New Insights into Understudied Phenomena in Healthcare: Second Edition

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

Deadline for manuscript submissions: 30 June 2026 | Viewed by 11668

Special Issue Editors


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Guest Editor
Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain
Interests: aging; healthy aging; aged 80 and over; questionnaire design; quantitative research; educational techniques; pedagogy
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain
Interests: end-of life care; terminal care; qualitative research; transients and migrants; sexology–gender studies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Healthcare is a field of knowledge that needs to be continually updated and revised due to the forces of change that are constantly redefining the very conception of health/disease processes and, as a result, care systems.

Today, an empowered individual/person/client not only seeks to treat health problems but also to achieve holistic wellbeing, which encompasses physical, mental, spiritual, emotional, social, and financial health. Furthermore, humanity is currently facing enormous challenges, such as the following, whose impact on the health status of individuals, groups, and communities remains unknown:

  • The global climate crisis and its profound impact on the wellbeing of the most vulnerable communities, families, and individuals;
  • The effects of unprecedented ageing population (The Aging Tsunami), which pose major health and service provision challenges;
  • The development of long-term care systems that are sustainable, accessible, and respectful of the care recipient's dignity (WHO, 2022);
  • Technological development, big data, and artificial intelligence, and how they can be applied to healthcare in an efficient and ethically responsible manner;
  • Global threats, such as the recent pandemic, could reoccur and thus require responses at all levels (prevention, treatment, public health, resource management, etc.).

Health systems and policies, as well as research, must be geared towards addressing these new challenges while not exacerbating old ones such as the gender gap, ethical issues, inequality in accessing resources, etc. 

In this Special Issue, we welcome original studies, reviews, and reflections conducted using a variety of methodological approaches including, but not limited to, qualitative, quantitative, mixed, participatory research, etc. We suggest discussing or contributing insights regarding the challenges mentioned, such as new determinants of health and innovation in care, including innovative resources, the use of big data and artificial intelligence, access to knowledge, new forms of management and organization, or new drugs, products, or interventions that promote the holistic wellbeing of autonomous and empowered individuals and communities.

Dr. José Manuel Hernández Padilla
Dr. Cayetano Fernández-Sola
Guest Editors

Manuscript Submission Information

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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

  • health promotion
  • aging
  • emerging diseases
  • new technologies
  • innovative healthcare approaches
  • innovative research methods
  • social determinants of health
  • patient rights
  • demographic challenges
  • understudied populations
  • vulnerable populations
  • gender issues

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Related Special Issue

Published Papers (8 papers)

