Exploring the long-term effects of HRV biofeedback interventions combined with mindfulness practices in alleviating workplace stress among Asian professionals

Abstract

Workplace stress constitutes a significant public health concern in high-performance economies, with particular salience in Hong Kong's demanding professional environment. Heart rate variability (HRV) has emerged as a validated psychophysiological biomarker for autonomic nervous system regulation and stress reactivity [1] while mindfulness-based interventions have demonstrated independent efficacy in promoting emotional regulation and psychological resilience. Despite the theoretical complementarity of these approaches, their combined application — and particularly their long-term effects — remains insufficiently investigated, especially within Asian professional populations where cultural factors may meaningfully shape stress appraisal and coping behavior. This study employed a mixed-methods, two-group parallel design to evaluate the efficacy of HRV biofeedback alone versus HRV biofeedback combined with structured mindfulness practices in reducing workplace stress among 100 Hong Kong professionals aged 25–50. Participants completed an 8-week intervention protocol with assessments at baseline, post-intervention, and 6-month follow-up. Outcome measures included time-domain and frequency-domain HRV parameters (SDNN, RMSSD, normalized coherence), self-reported stress via the Perceived Stress Scale (PSS) and Personal and Organizational Quality Assessment (POQA), cardiovascular health markers, and qualitative data on cultural attitudes toward stress and coping. Results demonstrated significant improvements in HRV parameters and perceived stress across both groups, with the combined intervention group exhibiting substantially greater gains and superior maintenance of benefits at 6-month follow-up. Qualitative findings identified emotional suppression as a culturally embedded barrier to stress regulation among Asian professionals — a pattern previously documented in Hong Kong organizational research [2]— with mindfulness practices offering a culturally congruent pathway to enhanced emotional awareness. These findings support the integration of physiologically grounded and psychologically informed interventions in workplace wellness programming, with implications for organizational policy and culturally adapted clinical practice.