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Advances in Public Health and Healthcare Management for Chronic Care
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Advances in Public Health and Healthcare Management for Chronic Care

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 10 October 2026 | Viewed by 8421

Special Issue Editors

Prof. Dr. Fabio Petrelli

E-Mail Website
Guest Editor
School of Pharmacy, Polo Medicina Sperimentale e Sanità Pubblica "Stefania Scuri", Via Madonna delle Carceri 9, 62032 Camerino, Italy
Interests: diabetes public health; diabetes management; diabetes health management; diabetes health care; diabetes chronic care; diabetes nursing care
Special Issues, Collections and Topics in MDPI journals
Dr. Giovanni Cangelosi

E-Mail Website
Guest Editor Assistant
Units of Diabetology, ASUR Marche, Area Vasta 4, 63900 Fermo, Italy
Interests: public health; chronic disease; healthcare management; prevention; health management; lifestyle medicine; nursing practice

Special Issue Information

Dear Colleagues,

This Special Issue of Healthcare will focus on the management of chronic diseases. Systematic/scoping/narrative reviews or protocols of reviews related to these issues are welcome. One of the primary focuses is to identify news model of care for different chronic diseases in Medical and Nursing practice. These approaches should promote an improving satisfaction for patients and the community. In chronic care, the personalized management of care improves clinical and psychosocial outcomes, and innovative models have been recommended in several areas of clinical practice, with significantly positive results in the quality of care and patient satisfaction, emphasizing the individual needs of each patient, and directing care in this same direction. This Special Issue aimed to demonstrated with our studies that it is necessary to place the patient in the center of care, to increase better results and health-related quality of life in general. Topics of interest include, but are not limited, to the following:

  • Investigation based on practice and personalized care approaches in chronic care;
  • New managed models in chronic diseases or other condition with long-term care;
  • Studies investigating promotion of care;
  • Nurse-led care;
  • Intervention for the management of chronic diseases;
  • New approaches of chronic care;
  • Health Economics evaluation.

You may choose our Joint Special Issue in Medicina.

Prof. Dr. Fabio Petrelli
Guest Editor

Dr. Giovanni Cangelosi
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic diseases
  • long-term care
  • nursing practice
  • public health
  • patient satisfaction
  • health economic

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (6 papers)