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Research

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19 pages, 250 KB  
Article
Approaching Young University Students’ Suffering Following the Death of a Family Member: A Qualitative Study
by Cristobal Merino-Meza, María José Cáceres-Titos, Angela María Ortega-Galán, María Dolores Ruiz-Fernández, Jose Miguel Robles-Romero and E. Begoña Garcia-Navarro
Healthcare 2026, 14(8), 991; https://doi.org/10.3390/healthcare14080991 - 9 Apr 2026
Viewed by 516
Abstract
Background/Objectives: The death of a parent due to illness during adolescence constitutes a highly disruptive experience that compounds the developmental losses inherent to this stage of life. Distinguishing between the emotional and behavioural changes characteristic of adolescent development and those specific to [...] Read more.
Background/Objectives: The death of a parent due to illness during adolescence constitutes a highly disruptive experience that compounds the developmental losses inherent to this stage of life. Distinguishing between the emotional and behavioural changes characteristic of adolescent development and those specific to grief can be complex, which may hinder the support provided by health, social care, and educational professionals. The aim of this study was to understand the grieving process and associated suffering in young university students who had lost a parent during adolescence. Methods: An exploratory qualitative design with a phenomenological approach was employed. Nine semi-structured interviews were conducted to examine in depth the experiences of suffering and grief associated with the loss of a family member among university students. The study adhered to the COREQ guidelines (Consolidated Criteria for Reporting Qualitative Research). Results: Among the main findings, the quality of the bond with the deceased parent emerged as particularly significant, as it influences the adolescent’s identity formation process. The loss of this parent may hinder processes of differentiation and independence, affecting the decisions young people must make as they transition into adulthood. This proves especially important in key life choices that shape their life project, such as vocational decisions and intimate partner relationships. Conclusions: Parental death during adolescence has long-lasting repercussions on identity construction and the shaping of one’s life project. It is necessary to strengthen psychosocial support within both clinical and educational contexts in order to address the specific needs of adolescents and young people undergoing this experience. Full article
11 pages, 344 KB  
Article
Ageing Population and Balance Under Stressful Conditions—A Cross-Sectional Observational Study
by Isabel Rodríguez-Costa, Belén Díaz-Pulido, Yolanda Pérez-Martín, Susana Nunez-Nagy, Miguel Ángel Valero-Gil, Alejandra Cano-Hernamperez and Sara Trapero-Asenjo
Healthcare 2026, 14(2), 237; https://doi.org/10.3390/healthcare14020237 - 18 Jan 2026
Viewed by 581
Abstract
Background/Objectives: Falls are a major global issue for older adults, and emotional stress may increase the risk due to its effects on postural control and balance. However, the immediate effects of a stressful stimulus on objective measures of balance and fall risk [...] Read more.
Background/Objectives: Falls are a major global issue for older adults, and emotional stress may increase the risk due to its effects on postural control and balance. However, the immediate effects of a stressful stimulus on objective measures of balance and fall risk are unknown. The study aims to explore differences in older adults’ performance on the Timed Up and Go (TUG) test before and after such exposure. Methods: In this cross-sectional study, 31 older adults (71.6 ± 4.98 years) were exposed to an emotionally stressful stimulus using high-arousal images from the International Affective Picture System. Participants performed the TUG before (t1) and after (t2) exposure as the primary outcome measure. To assess the physiological and psychological impact of the stressful stimulus, heart rate variability (HRV) was recorded before and during image viewing. A visual analogue scale (VAS) of unease was completed both before and after the stimulus. Results: During the stressful stimulus, the HRV high-frequency (HF) band decreased significantly (p = 0.001), while the low-frequency (LF) band (p = 0.002) and the LF/HF ratio (p = 0.004) showed a significant increase. Similarly, after stressful stimulus, VAS scores demonstrated a statistically significant increase (p < 0.001). The time to complete the TUG showed a statistically significant increase at t2 (p < 0.001). Conclusions: The stressful stimulus triggered both physiological and subjective stress responses. Subsequently, TUG test performance declined (increased duration), suggesting that emotionally stressful stimuli could deteriorate functional balance performance in older adults, potentially increasing fall risk. Full article
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16 pages, 272 KB  
Article
Maritime Response and Emergency Care for Irregular Migrants: Experiences of Spanish Rescue Professionals
by María del Mar Jiménez-Lasserrotte, Andrés Pomares Rodríguez, Dulcenombre de María García-López, Verónica Díaz-Sotero, Anabel Chica-Pérez and José Granero-Molina
Healthcare 2026, 14(1), 123; https://doi.org/10.3390/healthcare14010123 - 4 Jan 2026
Viewed by 925
Abstract
Background/Objectives: Irregular maritime migration is a global health challenge as it combines exposure to extreme physical risks with profound psychosocial vulnerability. Understanding the role of maritime rescue professionals is essential for designing effective public health strategies that respond to these realities. The [...] Read more.
