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Patient-Centered Care and Well-Being: Health Communication and Patient Engagement

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A Special Issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 30 September 2026 | Viewed by 6991

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Dr. Pavlos Sarafis

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Department of Nursing, University of Thessaly, Gaiopolis Campus, Larissa-Trikala Ring-Road, 415 00 Larissa, Greece
Interests: clinical research/education; surgical nursing; infections diseases; public health; health care; health policy; well being/quality of life
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Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute to the Special Issue titled “Patient-Centered Care and Well-Being: Health Communication and Patient Engagement”. In recent years, the essential role of patient-centered care has been increasingly recognized for its contribution to improved health outcomes, enhanced patient satisfaction, and long-term quality of life. At the heart of this approach lies the quality of communication between healthcare providers and patients—a factor that profoundly shapes patients’ understanding of their health, adherence to treatment plans, and emotional resilience throughout the care journey.

As healthcare systems evolve toward more inclusive and participatory models, key concepts such as shared decision-making, therapeutic alliance, and health literacy have become central in both clinical and community settings. Concurrently, the proliferation of digital health technologies—including telemedicine, mobile health applications, and patient portals—has transformed how individuals engage with healthcare professionals and manage their care. Understanding these evolving dynamics is essential to designing healthcare systems that are not only effective but also equitable and centered on the holistic needs and preferences of individuals, including their perceived quality of life.

This Special Issue provides a platform to explore these interdisciplinary challenges and to showcase innovative practices that view patients as active partners in the co-creation of health and well-being.

The aim of this Special Issue is to advance interdisciplinary dialog on how communication shapes patient-centered care, enhances patient engagement, and ultimately contributes to better quality of life across healthcare systems. In alignment with the journal’s focus on health, society, and well-being, this Issue will examine how communication strategies and engagement models affect the delivery, experience, and outcomes of care, from both biomedical and psychosocial perspectives.

We welcome contributions that draw from health communication, medical sociology, behavioral science, psychology, public health, and digital health. We are especially interested in studies that explore how communication and engagement intersect with broader issues such as health equity, access to care, cultural competence, and the digital transformation of healthcare. Ultimately, this Special Issue aims to promote practices and theoretical frameworks that support human-centered care grounded in empathy, dignity, and quality of life.

We welcome original research articles, comprehensive reviews, and conceptual papers using qualitative, quantitative, or mixed-methods approaches. Submissions may address, but are not limited to, the following themes:

Communication strategies in patient-centered care models;
Shared decision-making and co-production of care;
Health literacy and its impact on patient autonomy, outcomes, and quality of life;
The role of empathy, trust, and relational dynamics in healthcare communication;
Digital health tools and their influence on patient engagement and self-management;
Narrative medicine and storytelling in clinical care;
Communication with vulnerable populations and reducing health disparities;
Psychosocial well-being and the emotional dimensions of care experiences;
Quality of life as a core outcome in patient-centered interventions;
Education and training for healthcare professionals in patient-centered communication;
Interdisciplinary approaches to designing equitable, patient-centered health systems.

We look forward to receiving your contributions and fostering a vibrant dialog on how communication and engagement can transform healthcare into a more humane, responsive, and life-enhancing domain.

Dr. Pavlos Sarafis
Guest Editor

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-anonymized 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

patient-centered care
health communication
patient engagement
shared decision-making
health literacy
therapeutic alliance
digital health tools
patient empowerment
chronic disease management
narrative medicine
psychosocial well-being
quality of life
interdisciplinary approaches
health equity
culturally sensitive communication

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Published Papers (11 papers)

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Research

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15 pages, 604 KB

Open AccessArticle

This Is My Story (TIMS), a Five-Year Thematic Analysis of Patient Narratives from a Novel Intervention in an Academic Hospital

by Jason Wilson, Bikram Bains, Sampath Rapuri, Edgar Robitaille, Catherine Chan, Naomi Crane, Ellen Fei and Elizabeth Tracey

