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Towards Holistic Healthcare: Advancing Nursing and Medical Education

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

Deadline for manuscript submissions: closed (31 December 2025) | Viewed by 22653

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Dr. Polyxeni Mangoulia

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Department of Nursing, National and Kapodistrian University of Athens, Goudi, GR-11527 Athens, Greece
Interests: psychiatric nursing; mental health nursing; psychopharmacology; community nursing; psychoeducation; cognitive behavioral therapy; family nursing; patient education; nursing diagnosis; violence prevention
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Prof. Dr. Pavlos M. Myrianthefs

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National and Kapodistrian University of Athens, School of Nursing ICU at the “Agioi Anargyroi” Hospital, Noufaron and Timiou Stavrou Kaliftaki, Nea Kifissia, 14564 Athens, Greece
Interests: mechanical ventilation; spirometry; sepsis; septic shock; ventilation; lung; intensive care medicine; chronic obstructive pulmonary disease; ICU; CPR
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The Special Issue on issues of 'Towards Holistic Healthcare: Advancing Nursing and Medical Education' in holistic healthcare is dedicated to exploring the comorbidity of physical and psychiatric disorders in patients. The aim is to highlight the biopsychosocial model, according to which biological, psychological, and social parameters influence the predisposition, onset, course, and prognosis of most diseases. Many patients admitted to medical wards have co-occurring mental health issues, such as delirium, anxiety, depression, and dementia. unfortunately, a number of critically ill people remain untreated in hospitals due to unrecognized mental health issues, while the presence of psychological problems or psychiatric disorders is particularly common in chronic illness. When mental and physical illnesses coexist, this can result in worse health outcomes, longer hospital stays and more in-patient resources used, involvement from other related health services, prescription drug introduction, and discharge to long-term facilities, such as residential and nursing homes, as well as higher readmission and mortality rates. A higher percentage of mental illnesses coexist with physical illnesses, making interconnections between the medical and mental healthcare systems necessary. General hospitals place a high premium on the creation of liaison psychiatry services to address the requirements of patients with mental health issues who are admitted to medical wards.

The Special Issue aims:

To give nurses and doctors a comprehensive awareness of the biopsychosocial model;
To address the biological, psychological, and social needs of patients and their families;
Το investigate drug interactions and side effects so that healthcare professionals can incorporate this knowledge into their daily clinical practice;
To demonstrate the importance of education and training programs in equipping healthcare personnel with the skills and knowledge necessary to offer patients and their families holistic care;
To clarify the discipline of consultation liaison psychiatry and highlight its role in general hospitals;
To discuss how research conclusions could impact policy, with a focus on advocating for changes that enhance the standard and efficiency of care and recovery while also lowering hospitalization expenses and mortality.

Dr. Polyxeni Mangoulia
Prof. Dr. Pavlos M. Myrianthefs
Guest Editors

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

holistic care
nurses
doctors
consultation liaison psychiatry
hospitals
chronic disease
biopsychosocial model
comorbidity
drug interactions
depression
anxiety
dementia
delirium

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Related Special Issue

Towards Holistic Healthcare: Advancing Nursing and Medical Education—2nd Edition in Healthcare

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Research

16 pages, 807 KB

Open AccessArticle

Link Between Non-Invasive Intrapartum Interventions and Cardiotocography Patterns, Amniotic Fluid Color, and Immediate Neonatal Outcomes

by Nuria Garcia-Cuadrado, Ana Fernandez-Araque, Zoraida Verde, Maria Sainz-Gil, Carlos Durantez-Fernandez, Rosa M. Cardaba-Garcia and Veronica Velasco-Gonzalez

Healthcare 2026, 14(7), 888; https://doi.org/10.3390/healthcare14070888 - 30 Mar 2026