Background/Objectives: Irregular maritime migration is a global health challenge as it combines exposure to extreme physical risks with profound psychosocial vulnerability. Understanding the role of maritime rescue professionals is essential for designing effective public health strategies that respond to these realities. The objective of this study was to explore and describe the experiences of SASEMAR professionals involved in the emergency care and rescue of irregular migrants arriving by small boat to the Spanish coast. Methods: Using a qualitative descriptive design, we conducted in-depth interviews and focus groups with 12 SASEMAR professionals. Thematic analysis was performed using Braun and Clarke’s approach with ATLAS.ti software. Results: The findings were grouped into three overarching themes: (1) Innovative Emergency Response Systems for Vulnerable Populations; (2) Holistic Health Approaches in Maritime Emergency Care; and (3) Integrated Approaches to Resource Use and Migrant Care Policies. Conclusions: Rescuing irregular migrants at sea requires coordinated, flexible, and multidisciplinary strategies to address diverse profiles and challenging conditions. Strengthening rescue capacity and policies is essential to ensure effective, human care during maritime emergencies. Full article
12 pages, 751 KB  
Article
Modulation Effect of Physical Activity on Sleep Quality and Mental Hyperactivity in Higher-Education Students
by Rubén Fernández-García, Cristina González-Forte, José Granero-Molina and Eduardo Melguizo-Ibáñez
Healthcare 2025, 13(9), 1040; https://doi.org/10.3390/healthcare13091040 - 1 May 2025
Cited by 2 | Viewed by 2979
Abstract
Objectives: The present study seeks to analyze the relationships between the intensity of physical activity, mental hyperactivity and sleep quality. A comparative, descriptive and exploratory study was carried out. Methods: A sample of 1907 university students belonging to the degree of Physiotherapy and [...] Read more.
Objectives: The present study seeks to analyze the relationships between the intensity of physical activity, mental hyperactivity and sleep quality. A comparative, descriptive and exploratory study was carried out. Methods: A sample of 1907 university students belonging to the degree of Physiotherapy and Physical Activity and Sport Sciences was used. The International Physical Activity and Mental Hyperactivity Questionnaires were used. The scale used was the Pittsburgh sleep quality index. The proposed model analyzes the relationships of physical activity with mental hyperactivity and various sleep-related factors. Results: The following fit indices were evaluated: Chi-Square = 80.242; Degrees of Freedom = 3; Incremental Fit Index = 0.951, Comparative Fit Index = 0.977; Normed Fit Index = 0.946; Root Mean Square Error of Approximation = 0.071. The values obtained show the good fit of the theoretical model. Statistically significant differences are observed (p < 0.05) in the causal relationship of mental hyperactivity with the personal assessment of sleep as a function of the intensity of physical activity. A greater effect of light (β = 0.671) compared to moderate- (β = 0.428) or vigorous-intensity (β = 0.343) physical activity in personal sleep assessment is evident. Statistically significant differences were also observed in the causal relationship of mental hyperactivity with the time to fall asleep (p < 0.05). Light physical activity (β = 0.479) has a greater causal relationship with time to fall asleep than moderate- (β = 0.302) or vigorous-intensity (β = 0.413) physical activity. Conclusions: Based on the results obtained, it is concluded that the intensity with which physical activity is performed has a modulating effect on sleep quality and mental hyperactivity. Full article
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14 pages, 652 KB  
Article
Factors Hindering Access and Utilization of Maternal Healthcare in Afghanistan Under the Taliban Regime: A Qualitative Study with Recommended Solutions
by Sahra Ibrahimi, Sarah Yeo, Korede Yusuf, Zarah Akrami and Kevin Roy
Healthcare 2025, 13(9), 1006; https://doi.org/10.3390/healthcare13091006 - 27 Apr 2025
Cited by 5 | Viewed by 3228
Abstract
Background/Objectives: This study identifies barriers to maternal and child healthcare access in Afghanistan under the Taliban and proposes solutions using the WHO Health System Building Blocks Framework. Methods: Midwives and mothers were recruited via chain-referral sampling. After obtaining IRB and the [...] Read more.
Background/Objectives: This study identifies barriers to maternal and child healthcare access in Afghanistan under the Taliban and proposes solutions using the WHO Health System Building Blocks Framework. Methods: Midwives and mothers were recruited via chain-referral sampling. After obtaining IRB and the participants’ informed consent, in-depth virtual interviews, guided by Social Cognitive Theory, were recorded, transcribed, and analyzed using content analysis in MAXQDA 2020. Results: Data analysis revealed four primary consequences of the political unrest in Afghanistan that have exacerbated barriers to accessing maternal and child healthcare: (a) Taliban-imposed restrictions on women’s education and mobility, reducing female healthcare providers and limiting mothers’ access to care; (b) increased poverty, preventing women from attending perinatal visits due to out-of-pocket costs; (c) the deterioration of healthcare services, including medicine shortages, weakened health financing due to donor withdrawals, lack of insurance, and poor governance; and (d) the increased perpetuation of misinformation and harmful practices, such as the use of clergymen for medical advice instead of doctors. Using the WHO Health Systems Framework, we recommend solutions that address issues in service delivery, health workforce, health information systems, access to essential medicines, financing, and governance. Conclusions: This is the first qualitative study capturing Afghan mothers’ and healthcare providers’ experiences under Taliban rule. Our findings can inform international efforts to advocate for women’s healthcare and education rights and guide global aid programs in strengthening Afghanistan’s healthcare system in alignment with Sustainable Development Goal 5. Full article
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Review

