Digital Biofeedback–Based Nursing Program for Improving Physiological Regulation, Anxiety, Sleep Quality, and SelfManagement among Patients with Heart Failure

Background: Heart failure is a complex chronic condition characterized by impaired cardiovascular function and persistent physiological stress, often accompanied by anxiety, poor sleep quality, and difficulties in maintaining effective self-management. Digital biofeedback may provide patients with real-time physiological information that supports relaxation, symptom awareness, behavioral regulation, and active participation in disease management. Aim: To evaluate the effect of a digital biofeedbackbased nursing program on physiological regulation, anxiety, sleep quality, and self-management among patients with heart failure. Subjects and Methods: A quasi-experimental one-group pretest–posttest design was used. A purposive sample of 100 adult patients diagnosed with heart failure was recruited from the cardiac and medical outpatient clinics of Sohag University Hospitals. Data were collected using a structured patient assessment questionnaire, a physiological regulation assessment, the Generalized Anxiety Disorder Scale (GAD-7), the Pittsburgh Sleep Quality Index (PSQI), and a heart failure self-management assessment scale. The nursing program incorporated digital biofeedbackassisted breathing and relaxation exercises, physiological monitoring, symptom recognition, medication and dietary adherence, sleep-management strategies, and individualized self-management education. The intervention was implemented through structured sessions with digital biofeedback Digital Biofeedback–Based Nursing Program for Improving Physiological Regulation, Anxiety, Sleep Quality, and Self-Management among Patients with Heart Failure practice and follow-up support. Results: Following implementation of the program, patients demonstrated significant improvement in physiological regulation, with greater ability to recognize and control physiological responses. Anxiety levels decreased significantly, while sleep quality improved. A significant improvement was also observed in patients’ self-management behaviors, including medication adherence, symptom monitoring, dietary and fluid management, physical activity, and appropriate responses to worsening symptoms. Significant differences were observed between pre- and post-intervention measurements (p < 0.001). Conclusion: The Digital Biofeedback–Based Nursing Program was effective in improving physiological regulation and reducing anxiety while enhancing sleep quality and self-management among patients with heart failure. Recommendations: Digital biofeedback should be incorporated into nursing-led heart failure management programs as a supportive strategy for physiological regulation, psychological well-being, sleep improvement, and long-term self-management.