Healthcare 2026, 14(18), 2994; https://doi.org/10.3390/healthcare14182994 - 14 Sep 2026

Viewed by 88

Abstract

Background/Objective: This is My Story (TIMS) is a patient-centered, interview-based audio narrative program that provides a humanistic intervention to help the medical team understand more information about a patient’s story that is not routinely captured in their medical chart. The goal was to analyze themes present in the collected TIMS interview narratives and determine how they correspond to the specific interview prompts and discover whether there are any broader patterns and categories in responses. Methods: This is a secondary research study using retrospectively collected audio interviews, with hospitalized patients or their legally authorized representative, who provided their oral consent for the recording and future use of these interviews. A total of 362 TIMS interviews make up a subset of data for the reflexive thematic analysis, in which researchers analyzed, with some AI-assisted analysis, the themes that were present when the patient answered four structured interview questions. Results: The most common themes found were Experiences and Quality of Care, Family and Social Connections, Peace and Well-being, Joy and Meaning in Life, and Preferences and Personal Identity. Conclusions: The themes discovered in response to the four structured questions were directly related and influenced by the questions in which they correspond to, but there is also overlap between the questions, suggesting that each contributed to an overall cohesive patient narrative. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

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18 pages, 260 KB

Open AccessArticle

Stakeholder Perspectives on Power Transfer During Implementation of Psychiatric Self-Admission in Scandinavia: A Qualitative Study

by Maria Smitmanis Lyle, Alexander Rozental, Trine Ellegaard Laursen, Lena Flyckt, Inger Elise Opheim Moljord, Dag Øivind Antonsen, Merete Nordentoft, Sofie Westling and Rose-Marie Lindkvist

Healthcare 2026, 14(18), 2909; https://doi.org/10.3390/healthcare14182909 - 8 Sep 2026

Viewed by 445

Abstract

Background/Objectives: Psychiatric inpatient care is characterised by power asymmetries between care providers and care receivers. Despite international guidelines and policies promoting autonomy, involvement, and empowerment, these ideals remain challenging to implement in clinical practice. Psychiatric self-admission has been developed to strengthen autonomy; however, its implementation may challenge established power structures, professional roles, and responsibilities within mental healthcare settings. This study aimed to explore stakeholder perspectives on power transfer during the implementation of psychiatric self-admission in Scandinavia. Methods: A qualitative multi-source study was conducted using semi-structured interviews, focus group interviews, and document collection. Interviews were conducted with 36 participants involved in the development and implementation of self-admission in Denmark, Norway, and Sweden. Additionally, approximately 250 documents were gathered. The documentary material was analysed alongside the interviews and focus groups to provide an understanding of the implementation of self-admission models and how power transfer was represented within these processes. The analyses were inspired by methods in qualitative content analysis and document analysis. Results: Findings on stakeholder perspectives on power transfer during implementation revealed a tension reflected in two subthemes: ‘Responsive and Responsible’, where self-admission was viewed as a necessary response to needs that the healthcare system was unable to address, and ‘Unsafe and Unsound’, where self-admission was associated with uncertainties and risks related to losing control. Conclusions: Implementing psychiatric self-admission, which involved challenging traditional power relations in healthcare, was permeated by trust, distrust, and fear. The findings highlight the need to address stakeholders’ concerns related to safety and professional responsibility. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

21 pages, 682 KB

Open AccessArticle

Willingness to Share Smartwatch-Generated Health Data Among a Sample of Adults in Riyadh, Saudi Arabia

by Raniah N. Aldekhyyel, Leena M. Shagrani, Shoug M. Albattah, Basmah A. Alghamdi, Adwaa A. Alsalman, Shadin K. Alabbas and Haya E. Alkhlaiwi

Healthcare 2026, 14(17), 2838; https://doi.org/10.3390/healthcare14172838 - 3 Sep 2026