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Research

Jump to: Review, Other

16 pages, 758 KB  
Article
Mapping Competence in Gastrointestinal Endoscopy Nursing Practice: An Item Response Theory Analysis of Perceived Skill Acquisition and Maintenance in Italy
by Mattia Bozzetti, Gennaro Pascale, Ilaria Marcomini, Alessio Lo Cascio, Fabio Grilli, Caterina Sclapari, Grazia Multari, Nicoletta Orgiana, Mirko Gaggiotti, Giorgio Iori, Luciana Nicola Giordano, Stefano Mancin, Fabio Petrelli, Giovanni Cangelosi, Loris Riccardo Lopetuso and Daniele Napolitano
Healthcare 2026, 14(2), 203; https://doi.org/10.3390/healthcare14020203 - 13 Jan 2026
Cited by 1 | Viewed by 847
Abstract
Objective. The aim of this study was to define a structured competence model for nurses working in gastrointestinal endoscopy in Italy and to assess nurses’ perceptions of the number of procedural repetitions required to acquire and maintain competence across different endoscopic procedures. [...] Read more.
Objective. The aim of this study was to define a structured competence model for nurses working in gastrointestinal endoscopy in Italy and to assess nurses’ perceptions of the number of procedural repetitions required to acquire and maintain competence across different endoscopic procedures. Methods. A cross-sectional online survey targeted registered nurses working in Italian gastrointestinal endoscopy units. The questionnaire, developed from guidelines and expert consensus, covered demographics, organizational context, and perceived repetition thresholds for 30 procedures. Partial Credit Models (PCMs) estimated acquisition and maintenance thresholds; Differential Item Functioning (DIF) tested differences by self-reported experience level. Results. A total of 332 nurses participated (68.4% female; mean age 47.1 years; mean endoscopy experience 10.1 years). For competence acquisition, most procedures were placed in the 11–30 or 31–50 repetition range, with higher values for complex techniques. Competence maintenance generally required fewer repetitions, but thresholds varied by procedure. Advanced or infrequently performed techniques were perceived as more demanding. More experienced nurses reported higher thresholds, reflecting stricter internal standards. Conclusions. Acquisition and maintenance of gastrointestinal endoscopy competences differ in intensity and frequency requirements, supporting the need for tailored, modular training pathways. Findings highlight the importance of national competence standards, adaptive learning technologies, and structured mentorship to enhance skill development, reduce variability, and promote consistent, high-quality patient care across Italy. Full article
(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)
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18 pages, 947 KB  
Article
Fixation Methods in Primary Hip Arthroplasty: A Nationwide, Registry-Based Observational Study in Romania (2001–2024)
by Flaviu Moldovan and Liviu Moldovan
Healthcare 2025, 13(19), 2452; https://doi.org/10.3390/healthcare13192452 - 27 Sep 2025
Cited by 6 | Viewed by 996
Abstract
Background/Objectives: Arthroplasty registries provide a broad database that constitutes evidence for discussions about cemented versus uncemented fixations. The objective of this study is to determine the current trend in fixation of total hip arthroplasties. Methods: From the Romanian Arthroplasty Register we extracted data [...] Read more.