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25 pages, 805 KB  
Review
Nomophobia in Nursing Students: Psychological, Academic, and Clinical Impacts—An Integrative Review
by Assunta Guillari, Andrea Chirico, Chiara Palazzo, Maurizio Di Martino, Francesco Cristiano, Salvatore Suarato, Teresa Rea and Vincenza Giordano
Healthcare 2026, 14(7), 830; https://doi.org/10.3390/healthcare14070830 - 24 Mar 2026
Viewed by 766
Abstract
Background/Objectives: Nomophobia, the irrational fear of being without a mobile phone, is increasingly prevalent among university students and has emerged as a concerning form of digital dependence. Among nursing students, this condition is particularly relevant due to the emotional demands and cognitive [...] Read more.
Background/Objectives: Nomophobia, the irrational fear of being without a mobile phone, is increasingly prevalent among university students and has emerged as a concerning form of digital dependence. Among nursing students, this condition is particularly relevant due to the emotional demands and cognitive challenges of healthcare education. Nomophobia has been linked with adverse psychological outcomes, sleep disturbances, and impaired academic and clinical performance. However, existing evidence remains fragmented and lacks an integrated conceptual synthesis. This review aimed to synthesize current evidence on the prevalence, correlates, and outcomes of nomophobia among nursing students. Methods: An integrative review was conducted following Whittemore and Knafl’s methodology and PRISMA guidelines. A systematic search was performed in PubMed, CINAHL, PsycINFO, PsycArticles, and Medline (between 2015 and 2025), supplemented by Google Scholar. Cross-sectional studies and literature focusing on nomophobia in nursing students were included. The primary studies and selected review articles were considered when no overlap with the included primary evidence was identified. Methodological quality appraisal was assessed using validated tools (QuADS and JBI). Results: Twenty-two studies were included (19 cross-sectional and 3 reviews). Four thematic areas emerged: prevalence and severity (50–90% moderate to severe); psychological correlates (anxiety, depression, stress, insomnia, alexithymia, fear of missing out); academic and cognitive outcomes (impaired performance, procrastination, reduced decision-making); and behavioural predictors (excessive smartphone use and emotional dysregulation). The Nomophobia Questionnaire (NMP-Q) was the most frequently used instrument. Conclusions: Nomophobia represents a relevant dimension of the mind–technology relationship in nursing education, with implications for students’ mental health, academic engagement, and clinical readiness. Addressing nomophobia may support healthier learning environments and contribute to the development of emotionally competent and safe future healthcare professionals. However, significant gaps remain, particularly regarding longitudinal evidence and intervention-based approaches. Full article
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Other