Viewed by 299

Abstract

Background/Objectives: Wearable devices, such as smartwatches, represent an emerging digital health tool that can enhance patient engagement, support patient-provider communication, and enable more personalized, patient-centered care. Understanding public willingness to share health-generated data with healthcare providers is essential for informing digital health implementation strategies that prioritize patient trust and active participation in the care process. This study aimed to address this gap by assessing the willingness of a sample of smartwatch users in Riyadh to share their health-generated data and identifying factors associated with this willingness. Methods: A cross-sectional study was conducted using venue-based convenience sampling at a large public venue in Riyadh, Saudi Arabia. Data were collected using an electronic self-administered questionnaire. Descriptive statistics summarized participant characteristics, while bivariate analyses and multivariable logistic regression were used to examine factors associated with willingness to share health-generated data. Results: Among the 391 participants, 168 reported owning a smartwatch and comprised the population for the primary analysis of willingness to share health-generated data. Among smartwatch owners (n = 168), 104 (62%; 95% CI: 54–69%) expressed willingness to share their health-generated data. Among those willing to share, healthcare providers were the most preferred recipients (95%, 99/104), followed by family members and friends (63%, 66/104). Most demographic, socioeconomic, health-related, and behavioral characteristics were not significantly associated with willingness to share; however, in bivariate analysis, previous use of online support groups was significantly associated with greater willingness to share health-generated data (OR 5.00; 95% CI: 1.66–15.10; p = 0.002). None of the predictors included in the multivariable model was independently associated with willingness to share. Conclusions: Most smartwatch users were willing to share their health-generated data with healthcare providers, reflecting positive public attitudes toward integrating this data into healthcare systems. These findings support Saudi Arabia’s digital health transformation initiatives, while highlighting the need to address privacy, trust, and data governance to enable successful implementation. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

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17 pages, 514 KB

Open AccessArticle

When Antibiotics Are Refused: A Qualitative Study of Patient–Provider Communication, Trust, and Reported or Anticipated Responses in Jordan

by Mohammad Abu Assab, Anas Abed, Zekrayat J. H. Merdas, Mona Bustami, Saba Ammar Alabdali, Wafa’ A. Al-Haj, Wael Abu Dayyih, Sireen Abdul Rahim Shilbayeh and Zainab Zakaraya

Healthcare 2026, 14(16), 2612; https://doi.org/10.3390/healthcare14162612 - 19 Aug 2026

Viewed by 341

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Background/Objectives: Patient-centered antimicrobial stewardship depends not only on restricting non-prescription antibiotic access, but also on how people interpret professional advice when an antibiotic request is declined. This study explored how adults in Jordan interpreted antibiotic refusal and distinguished personally reported experiences from anticipated vignette responses and perceptions of other people’s behavior. Methods: Semi-structured interviews were conducted between November 2025 and March 2026 with 32 adults purposively recruited for variation in age, gender, region, education, caregiving status, healthcare access, and antibiotic-use experience. Thirteen participants reported a previous refusal encounter—seven involving a pharmacist and six involving a physician—whereas 19 discussed refusal primarily through vignettes. Data were analyzed using an experiential, contextualist form of reflexive thematic analysis. Results: Three themes were developed: (1) antibiotics as active and responsible care under uncertainty; (2) refusal as a negotiation of credibility and care; and (3) continued antibiotic seeking after refusal as a set of reported, anticipated, or socially attributed possibilities. Antibiotics could symbolize strength, rapid recovery, and responsible caregiving. Refusal was more readily interpreted as care when participants described or anticipated acknowledgement, a reasoned explanation, symptom-relief options, and safety-netting. Responses after refusal included acceptance and monitoring, uncertainty or clinical reassessment, and continued antibiotic seeking, but these were not equivalent forms of evidence. Conclusions: Antibiotic refusal is a trust-sensitive and context-dependent patient–provider interaction rather than a uniform behavioral pathway. The findings identify communication and access conditions that merit prospective evaluation; they do not establish that communication causes acceptance or that vignette intentions predict behavior. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

