Heart Rate Variability Biofeedback (HRVB) has been widely used to improve cardiovascular health and well-being. HRVB is based on breathing at an individual’s resonance frequency, which stimulates respiratory sinus arrhythmia (RSA) and the baroreflex. There is, however, no methodological consensus on how to apply HRVB, while details about the protocol used are often not well reported. Thus, the objectives of this systematic review are to describe the different HRVB protocols and detect methodological concerns. PsycINFO, CINALH, Medline and Web of Science were searched between 2000 and April 2021. Data extraction and quality assessment were based on PRISMA guidelines. A total of 143 studies were finally included from any scientific field and any type of sample. Three protocols for HRVB were found: (i) “Optimal RF” (n = 37), each participant breathes at their previously detected RF; (ii) “Individual RF” (n = 48), each participant follows a biofeedback device that shows the optimal breathing rate based on cardiovascular data in real time, and (iii) “Preset-pace RF” (n = 51), all participants breathe at the same rate rate, usually 6 breaths/minute. In addition, we found several methodological differences for applying HRVB in terms of number of weeks, duration of breathing or combination of laboratory and home sessions. Remarkably, almost 2/3 of the studies did not report enough information to replicate the HRVB protocol in terms of breathing duration, inhalation/exhalation ratio, breathing control or body position. Methodological guidelines and a checklist are proposed to enhance the methodological quality of future HRVB studies and increase the information reported.

Objective This meta-review aims to discuss the methodological, research and practical applications of tools that assess the measurement properties of instruments evaluating health-related quality of life (HRQoL) that have been reported in systematic reviews. Design Meta-review. Methods Electronic search from January 2008 to May 2020 was carried out on PubMed, CINAHL, PsycINFO, SCOPUS, WoS, Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) database, Google Scholar and ProQuest Dissertations and Theses. Results A total of 246 systematic reviews were assessed. Concerning the quality of the review process, some methodological shortcomings were found, such as poor compliance with reporting or methodological guidelines. Regarding the procedures to assess the quality of measurement properties, 164 (66.6%) of reviewers applied one tool at least. Tool format and structure differed across standards or scientific traditions (ie, psychology, medicine and economics), but most assess both measurement properties and the usability of instruments. As far as the results and conclusions of systematic reviews are concerned, only 68 (27.5%) linked the intended use of the instrument to specific measurement properties (eg, evaluative use to responsiveness). Conclusions The reporting and methodological quality of reviews have increased over time, but there is still room for improvement regarding adherence to guidelines. The COSMIN would be the most widespread and comprehensive tool to assess both the risk of bias of primary studies, and the measurement properties of HRQoL instruments for evaluative purposes. Our analysis of other assessment tools and measurement standards can serve as a starting point for future lines of work on the COSMIN tool, such as considering a more comprehensive evaluation of feasibility, including burden and fairness; expanding its scope for measurement instruments with a different use than evaluative; and improving its assessment of the risk of bias of primary studies. PROSPERO registration number CRD42017065232.

Aim: To analyse the psychometric properties and the utility of instruments used to measure patient comfort, physical, social, psychospiritual and/or environmental, during hospitalization.Background: There are no systematic reviews nor psychometric reviews of instruments used to measure comfort, which is considered an indicator of quality in health care associated with quicker discharges, increased patient satisfaction and better cost–benefit ratios for the institution.Design: Psychometric review.Data sources: MEDLINE, CINAHL, PsycINFO, Web of Knowledge, ProQuest Thesis&Dissertations, Google.Review methods: We limited our search to studies published between 1990‐2015. The psychometric analysis was performed using the COnsensus‐based Standards for the selection of health status Measurement INstruments (COSMIN), along with the Quality Criteria for Measurement Properties. The utility of the instruments was assessed according to their cost‐efficiency, acceptability and educational impact. Protocol registration in PROSPERO, CRD42016036290.Results: Instruments reviewed showed moderate methodological quality and their utility was poorly reported. Thus, we cannot recommend any questionnaire without reservations, but the Comfort Scale, the General Comfort Questionnaire and their adaptations in adults and older patients, the Psychosocial Comfort Scale and the Incomfort des Patients de Reanimation are the most recommendable instruments to measure comfort.Conclusions: The methodology of the studies should be more rigorous and authors should adequately report the utility of instruments. This review provides a strategy to select the most suitable instrument to assess patient comfort according to their psychometric properties and utility, which is crucial for nurses, clinicians, researchers and institutions.

The European Higher Education Area (EHEA) proposes to enhance active learning and student protagonism in order to improve academic performance. In this sense, different methodologies are emerging to create scenarios for self-regulation of their learning. In this study the cooperative, collaborative and interdisciplinary learning methodologies were compared in Spanish universities. The main objectives were to evaluate their effects in higher education and to explore the relationship between perceived group cooperation and self-perceived ability to work in a group, differences between educational Spanish contexts, educational methodologies and gender. To this end, a quasi-experimental design was carried out. Data analysis included the descriptive metrics, correlations and analysis of variance to evaluate the differences among pedagogical methods, their effects on cooperative learning, teamwork outcomes and gender differences, comprising a total of 229 students in Spain from Psychology, Early Childhood Education, Primary Education and Computer Engineering completed the two questionnaires. Results showed that the highest correlation between perceived cooperative activity and self-perceived ability to work in a group was found among computer science students, especially among women, suggesting that the interdisciplinary learning focused on software tool development may be the most effective methodology to improve teamwork and cooperative learning outcomes. Despite these findings concern only to Spanish universities, limiting the generalizability of results, the interdisciplinary methodology seems promising for improving both teaching quality and teamwork skills. The learning methodologies of interdisciplinary projects may therefore need to be implemented within the framework of cooperative and collaborative methodologies.