Background/Objectives: Arthroplasty registries provide a broad database that constitutes evidence for discussions about cemented versus uncemented fixations. The objective of this study is to determine the current trend in fixation of total hip arthroplasties. Methods: From the Romanian Arthroplasty Register we extracted data regarding primary hip replacement surgery and revisions. We established evaluation variables and methodologies that contain volumes, variation trends, and gradients for surgical procedures, fixations and revision burdens. Results: In the period 2001–2024, the share of uncemented fixations was 56.8%, and that of cemented ones was 43.13%. The uncemented fixation gradient showed an increase from 0.32 in 2001 to 3.43 in 2024. We found an annual increase in the share of uncemented fixations (2.08%), to the detriment of cemented fixations, which decreased (−6.97%). We found that there is an obvious trend towards uncemented fixation, which is also evident in the elderly age group of 80+ years. The results regarding revision burdens remain within a relatively narrow range of 5.09–7.23%. The revision burdens of uncemented fixations are lower, ranging between 4.82% and 5.36%, compared to cemented fixations. Also, the revision burdens of cemented fixations have a decreasing trend of 0.54%. Conclusions: The variation trend of total uncemented implants is almost double compared to the variation trend of all primary hip joint surgeries. This indicates a trend towards uncemented fixation, and its share is increasing in all age groups. The increase in the proportion of uncemented fixations was associated with a small, non-significant decrease in revision burden. Full article
(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)
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Review

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26 pages, 1429 KB  
Review
Healthcare Management in Cardio-Oncology, Clinical Strategies and Future Perspectives: A Narrative Review
by Vincenzo Quagliariello, Massimiliano Berretta, Fabrizio Maurea, Matteo Barbato, Andrea Paccone, Martina Iovine, Alfredo Mauriello, Celeste Fonderico, Domenico Gabrielli, Andrea Camerini, Carmine Riccio, Marino Scherillo, Stefano Oliva, Maria Laura Canale and Nicola Maurea
Healthcare 2025, 13(20), 2599; https://doi.org/10.3390/healthcare13202599 - 15 Oct 2025
Cited by 3 | Viewed by 2245
Abstract
The growing overlap between cardiovascular disease and cancer has made cardio-oncology a key subspecialty in modern oncology care. Improved cancer survival has increased the burden of therapy-related cardiovascular complications, including heart failure, arrhythmias, ischemic events, and vascular toxicity, driven by oxidative stress, endothelial [...] Read more.
The growing overlap between cardiovascular disease and cancer has made cardio-oncology a key subspecialty in modern oncology care. Improved cancer survival has increased the burden of therapy-related cardiovascular complications, including heart failure, arrhythmias, ischemic events, and vascular toxicity, driven by oxidative stress, endothelial dysfunction, immune-mediated injury, and metabolic vulnerability. Effective management requires a continuum-of-care approach, integrating baseline risk assessment, biomarker- and imaging-guided surveillance, and timely cardioprotective therapy without compromising cancer treatment. Key strategies include validated risk scores (HFA/ICOS, Mayo), early detection of subclinical dysfunction via troponin, natriuretic peptides, and strain imaging, and proactive cardioprotective agents such as ACE inhibitors, beta-blockers, SGLT2 inhibitors, and statins in high-risk patients. This narrative review summarizes risk-stratification models, structured care pathways, and multidisciplinary hub-and-spoke networks linking specialized centers with community oncology services. It emphasizes modifiable cardiometabolic factors, obesity, insulin resistance, NAFLD, sarcopenia, and chronic inflammation, which heighten cardiotoxicity risk and should guide precision prevention and survivorship care. We also address emerging challenges, including the integration of digital health, tele-monitoring, and AI-based decision support, and the shift toward value-based reimbursement models, highlighting persistent barriers such as data privacy, infrastructure gaps, and inequitable access to specialized care. Full article
(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)
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Other