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18 pages, 788 KB  
Study Protocol
Understanding the Lived Experience and Bereavement of Caregivers of People with Alzheimer’s Disease: A Mixed-Methods Study Protocol
by Nerea Risquez-Salgado, Sara García-Bravo, Elisabet Huertas-Hoyas, Jorge Pérez-Corrales, María Salcedo-Perez-Juana, Madeleine Donovan, Domingo Palacios-Ceña, Elisa Bullón-Benito and Cristina García-Bravo
Healthcare 2026, 14(7), 899; https://doi.org/10.3390/healthcare14070899 - 31 Mar 2026
Viewed by 512
Abstract
Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that severely affects cognitive, behavioral, and functional abilities, creating a substantial burden for family members who provide continuous care. Caregivers often experience role changes, occupational imbalance, emotional distress, and reduced quality of life, [...] Read more.
Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that severely affects cognitive, behavioral, and functional abilities, creating a substantial burden for family members who provide continuous care. Caregivers often experience role changes, occupational imbalance, emotional distress, and reduced quality of life, although some report personal growth. These experiences extend beyond active caregiving and include anticipatory grief during disease progression and grief after the relative’s death. Despite this continuum, few studies have examined caregiving, loss, and bereavement from an integrative perspective. This protocol describes a mixed-methods study aimed at exploring the lived experiences of family caregivers of individuals with AD, focusing on how evolving relational, occupational, and identity-related losses influence their well-being and adaptation. Methods: A parallel convergent mixed-methods design will be used. The quantitative component consists of a cross-sectional observational study including 66 caregivers recruited through purposive sampling across kinship categories (spouse/partner, adult child, grandchild) and care settings (home care with day-center attendance vs. institutionalized care). Data will be collected using the Zarit Burden Interview, Role Checklist, Short Form-36 Health Survey, and Occupational Balance Questionnaire. Descriptive and subgroup analyses will be conducted using SPSS (version 27). The qualitative component comprises a multiple-case study with approximately 36 participants across three groups: caregivers living with individuals with AD, caregivers of institutionalized relatives, and bereaved family members. Semi-structured interviews (45–80 min) will be conducted online or in person, transcribed verbatim, and analyzed thematically using MAXQDA (version 26). Integration will follow a concurrent approach, combining quantitative and qualitative results through joint narratives and displays to produce a comprehensive interpretation. Discussion: This study aims to deepen understanding of the caregiving–grief continuum in families affected by AD by integrating quantitative indicators of burden, health status, and occupational balance with qualitative accounts of adaptation and meaning-making. Findings are expected to support the development of holistic, evidence-based interventions that promote caregiver well-being throughout the care trajectory and during bereavement. Ethics and Dissemination: Ethical approval was granted by the Research Ethics Committee of Universidad Rey Juan Carlos (Code: 041220246522024; 15 October 2025). ClinicalTrials.gov Identifier: NCT07251738. Registered November 2025. Protocol version: Version 2. Full article
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18 pages, 438 KB  
Systematic Review
Experiences and Opinions of Physiotherapists, Children, Families, and Teachers About School-Based Physiotherapy-Led Interventions: A Metasynthesis of Qualitative Studies
by Gonzalo Granero-Heredia, Nuria Sánchez-Labraca, José Granero-Molina, Rubén Fernández-García, Laura Helena Antequera-Raynal and Susana Núñez-Nagy
Healthcare 2025, 13(22), 2859; https://doi.org/10.3390/healthcare13222859 - 11 Nov 2025
Viewed by 1077
Abstract
Background/Objectives: Physiotherapy is a clinical discipline that provides services in healthcare centres, the community, at home, and in school. School Physiotherapy (SP) focuses its practice on children with disabilities or special motor needs during the school period. SP addresses psychomotricity, ergonomics, and [...] Read more.
Background/Objectives: Physiotherapy is a clinical discipline that provides services in healthcare centres, the community, at home, and in school. School Physiotherapy (SP) focuses its practice on children with disabilities or special motor needs during the school period. SP addresses psychomotricity, ergonomics, and posturology issues in order to improve health and academic performance. The objective of this study was to identify qualitative evidence on the experience and opinions of physiotherapists, children, parents, and teachers about school-based physiotherapy-led interventions. Methods: Metasynthesis of qualitative studies. The search included articles published between 2015 and 2025 on the PubMed, WOS, SCOPUS, and CINAHL databases. Results: The review included 15 selected studies. Three main themes emerged from this analysis: (1) Clinical and school physiotherapy: separated by a fine line. (2) Ensuring healthcare for children with specific conditions in schools. (3) The challenge of incorporating SP in educational settings. Conclusions: Physiotherapists, children, parents, and teachers perceive significant advantages in implementing SP in educational settings. Participants advocate for the development of collaborative goals and the inclusion of physiotherapists within educational teams. Understanding the experiences of physiotherapists, children, parents, and teachers may help improve SP in practice. Full article
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