniques exhibited the strongest effects. However, non-randomized designs and small samples limited the robustness of findings. Discussion/Conclusions: Biofeedback represents a feasible and potentially effective strategy for mitigating occupational stress and enhancing psychophysiological well-being in healthcare professionals. Despite promising results, evidence remains preliminary due to heterogeneity, limited methodological rigor, and scarce long-term follow-up. Future large-scale randomized trials with standardized protocols are needed to strengthen the evidence base and support implementation in occupational health settings. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024544687.

Indexed as

biofeedbackhealthcare professionalsself-regulationwell-beingwork-related stress

Identifiers

PMID41918582
PMCPMC13033714

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.