Breathwork as a Complementary Therapy for Anxiety in the Context of Wellness Tourism in Bali : A Systematic Review
DOI:
https://doi.org/10.53366/jimki.v12i3.934Keywords:
breathwork, anxiety, complementary therapy, wellness tourism , BaliAbstract
Introduction: Anxiety is a natural response to stress which, when excessive, can lead to psychological disorders. Conventional therapies such as pharmacotherapy and psychotherapy have not fully addressed the complexity of anxiety symptoms, leading to the development of breathwork as a complementary therapy. This review aims to evaluate the effectiveness of breathwork in reducing anxiety and to explore its potential role in supporting the development of wellness tourism based on holistic health in Bali.
Method: This systematic review was conducted following the PRISMA guidelines through literature searches in PubMed, ScienceDirect, and Google Scholar databases. The included articles were original studies published between 2015 and 2025 that investigated the effectiveness of breathwork in reducing anxiety levels.
Discussion: Based on the analysis of twelve selected articles, breathwork was found to be a significant complementary therapy for reducing anxiety. These findings also highlight its potential to be developed within the context of wellness tourism in Bali through the integration of breathwork practices as part of holistic health programs emphasizing mind–body balance.
Conclusion: This review demonstrates that various forms of breathwork are consistently effective in reducing anxiety across different populations and hold potential for development within the framework of wellness tourism based on holistic health in Bali.
References
Ahmed A, Devi RG, Priya AJ. Effect of Box Breathing Technique on Lung Function Test. J Pharm Res Int. 2021;33(58A):25–31. doi:10.9734/JPRI/2021/v33i58A34085.
Aminoto T. Analisis pengaruh intervensi breathing exercise terhadap tingkat kecemasan siswa bimbingan belajar Sakura. J Bahan Kesehatan Masyarakat. 2018;2(1):57–60.
Aqwani N, Herawati I. Manfaat deep breathing exercise dalam menurunkan kecemasan pada lanjut usia. Universitas Muhammadiyah Surakarta; 2023.
Balban MY, Murat C, Dutt S, Yu L, Breazeal C, Nater UM, et al. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Rep Med. 2023;4(7):101097. doi:10.1016/j.xcrm.2023.101097
Banushi B, Brendle M, Ragnhildstveit A, Murphy T, Moore C, Egberts J, et al. Breathwork interventions for adults with clinically diagnosed anxiety disorders: a scoping review. Brain Sci. 2023;13(2):256. doi:10.3390/brainsci13020256.
Budiawan M, Widiastini NMA, Irwansyah MR. How can wellness tourism be developed in Buleleng Regency? J Tour Hosp Manag. 2020;8(1):59–68. doi:10.15640/jthm.v8n1a6.
Canals J, Voltas N, Hernández-Martínez C, et al. Prevalence of DSM-5 anxiety disorders, comorbidity, and persistence of symptoms in Spanish early adolescents. Eur Child Adolesc Psychiatry. 2019;28:131–43.
Dewi LP, Musmini LS. A Literature Review: Pengalaman dan Kepuasan Wisatawan Terhadap Niat Berkunjung Kembali ke Desa Wisata. J Manaj Perhotelan Pariwisata. 2023;6(2):700–703.
Domhardt M, Geßlein H, von Rezori RE, Baumeister H. Internet- and mobile-based interventions for anxiety disorders: A meta-analytic review of intervention components. Depress Anxiety. 2019 Mar;36(3):213–24.
Eghbali M, Ghalandari S, Rezaei M, Alimoradi Z, Shamsizadeh M, Barati F, et al. Effectiveness of deep breathing exercises on anxiety, depression, and sleep quality in patients undergoing coronary artery bypass graft surgery: a randomized controlled trial. Sci Rep. 2025;15(4127):1–9. doi:10.1038/s41598-025-57315-7.
Erawati NK, Sugandini W, Juliani M. Edukasi manajemen stres pada remaja di masa pandemi Covid-19. Surya Medika. 2023;18(1):1–7.
Fincham GW, Strauss C, Montero-Marin J, Cavanagh K. Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Sci Rep. 2023;13:432. doi:10.1038/s41598-022-27247-y.
Firmawati F, Nur Uyuun N, Rahayu S. Anxiety score in anxiety patients using slow deep breathing relaxation therapy. J La Medihealtico. 2024;5(5):1043–50. doi:10.37899/journallamedihealtico.v5i5.1568.