Viewed by 536

Abstract

Background: Non-invasive intrauterine resuscitation measures, such as maternal repositioning and intravenous fluid therapy, are used in the presence of suspicious or pathological cardiotocographic (CTG) patterns during labor. However, evidence regarding their link with CTG abnormalities, amniotic fluid color, and immediate neonatal outcomes is limited. Objectives: To analyze the link between maternal repositioning and intravenous fluid therapy and the occurrence of suspicious or pathological intrapartum CTG patterns, as well as their relationship with amniotic fluid color and immediate neonatal effects. Methods: An analytical, observational, prospective study was conducted in women in labor with continuous monitoring. Changes in maternal position, administration of intravenous fluid therapy, CTG patterns, amniotic fluid color, and immediate neonatal outcomes were analyzed. Links were evaluated using appropriate statistical tests, considering maternal positions in isolation and in combination. Results: Maternal repositioning, both alone and in combination, was associated with the presence of suspicious or pathological CTG and with statistically significant differences in the 5 min Apgar score when analyzed as a continuous variable. No significant association was observed between intravenous fluid therapy and CTG patterns or neonatal outcomes. The presence of meconium-stained amniotic fluid was associated with a higher frequency of suspicious or pathological CTG. Conclusions: Maternal repositioning was most frequently applied as a clinical response to a suspicious CTG. Intravenous fluid therapy showed no link with CTG abnormalities or adverse neonatal outcomes. These findings reinforce the need to interpret intrapartum CTG in an integrated manner with the overall clinical context and support the use of maternal repositioning as a non-invasive measure in intrapartum management. Full article

(This article belongs to the Special Issue Towards Holistic Healthcare: Advancing Nursing and Medical Education)

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14 pages, 274 KB

Open AccessArticle

Influence of Self-Compassion, Burden of BPSD, Communication Behavior, and Nursing Work Environment on Person-Centered Care for Patients with Dementia Among Long-Term Care Hospital Nurses

by Yong Min Kim, Mi Heui Jang and Min Jung Sun

Healthcare 2026, 14(1), 15; https://doi.org/10.3390/healthcare14010015 - 20 Dec 2025

Viewed by 967

Abstract

Objectives: This study aimed to identify the factors influencing person-centered care (PCC) among nurses working at long-term care hospitals for patients with dementia and to propose strategies for strengthening their capacity to provide PCC. Methods: Guided by the ecological model, this descriptive study examined the effects of personal factors (self-compassion and the burden of behavioral and psychological symptoms of dementia [BPSD]), interpersonal factors (communication behavior), and organizational factors (nursing work environment) on PCC. Participants were 152 nurses who had worked for more than two months at four long-term care hospitals in Seoul and Gyeonggi Province, South Korea. Data were collected between 8 January and 4 February 2024, and analyzed using SPSS version 23.0. Results: Hierarchical multiple regression analysis showed that the strongest predictors of PCC were the nursing work environment (β = 0.36, p < 0.001), having received dementia-related education twice (β = 0.26, p = 0.008), self-compassion (β = 0.23, p = 0.017), having received dementia-related education three or more times (β = 0.22, p = 0.036), and communication behavior (β = 0.20, p = 0.026). The final model (Model 3) explained 41.5% of the variance in PCC (adjusted R² = 0.415, F = 5.70, p < 0.001). Conclusions: To strengthen PCC among nurses in long-term care hospitals, comprehensive efforts to improve the nursing work environment are essential. Institutional support should particularly focus on securing sufficient nursing staff and ensuring adequate material resources. In addition, continuous dementia-related education and training programs that foster self-compassion and communication skills among nurses are recommended. Full article

(This article belongs to the Special Issue Towards Holistic Healthcare: Advancing Nursing and Medical Education)

16 pages, 797 KB

Open AccessArticle

Implementation of +PERTO^® in Rehabilitation for Total Knee Arthroplasty: A Pilot Study

by Tiago Emanuel Soares de Araújo, Elsa Paula Santos Rodrigues, Ana Raquel Varejão Files, João Miguel Almeida Ventura-Silva, Jorge Eduardo Ferreira Mendes, André Filipe Morais Pinto Novo and Olga Maria Pimenta Lopes Ribeiro

Healthcare 2025, 13(6), 605; https://doi.org/10.3390/healthcare13060605 - 11 Mar 2025