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13 pages, 238 KB

Open AccessArticle

Empathic Listening and Communication Competencies Among Oncology Healthcare Professionals in Croatia: A Cross-Sectional Study Conducted in 2025

by Sandra Karabatić, Marin Mamić, Božica Lovrić, Vajdana Tomić and Stjepan Orešković

Healthcare 2026, 14(13), 1842; https://doi.org/10.3390/healthcare14131842 - 24 Jun 2026

Viewed by 419

Abstract

Introduction/Objectives: Patient-centered communication is essential in oncology care, where healthcare professionals often manage emotionally demanding conversations, uncertainty, complex decisions, and patient involvement in care. However, the relationship between communication knowledge, empathic listening, and practical communication skills remains insufficiently examined. This study aimed to examine the associations between communication knowledge, empathic listening, and interpersonal communication skills among healthcare professionals involved in oncology care. Methods: A cross-sectional study was conducted in Croatia from May to November 2025 on a convenience sample of 138 healthcare professionals involved in oncology care. Communication knowledge was assessed using a study-specific questionnaire, empathic listening using an adapted Active Empathic Listening Scale, and interpersonal communication skills using an adapted Interpersonal Communication Skills Inventory. Because the instruments were adapted to the oncology care context, their dimensions were examined using exploratory factor analysis and interpreted as sample-specific exploratory constructs. Descriptive statistics, correlation analyses, and multiple linear regression analyses were performed. Results: Clear message delivery and assertiveness had the highest self-reported score, whereas emotional interaction management had the lowest. Communication knowledge was not an independent predictor of communication skills dimensions. Processing and responding positively predicted clear message delivery and assertiveness (β = 0.361; p = 0.001; R² = 13.4%), while noticing emotional and nonverbal cues negatively predicted emotional interaction management (β = −0.234; p = 0.032; R² = 7.6%). The explained variance of the models was low. Conclusions: The findings suggest limited but potentially relevant associations between selected dimensions of empathic listening and self-reported communication skills in oncology care. Communication knowledge, measured using a study-specific exploratory instrument, was not independently associated with communication skills. Because of the exploratory design, self-report measures, adapted instruments, and convenience sampling, the results should be interpreted with caution. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

19 pages, 575 KB

Open AccessArticle

Listening to the Patient’s Voice: A Quantitative Study on Patient-Centredness in Diabetes Care in Palestinian Public Primary Care Services

by Hiba Ziad AbuZayyad and Shahenaz Najjar

Healthcare 2026, 14(12), 1747; https://doi.org/10.3390/healthcare14121747 - 17 Jun 2026

Viewed by 362

Abstract

Background/Objectives: Despite the growing burden of type 2 diabetes in Palestine and the central role of patient-centred care (PCC) in high-quality primary healthcare, evidence on PCC from the perspective of people with diabetes remains limited. This study aimed to assess patient-centredness in governmental primary healthcare centres in the West Bank from the perspective of adults with diabetes. Methods: A cross-sectional study was implemented in three primary healthcare directorates covering north, south, and central West Bank (WB). The perspectives of patients with type 2 diabetes mellitus (DM) on patient-centredness were investigated using an Arabic-translated version of the PPPC-R questionnaire. A total of 450 eligible patients were approached using non-probability convenience and quota sampling across the three directorates between August and September 2025. We used R (version 4.5.1) for the analysis. Results: A total of 417 patients completed the questionnaire (response rate 91%). Participants were (50.4%) women and (49.6%) men, with a mean age of 54.6 years (SD = 12.9). Participants reported moderate overall PCC perceptions (M = 2.82, SD = 0.50), with the highest mean scores for Enhancing the Clinician–Patient Relationship (M = 2.90, SD = 0.52), followed by Understanding the Whole Person (M = 2.77, SD = 0.56) and Finding Common Ground (M = 2.71, SD = 0.71). After adjustment for sociodemographic variables in multivariable analysis HC3-robust regression models, no predictor remained independently significant, and the models explained only a modest share of variance (R² ≈ 0.03–0.06). Conclusion: Perceived patient-centredness of diabetes care in governmental PHC clinics in the West Bank was moderate and varied by geographic and contextual factors. Findings suggest a need for targeted quality improvement initiatives to strengthen PCC in diabetes services and to expand the research to other governorates to obtain a clearer picture of the regional disparities within the Palestinian PHC system. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