Hendrajana IGM R, Amir FL, Parwati KSM, Putra IPRD. Wellness Tourism as Future Alternative Tourism: Strategi Pengembangan Wellness Tourism di Kintamani. J Innov Res Knowl. 2024 Dec;4(7):5109–12.
Kusuma PN, Trianasari, Rahmawati PI. The use of social media as a water tourism destination promotional media at Banjar Hot Spring: digital marketing perspective. Int J Soc Sci Bus. 2022;6(2):282–88. doi:10.23887/ijssb.v6i2.44073.
Kusumah I, Widianti E, Salafi KA. Breathing exercises for anxiety management: a scoping review of the most recent RCTs. Southeast Asia Psychol J. 2022;10(2):111–13.
Magnon V, Dutheil F, Vallet GT. Benefits from deep and slow breathing on affective, cardiovascular, and respiratory responses during and after anger recall. Front Psychol. 2021;12:725–32.
Maleki A, Ravanbakhsh M, Saadat M, Bargard MS, Latifi SM. Effect of breathing exercises on respiratory indices and anxiety level in individuals with generalized anxiety disorder: a randomized double-blind clinical trial. J Phys Ther Sci. 2022;34(4):247–51.
Muderawan IW, Widiastuti Giri M, Budiawan I. The Potential of Ayurvedic Medicinal Plants for Prevention and Therapeutic Treatment of Covid-19: A Review Article. Int J Ayurvedic Herbal Med. 2021;11(2):3954–96.
Nurhidayah Usman, Widyastuti, Ridfah A. Efektivitas deep breathing relaxation terhadap penurunan tingkat kecemasan mahasiswa bimbingan skripsi. Makassar: Universitas Negeri Makassar; 2021.
Preti A, et al. The lifetime prevalence and impact of generalized anxiety disorders in an epidemiologic Italian national survey carried out by clinicians by means of semi-structured interviews. BMC Psychiatry. 2021;21(1):4–11.
Pristianto A, Tyas RH, Muflikha I, Ningsih AF, Vanath IL, Nashrillah F. Deep Breathing dan Butterfly Hug: Teknik Mengatasi Kecemasan pada Siswa MAN 2 Surakarta. Kontribusi: J Penelit Pengabdian Masyarakat. 2022;3(1):36–46. doi:10.53624/kontribusi.v3i1.127
Rahmawati NA, Qurrota A’yun AZ, Ma’rufah SA. Deep Breathing Exercise terhadap tingkat kecemasan pasien tuberkulosis di Kecamatan Dau. J Ilm Kesehatan (JIKA). 2024;6(1):122–28. doi:10.36590/jika.v6i1.564.
Sau A, Bhakta I. Screening of anxiety and depression among seafarers using machine learning technology. Informatics Med Unlocked. 2019;16:100225.
Sheikh S, Farooq F, Khan S, Bano S. The effect of guided breathing exercises on anxiety, stress, and depression in COVID-19 patients: A randomized controlled trial. J Pak Med Assoc. 2024;74(2):213–8.
Soen CC, Hardjasasmita IM, Ulitua AE. Generalized anxiety disorder: diagnosis and treatment. J Muara Medika Psikol Klin. 2021;1(2):133–38. doi:10.24912/jmmpk.v1i2.14865
Suendra IM. Pengaruh slow deep breathing terhadap tingkat kecemasan perawat dalam merawat pasien COVID-19 di RSUD Depok. Denpasar: Universitas Udayana; 2021
Widiastini NMA, Arsa IKS, Adinata KRW, Suryanto IGB. Harmonization of Tri Hita Karana local value in tourism development in Sidetapa Village. Int J Innov Manag Econ Soc Sci. 2023;3(3):22–30.
Widiastuti Giri MK. Self-Spiritual Healing Therapy on Anxiety Conditions in Diabetes Type II in the Lovina Tourism Area. J Sains Teknol (JST Undiksha). 2023;12(1):11–16. doi:10.23887/jstundiksha.v12i1.59711.
Windarwati HD, Lestari R, Poeranto S, Ati NAL, Kusumawati MW, Ilmy SK, et al. Anxiety, depression, and associated factors among general population in Indonesia during COVID-19 pandemic: a cross-sectional survey. J Caring Sci. 2023;12(3):144–54. doi:10.34172/jcs.2023.33099.
Windarwati HD, Lestari R, Wicaksono SA, Kusumawati MW, Ati NAL, Ilmy SK, et al. Relationship between stress, anxiety, and depression with suicidal ideation in adolescents. J Ners. 2022;17(1):36–41. doi:10.20473/jn.v17i1.31216.
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