Cited by 1 | Viewed by 2404

Abstract

Background/Objectives: Total knee Arthroplasty (TKA) is a prevalent treatment modality for degenerative knee diseases. Nevertheless, the success of the intervention is contingent on effective rehabilitation. The +PERTO^® program (a Technological Rehabilitation Nursing Program) was developed as a mobile application comprising three phases to support patients during the perioperative period by providing exercises, information, and direct communication with healthcare professionals. The present study aims to evaluate the effects and usability of the +PERTO^® program in patients undergoing total knee arthroplasty. Methods: In 2024, a hospital in northern Portugal conducted a pilot trial with eleven patients undergoing elective total knee arthroplasty. Researchers collected data both before surgery and six weeks after discharge. To evaluate effectiveness, software satisfaction, and usability, they used several assessment tools, including the Oxford Knee Score (OKS), SF-36v2, Visual Analog Scale (VAS), Short Physical Performance Battery (SPPB), QSEnf-10, and System Usability Scale (SUS). Researchers analyzed the data using both descriptive and inferential statistics. The hospital’s ethics committee and board of directors approved the study. Results: There was a significant reduction in pain (p = 0.041) and improvement in knee functionality (p = 0.010), physical performance (p = 0.038), and quality of life (p < 0.05). Patient satisfaction was high (QSEnf-10: 3.8/4), and the usability of +PERTO^® was considered excellent (SUS: 96.6/100). Conclusions: The +PERTO^® program proved to be an effective and innovative solution to support rehabilitation after TKA, promoting improvements in pain, functionality, and quality of life. This digital program stands out for its high rate of usability and its ability to modernize healthcare by providing a patient-centered approach. Full article

(This article belongs to the Special Issue Towards Holistic Healthcare: Advancing Nursing and Medical Education)

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25 pages, 367 KB

Open AccessArticle

Exploring the Levels of Stress, Anxiety, Depression, Resilience, Hope, and Spiritual Well-Being Among Greek Dentistry and Nursing Students in Response to Academic Responsibilities Two Years After the COVID-19 Pandemic

by Polyxeni Μangoulia, Antonia Kanellopoulou, Georgia Manta, Georgios Chrysochoou, Evangelos Dimitriou, Theodora Kalogerakou and Maria Antoniadou

Healthcare 2025, 13(1), 54; https://doi.org/10.3390/healthcare13010054 - 31 Dec 2024

Cited by 7 | Viewed by 5598

Abstract

Background: Dentistry and nursing students experience significant anxiety, negatively impacting their well-being and academic performance. Objectives: This study aims to assess the prevalence and relationships of stress, anxiety, depression, resilience, hope, and spiritual well-being among dentistry and nursing students, identify demographic influences and propose strategies to enhance resilience and well-being. Methods: This study surveyed 271 students attending Greece’s departments of dentistry and nursing at the National and Kapodistrian University of Athens, using an electronic questionnaire aimed to assess stress, anxiety, and depression (depression, anxiety, stress scale—DASS-21); resilience (resilience assessment questionnaire—RAQ8, brief resilience scale—BRS); hope (adult hope scale—AHS); and spiritual well-being (functional assessment of chronic illness therapy–spiritual well-being scale—FACIT-Sp-12). The survey also collected demographic data to identify factors influencing these variables. Statistical analyses, including hierarchical multiple linear regression and t-tests, were performed to analyze the relationships between variables. Results: The sample included 145 dentistry and 126 nursing students, with 68.6% female and 80.1% undergraduate. Half of the students reported mild or higher levels of stress (48.7%), anxiety (51.3%), and depression (53.5%). The prevalence of depression was the highest in our sample, followed by anxiety and stress. Higher family wealth was associated with reduced stress levels, while female undergraduate students reported higher levels of anxiety than their male counterparts. Hope was a strong predictor of resilience, but stress and worry had a negative correlation. Conclusions: Promoting students’ well-being and academic success requires effective stress-reduction and resilience-building techniques to improve students’ performance and support future healthcare professionals’ personal sustainability and holistic growth. Full article

(This article belongs to the Special Issue Towards Holistic Healthcare: Advancing Nursing and Medical Education)

11 pages, 234 KB

Open AccessArticle

Assessing Daily Function and Sleep Disorders in Hemodialysis Patients with End-Stage Renal Disease

by Maria Saridi, Georgios Batziogiorgos, Aikaterini Toska, Ioanna Dimitriadou, Foteini Malli, Stella Zetta and Evangelos C. Fradelos

Healthcare 2024, 12(21), 2115; https://doi.org/10.3390/healthcare12212115 - 23 Oct 2024