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23 pages, 269 KB

Open AccessArticle

Assessing Cultural, Religious, and Spiritual Confidence and Perceived Preparedness in Community Palliative and End-of-Life Care: A Service Evaluation

by Zoebia Islam and Francesca Horne

Healthcare 2026, 14(11), 1555; https://doi.org/10.3390/healthcare14111555 - 2 Jun 2026

Viewed by 494

Abstract

Background: Cultural, religious, and spiritual (CRS) needs are central to holistic palliative and end-of-life care (PEoLC), yet the confidence and perceived preparedness of community and voluntary sector staff in addressing them remain underexplored. As PEoLC increasingly occurs in community settings, understanding staff preparedness for culturally and spiritually sensitive care is vital. Objective: This service evaluation examined CRS perceived preparedness and confidence among staff across Leicester, Leicestershire, and Rutland (LLR), exploring perceived challenges and available resources. Methods: A modified Confidence and Perceived preparedness in the CRS Care Survey was distributed to healthcare, hospice, charity, and community staff (May–August 2025). Likert scale data (n = 39) were analysed descriptively; qualitative responses underwent thematic analysis using Braun and Clarke’s framework, which was co-produced with stakeholders. Results: Staff placed high importance on CRS needs (cultural M = 4.48, SD = 0.61; religious/spiritual M = 4.66, SD = 0.53) but reported lower confidence in the organisational capacity to meet them (M = 3.15 and M = 3.05). Qualitative survey findings showed that staff recognised CRS needs as central to holistic, individualised care, emphasising proactive assessment and avoiding assumptions. Barriers included fear of causing offence, organisational constraints, and challenges in supporting families, alongside concerns about unmet needs. Participants highlighted reliance on informal resources and a clear need for accessible, lived-experience-based training and practical guidance. A prototype CRS resource toolkit, including lived-experience videos and guidance for supporting Muslim patients, was co-developed and reviewed by healthcare, community, and public contributors. Conclusions: Staff commitment to CRS-sensitive PEoLC is strong, but practical tools and training are lacking. A virtual CRS toolkit could enhance confidence, communication, and culturally responsive care across multidisciplinary settings. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

16 pages, 1100 KB

Open AccessArticle

Educating, Contextualizing, and Deferring: Qualitative Investigation of Physician Communication About Chronic Kidney Disease

by Amanda Ziegler, Kennedy Walcott-George, Adam Sullivan, Mary Gailor, Liise Kayler and Laurene Tumiel Berhalter

Healthcare 2026, 14(10), 1403; https://doi.org/10.3390/healthcare14101403 - 20 May 2026

Viewed by 742

Abstract

Background/Objectives: Chronic Kidney Disease (CKD) is a prevalent condition requiring ongoing patient counseling and engagement, yet little is known about how physicians communicate with patients about CKD in routine clinical practice. We conducted a qualitative study to examine physician communication approaches related to CKD and to assess how these approaches align with Picker’s principles of patient-centered care framework. Methods: Semi-structured interviews were conducted with primary care physicians and nephrologists practicing in community and safety-net settings. Using directed content analysis, we identified patterns in how clinicians describe educating patients, contextualizing clinical information, and deferring aspects of counseling to other providers. Results: Physicians predominantly emphasized information-giving and the use of laboratory data to explain disease status. In contrast, practices such as explicit patient preference elicitation, addressing fear, anxiety, or physical comfort, and involving family or support persons were infrequently described. Mapping these communication behaviors to patient-centered care principles highlighted specific elements that are routinely enacted and others that remain underutilized in everyday CKD counseling. Conclusions: These findings identify concrete, feasible opportunities to strengthen patient-centered communication through brief, practice-ready strategies such as plain-language explanations, teach-back, values checks, and shared decision-making prompts. Enhancing these communication practices represents a pragmatic opportunity to improve the quality and patient-centeredness of CKD care. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