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15 pages, 852 KB  
Systematic Review
A COSMIN Systematic Review of Transition Readiness Assessment Tools for Adolescents with Type 1 Diabetes
by Valentina Vanzi, Maddalena De Maria, Gabriele Caggianelli, Dhurata Ivziku, Clara Donnoli, Immacolata Dall’Oglio, Francesco Scerbo, Alessandro Stievano, Gennaro Rocco, Maurizio Zega and Marzia Lommi
Healthcare 2026, 14(5), 639; https://doi.org/10.3390/healthcare14050639 - 3 Mar 2026
Cited by 1 | Viewed by 639
Abstract
Background: Diabetes in youth, specifically type 1 diabetes (T1D), is an increasing global health concern. As prevalence rises, a growing number of adolescents are required to transition from pediatric to adult healthcare services. This phase is recognized as a particularly critical and [...] Read more.
Background: Diabetes in youth, specifically type 1 diabetes (T1D), is an increasing global health concern. As prevalence rises, a growing number of adolescents are required to transition from pediatric to adult healthcare services. This phase is recognized as a particularly critical and high-risk period, during which emerging adults with T1D must exhibit advanced self-management skills to maintain optimal outcomes. When transition support is inadequate, the process is frequently associated with deterioration in glycemic control, higher rates of hospitalization, and significant psychological distress. Methods: A systematic review was conducted in accordance with PRISMA guidelines to identify and evaluate instruments that assess transition readiness in adolescents with diabetes, focusing on their psychometric properties. Five electronic databases (PubMed, CINAHL, Embase, APA PsycInfo, and Web of Science) were searched. Methodological quality and measurement properties were appraised using the updated 2024 COSMIN Guidelines. Results: Eleven studies were included, examining 10 distinct instruments. Overall, psychometric evidence was promising but limited. Only the “On TRAck” instrument demonstrated moderate-quality evidence with acceptable feasibility and reliability. Other tools showed partial support for validity, reliability, and responsiveness, but presented methodological limitations. Conclusions: Interest in diabetes-specific tools to assess transition readiness is growing, yet their psychometric robustness remains limited. Further research is needed to develop and validate instruments with stronger methodological rigor. Future efforts should focus on longitudinal performance and predictive validity to enhance their applicability in clinical practice and ultimately improve outcomes during transition. Full article
(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)
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19 pages, 9109 KB  
Systematic Review
Influence of Self-Care on the Quality of Life of Elderly People with Chronic Non-Communicable Diseases: A Systematic Review
by Poliana Martins Ferreira, Jonas Paulo Batista Dias, Monica Barbosa, Teresa Martins, Rui Pedro Gomes Pereira, Murilo César do Nascimento and Namie Okino Sawada
Healthcare 2026, 14(3), 308; https://doi.org/10.3390/healthcare14030308 - 26 Jan 2026
Viewed by 1610
Abstract
Background/Objectives: Self-care is a cornerstone of healthy aging and chronic disease management; however, evidence on the most effective intervention models for improving quality of life in older adults with chronic non-communicable diseases (NCDs) remains fragmented. This review aimed to evaluate the effectiveness of [...] Read more.
Background/Objectives: Self-care is a cornerstone of healthy aging and chronic disease management; however, evidence on the most effective intervention models for improving quality of life in older adults with chronic non-communicable diseases (NCDs) remains fragmented. This review aimed to evaluate the effectiveness of self-care interventions in promoting quality of life and health outcomes in older adults with NCDs. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251040613). Randomized and non-randomized clinical trials published between 2019 and 2024 were retrieved from Scopus, Web of Science, and EBSCOhost. Eligible studies included adults aged ≥60 years with NCDs receiving self-care interventions. Data extraction and risk of bias assessment were independently performed using Joanna Briggs Institute tools. Results: Twenty-nine studies involving 7241 older adults were included. Self-care interventions comprised nurse-led educational programs, digital health strategies, community- and peer-based approaches, and person-centered care models. Multicomponent and continuous interventions demonstrated consistent improvements in physical and psychological domains of quality of life, self-efficacy, autonomy, symptom management, and treatment adherence. Digital interventions enhanced monitoring and engagement, although their effectiveness varied according to sensory and health literacy limitations. Conclusions: Structured, person-centered, and nurse-led self-care interventions are effective in improving quality of life and autonomy among older adults with NCDs. These findings support their integration into primary and community-based care, reinforcing their relevance for clinical practice, care planning, and the development of assistive and educational strategies in aging care. Full article
(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)
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11 pages, 524 KB  
Brief Report
Effects of Active Spinal Orthosis on Fatty Infiltration in Paraspinal Muscles in Kyphotic Women with Osteoporotic Vertebral Fracture—Sub-Analysis of a Randomized Controlled Trial
by Marco Hiller, Matthias Kohl, Oliver Chaudry, Klaus Engelke, Simon von Stengel and Wolfgang Kemmler
Healthcare 2025, 13(11), 1262; https://doi.org/10.3390/healthcare13111262 - 27 May 2025
Cited by 1 | Viewed by 1255
Abstract
Background/Objectives: Fatty infiltration of muscle is a predictor of degeneration. The present study determined the effect of an active spinal orthosis on muscle quality as determined by fatty infiltration in paraspinal muscles in older women with vertebral fractures and kyphosis. Methods: [...] Read more.
Background/Objectives: Fatty infiltration of muscle is a predictor of degeneration. The present study determined the effect of an active spinal orthosis on muscle quality as determined by fatty infiltration in paraspinal muscles in older women with vertebral fractures and kyphosis. Methods: Twenty-one community-dwelling women ≥65 years with chronic back pain and vertebral fractures ≥3 months were randomly allocated to a group which wore the Spinomed active orthoses 2 × 2–3 h/d for 16 weeks (SOG: n = 11) or an untreated control group (CG: n = 10). Outcomes of the present study were parameters related to fatty infiltration of the musculi erector spinae and psoas major as determined by Magnetic Resonance Imaging (MRI). We applied a per protocol analysis; data were consistently adjusted for baseline values applying an ANCOVA. Results: Despite positive trends for all MRI parameters, no significant effects of the active spinal orthosis on fat infiltration of the musculus erector spinae were observed. Significant positive effects were, however, determined for musculus psoas major intra-fascial volume (p = 0.021; d’: 1.18) and muscle tissue volume (p = 0.001; d’: 1.80). No further significant effects on m. psoas major intra-fascial or muscle tissue average fat fraction or m. psoas major intramuscular adipose tissue volume were assessed. Of importance, no changes in variables that might have confounded the present result were reported. Conclusions: In line with recent exercise studies, the present high-volume, low-intensity back-strengthening intervention, induced by an active spinal orthosis, failed to generate significant effects on MRI measures of the m. erector spinae. On the other hand, significant effects on m. psoas major hypertrophy, albeit not fatty muscle infiltration, were determined. This new and unexpected finding should be confirmed by future studies. Full article
(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)
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