Cited by 3 | Viewed by 3671

Abstract

Background: Chronic, end-stage renal disease significantly impacts patients’ daily activities and sleep quality, particularly those undergoing hemodialysis. However, there is limited research on the extent of these challenges and their correlation with this population. Aim: This study aims to assess the level of activity of daily living and the prevalence of sleep disturbances in patients with end-stage renal disease undergoing hemodialysis. Method: A cross-sectional study involved 130 patients receiving hemodialysis in two public General Hospitals in Greece. The Barthel Index was used to measure daily living activity, while the Athens Insomnia Scale assessed sleep disorders. The data were analyzed using SPSSV25.0. Results: Of the 210 questionnaires, 130 were returned fully completed (response rate 62%). Most of the sample participants suffered from comorbidities (76.9%). The total Barthel Index score showed moderate dependence for patients, significantly related to the years and hours of dialysis (p = 0.007 and p = 0.000, respectively). The total score of the Athens Insomnia Scale was also significantly associated with age (p = 0.029), marital status (p = 0.015) and the years and hours of hemodialysis (p = 0.004 and p = 0.001, respectively). A statistically significant difference was recorded between the daily activity of patients with end-stage renal failure and their sleep quality (p = 0.000) Finally, the physical activity level of the participants was related to the existence of another physical health (p = 0.000) or mental health problem (p = 0.000). Conclusions: Hemodialysis patients with chronic, end-stage renal disease experience significant challenges in maintaining daily activities and are prone to sleep disorders. These findings suggest a need for integrated care strategies that address both physical function and sleep quality to improve the overall well-being of this population. Full article

(This article belongs to the Special Issue Towards Holistic Healthcare: Advancing Nursing and Medical Education)

12 pages, 264 KB

Open AccessArticle

Emotional Intelligence as Critical Competence in Nurses’ Work Performance: A Cross-Sectional Study

by Petros Galanis, Aglaia Katsiroumpa, Ioannis Moisoglou, Konstantina Derizioti, Parisis Gallos, Maria Kalogeropoulou and Vasiliki Papanikolaou

Healthcare 2024, 12(19), 1936; https://doi.org/10.3390/healthcare12191936 - 27 Sep 2024

Cited by 12 | Viewed by 7844

Abstract

Background/Objectives: Emotional intelligence may help nurses to cope with demanding work environments where the need to improve the quality and safety of the care provided, as well as the care of the chronically ill, prevails. Although it is well known that emotional intelligence is positively related to work performance, the literature on nurses is limited. The aim of our study was to examine the impact of emotional intelligence on work performance in a sample of nurses in Greece. Methods: We conducted a cross-sectional study with 318 nurses. We collected data from a convenience sample of nurses during January 2024. Since we conducted an online survey through social media, our sample could not be representative of all nurses in Greece. For instance, older nurses may be underrepresented in our study due to limited access on social media. We measured emotional intelligence with the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF) and work performance with the Individual Work Performance Questionnaire (IWPQ). We created multivariable linear regression models adjusted for sex, age, educational level, and work experience. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: We found that the four streams of emotional intelligence (i.e., well-being, self-control, emotionality, sociability) increased nurses’ work performance. In particular, we found a positive relationship between well-being and task performance (adjusted beta = 0.210, 95% CI = 0.140 to 0.281, p-value < 0.001) and contextual performance (adjusted beta = 0.135, 95% CI = 0.050 to 0.221, p-value = 0.002). Similarly, there was a positive relationship between self-control and task performance (adjusted beta = 0.136, 95% CI = 0.030 to 0.241, p-value = 0.012). Additionally, sociability increased task performance (adjusted beta = 0.223, 95% CI = 0.151 to 0.295, p-value < 0.001) and contextual performance (adjusted beta = 0.198, 95% CI = 0.111 to 0.286, p-value < 0.001). Moreover, emotionality (adjusted beta = −0.198, 95% CI = −0.319 to −0.076, p-value = 0.002) and sociability (adjusted beta = −0.133, 95% CI = −0.221 to −0.044, p-value = 0.003) reduced counterproductive work behavior. Conclusions: Our multivariable models identified a positive impact of emotional intelligence on nurses’ work performance. Nurse managers and healthcare organizations should adopt appropriate interventions to improve nurses’ emotional intelligence. Enhancing emotional intelligence among nurses can improve work performance and, thus, healthcare outcomes. Moreover, higher levels of emotional intelligence may empower nurses’ compassion and resilience, fostering a supportive work environment. In this context, the well-being of both nurses and patients may improve. Full article

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