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13 pages, 222 KB

Open AccessArticle

Patient Perceptions of Vascular Access and Quality of Life in Maintenance Hemodialysis: A Multicenter Study on Patient-Centered Outcomes

by Eirini Eftychia Kokkinidi, Angeliki Chandrinou, Konstantinos Exarchos, Alexios Alexopoulos, Evangelos Fradelos, Aikaterini Toska, Maria Saridi, Maria Malliarou and Pavlos Sarafis

Healthcare 2026, 14(5), 697; https://doi.org/10.3390/healthcare14050697 - 9 Mar 2026

Viewed by 1519

Abstract

Background: Vascular access is a core component of hemodialysis and may influence both clinical outcomes and patient-reported quality of life. This study examined the association between vascular access type and quality of life among patients receiving maintenance hemodialysis in multiple nephrology centers. Methods: We conducted a multicenter, cross-sectional observational study of 152 adults with end-stage kidney disease undergoing hemodialysis in public and private dialysis units in the Attica region, Greece (January–May 2022). Data were collected using a demographic/clinical questionnaire, the 36-Item Short Form Health Survey (SF-36), the Dialysis Patient Satisfaction Questionnaire (SDIALOR), and the Missoula VITAS Quality of Life Index (MVQOLI). Multivariable linear regression models were fitted for SF-36 and MVQOLI domain scores. Results: Most participants reported being very (40.8%) or quite (53.3%) satisfied with their current vascular access, and 69.5% considered an arteriovenous fistula (AVF) the most appropriate option. SF-36 scores were generally lower than those reported for the general population, except for the mental health domain. Compared with AVF, permanent catheter use was associated with lower SF-36 physical functioning scores, and graft use was associated with lower vitality scores. Lower vascular access satisfaction was consistently associated with lower HRQoL: compared with being “very” satisfied, being “quite” satisfied was associated with lower general health, vitality, social functioning, mental health, and lower PCS/MCS scores, while being “a little/not at all” satisfied was associated with lower general health and worse bodily pain scores. On MVQOLI, living alone and lower access satisfaction were associated with lower interpersonal relationships, transcendence/spirituality, and overall quality-of-life scores, while obesity was associated with lower function scores. Conclusions: Vascular access type, particularly AVF versus catheter, is associated with meaningful differences in quality of life among hemodialysis patients. Patient satisfaction with access and sociodemographic characteristics should be considered in patient-centered access planning and follow-up. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

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19 pages, 406 KB

Open AccessReview

Patient Engagement Strategies for Women with Gestational Diabetes Mellitus in Low-Resource Community Health Settings: A Narrative Review and Clinical Principles

by Matthew P. Martin, Nina Russin and Misha Pangasa

Healthcare 2026, 14(17), 2860; https://doi.org/10.3390/healthcare14172860 - 5 Sep 2026

Viewed by 333

Abstract

Background/Objectives: Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications and requires sustained patient engagement to achieve optimal maternal and neonatal outcomes. This narrative review synthesized current evidence on patient engagement strategies and developed clinical principles for implementing patient-centered care across the GDM care continuum. Methods: A domain-based narrative review was conducted using the Consensus literature search platform. A total of 5359 records were identified. After multi-phase screening for relevance and eligibility, 37 studies, including systematic reviews, randomized controlled trials, observational studies, and qualitative research, were included. Evidence was synthesized across four domains: universal screening and linkage to care, whole-person assessment, digital patient engagement, and postpartum transition. Results: Universal screening consistently detected more women with GDM than risk-based approaches, although greater detection alone did not consistently improve maternal or neonatal outcomes. Evidence supported structured patient education, culturally responsive communication, self-management support, and active clinician feedback as key components of effective engagement. Digital health interventions, including telehealth, mobile applications, and remote monitoring, improved adherence, self-management, patient satisfaction, and, in many studies, glycemic control when integrated with clinician oversight. Postpartum follow-up remained a persistent gap despite evidence supporting reminder systems and coordinated care transitions. These findings informed a stepped clinical care pathway tailored to low-resource community health settings. Conclusions: Current evidence supports several components of patient-centered GDM care that informed a proposed stepped clinical care pathway integrating early identification, whole-person assessment, structured education, self-management support, digital engagement, and coordinated postpartum care. Many recommended strategies can be implemented using existing personnel and low-cost digital technologies, although additional implementation research is needed to evaluate culturally tailored interventions and long-term effectiveness in underserved populations. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

