Effects of Stepwise Combined Biofeedback Training on Attention and Self-control of High School Students Based on the Reflection and Reflexion Model

Purpose: To investigate effects of a stepwise combined biofeedback training program (SCBT) including physiological response-focused training and brainwave change-focused training based on the Reflection and Reflexion model on attention and self-control of male high school students. Methods: This research employed a non-equivalent control group pretest-posttest design. A total of 54 students from two cities in South Korea were divided into experimental, comparison, and control groups. The training consisted of ten sessions over five weeks. The experimental group participated in the SCBT, while the comparison group only engaged in physiological response-focused training. Physiological attention rate and span were used in this study to quantify attention. These measures were calculated using physiological responses. Self-control was assessed using a self-report questionnaire and changes of brainwaves in the experimental group. Data were analyzed using the statistical software SPSS/WIN 25.0. Results: Physiological attention rate, physiological attention span, and self-control scores were significantly different across the three groups. Furthermore, in the experimental group, there was a significant increase in the mean amplitude of the alpha and SMR wave while high-beta waves exhibited a notable drop. Conclusion: The present study reveals that the SCBT can serve as a distinct nursing intervention to enhance attention and self-control among high school students.