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28 pages, 1130 KB

Open AccessReview

Psychotherapeutic Interventions and Psychosocial Outcomes Following Perinatal Loss: An Umbrella Review with a Patient-Centered Care Perspective

by Thalia Bellali, Anna Papadopoulou, Polyxeni Liamopoulou and Chrysovalantis Karagkounis

Healthcare 2026, 14(14), 2141; https://doi.org/10.3390/healthcare14142141 - 16 Jul 2026

Viewed by 731

Abstract

Background/Objectives: Perinatal loss is a profoundly distressing life event associated with grief, depression, anxiety, post-traumatic stress symptoms, and long-term psychosocial challenges among bereaved parents who experience miscarriage, stillbirth, or neonatal death. Although psychotherapeutic interventions are increasingly used to address these adverse outcomes, there is limited synthesis on how characteristics consistent with a patient-centered care perspective are reflected in such interventions and how they may relate to psychosocial well-being. This umbrella review aimed to synthesize evidence on psychotherapeutic interventions following perinatal loss and to examine patient-centered care–related dimensions reported across the included reviews, including therapeutic communication, patient engagement, therapeutic relationships, emotional validation, and meaning-making processes. Methods: An umbrella review was conducted in accordance with the Joanna Briggs Institute methodological guidance. Systematic reviews and meta-analyses published between 2019 and 2025 were identified through searches of PubMed, CINAHL, PsycINFO, and the Cochrane Library from database inception to 31 May 2026. Eligible reviews examined psychotherapeutic, psychosocial, and psychological support interventions designed to improve grief, depression, anxiety, post-traumatic stress symptoms, psychological distress, coping, and psychosocial well-being among bereaved parents following perinatal loss. In accordance with the predefined secondary exploratory objective, a secondary interpretive synthesis examined patient-centered care–related dimensions described within the included reviews. Results: Five systematic reviews and meta-analyses met the inclusion criteria. Interventions included cognitive behavioral therapy, mindfulness-based approaches, bereavement counseling, psychosocial support programs, narrative interventions, supportive counseling, and digitally delivered psychological therapies. Across reviews, psychotherapeutic interventions were generally associated with beneficial effects on grief, depression, anxiety, post-traumatic stress symptoms, and broader indicators of psychosocial well-being. Communication-, support-, and engagement-related characteristics consistent with a patient-centered care perspective, including empathy, therapeutic alliance, individualized support, emotional validation, and continuity of communication, were identified through secondary interpretive synthesis as recurring features of beneficial interventions. Digital modalities, such as internet-based cognitive behavioral therapy and telephone-delivered counseling, were consistently described as supporting accessibility, engagement, and continuity of care. Conclusions: Psychotherapeutic interventions following perinatal loss appear to improve a range of psychosocial outcomes. A patient-centered care perspective may help interpret how communication, emotional validation, patient engagement, and supportive therapeutic relationships are described in relation to psychological adaptation after loss. These dimensions should be understood as interpretive characteristics identified across the included reviews rather than as directly measured mechanisms of intervention effectiveness. Future research should examine communication processes, therapeutic alliance, and patient engagement using validated measures, assess how these factors relate to intervention effectiveness, and support the development of integrated, patient-centered models of perinatal bereavement care. Full article

(This article belongs to the Special Issue Patient-Centered Care and Well-Being: Health Communication and Patient Engagement)

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