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Quality of Life and Health Promotion in Chronic Illness or...
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Quality of Life and Health Promotion in Chronic Illness or Critical Medical Conditions: Implications for Integrated Health Care Delivery

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: closed (30 June 2025) | Viewed by 8114

Special Issue Editor

Dr. M. Graça Pereira

E-Mail Website
Guest Editor
Psychology Research Center (CIPsi), School of Psychology, University of Minho, 4710-057 Braga, Portugal
Interests: impact of chronic illness in patients, family and/or caregivers; health and iIlness processes in vulnerable groups; individual and family health promotion; integrated health care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue seeks to address the impact of chronic disease or critical medical conditions across an individual’s lifespan. The goal is to bring together researchers addressing quality of life and health promotion in chronic illness in order to inform high-quality integrated care programs to facilitate adaptation and treatment in patients, families and caregivers.

The current Special Issue welcomes research papers in the area of clinical health informed by all disciplines including, but not limited to, psychology, public health sciences, behavioral medicine, epidemiology, family therapy, and nursing, addressing patients, couples, families and caregivers. Research based on the integration between primary care and secondary care as well as between health care and community care are particularly welcome.

Dr. M. Graça Pereira
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 100 words) can be sent to the Editorial Office for announcement on this website.

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

  • quality of life
  • health promotion
  • integrated healthcare
  • family
  • caregivers

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Published Papers (4 papers)

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Research

26 pages, 421 KB  
Article
Autonomic Dysregulation Mediates the Association Between Childhood Trauma and Pain Severity: Evidence from a Mediation Model
by Eleonora C. V. Costa, Patrícia Gonçalves, Fernando Martins, Sílvia Monteiro and Carla Pais-Vieira
Healthcare 2025, 13(18), 2310; https://doi.org/10.3390/healthcare13182310 - 16 Sep 2025
Viewed by 518
Abstract
Background: Childhood trauma is increasingly recognized as a key risk factor for autonomic nervous system (ANS) dysregulation and chronic pain. However, the mechanisms underlying this association remain insufficiently explored, particularly within integrated healthcare frameworks. Objective: This study examined whether autonomic reactivity mediates the [...] Read more.
Background: Childhood trauma is increasingly recognized as a key risk factor for autonomic nervous system (ANS) dysregulation and chronic pain. However, the mechanisms underlying this association remain insufficiently explored, particularly within integrated healthcare frameworks. Objective: This study examined whether autonomic reactivity mediates the relationship between childhood trauma and pain severity while accounting for age and gender. Methods: A total of 124 participants—64 with formally documented interpersonal trauma and 60 without—completed validated measures of childhood trauma (CTQ), cumulative trauma (LEC-17), autonomic reactivity (BPQ), and pain severity (BPI). Group comparisons, correlation analyses, and hierarchical regressions were used to assess associations among variables. A mediation model was used to test whether autonomic reactivity explained the trauma–pain relationship. Results: Trauma-exposed participants showed significantly higher autonomic reactivity than those without, while pain severity did not differ significantly between groups (p < 0.001). Childhood physical and emotional abuse was strongly associated with autonomic reactivity and moderately associated with pain severity but not directly linked to pain. Mediation analysis supported a full mediation, with childhood trauma predicting pain severity indirectly via autonomic reactivity (β = 0.220, 95% CI [0.087–0.422], p = 0.009). A preliminary gender effect on the trauma–ANS pathway was observed but was not sustained in weighted models correcting for sample imbalance. Conclusions: Autonomic dysregulation was found to mediate the link between childhood trauma and pain vulnerability. Incorporating autonomic assessment into trauma-informed, integrated healthcare could inform early detection and tailored interventions, with preliminary evidence suggesting generalizability across gender. Full article
(This article belongs to the Special Issue Quality of Life and Health Promotion in Chronic Illness or Critical Medical Conditions: Implications for Integrated Health Care Delivery)
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15 pages, 281 KB  
Article
The Role of Physical Activity in Moderating Psychopathological Symptoms and Quality of Life Among Adult Cancer Survivors: A Cross-Sectional Study
by Andreia Pereira Tavares, Paula Saraiva Carvalho and Ana Torres
Healthcare 2025, 13(17), 2232; https://doi.org/10.3390/healthcare13172232 - 6 Sep 2025
Viewed by 441
Abstract
Background/Objectives: Several studies indicate that physical activity is both safe and beneficial for most cancer survivors—before, during and after treatment. These benefits include improved mental health and a subsequent positive impact on quality of life. This study aimed to (1) assess the [...] Read more.
Background/Objectives: Several studies indicate that physical activity is both safe and beneficial for most cancer survivors—before, during and after treatment. These benefits include improved mental health and a subsequent positive impact on quality of life. This study aimed to (1) assess the mental health of cancer survivors in terms of depression and anxiety, (2) analyze levels of physical activity within the sample, and (3) explore the relationship between psychopathological symptoms, physical activity, and perceived quality of life. Methods: This is a cross-sectional study of 55 cancer survivors, with a mean age of 62.27 ± 11.91, living in inland of Portugal and not undergoing palliative care. Data were collected using a sociodemographic, clinical and physical activity questionnaire, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder scale (GAD-7), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30), and the Godin Leisure-Time Exercise Questionnaire (GLTEQ). Data was analyzed using descriptive statistics, Cronbach’s coefficient to assess the internal consistency, Spearman’s correlation, and multiple linear regression. Results: The results revealed significant associations between physical activity, psychopathological symptomatology, and quality of life. Specifically, the interaction between depression and physical activity had a negative impact on quality of life (B = −0.181; 95% CI −0.291 to −0.070; p = 0.002), whereas the interaction between anxiety and physical activity showed a positive effect (B = 0.165; 95% CI 0.037 to 0.293; p = 0.013). Conclusions: Physical activity enhances the quality of life of cancer survivors and moderates the negative impact of psychopathological symptoms. This highlights the importance of promoting healthy lifestyles and empowering healthcare professionals to recommend supervised physical activity as part of integrated and personalized care. Further studies should explore the relationship between other psychopathological symptoms, such as somatization, and physical activity in relation to quality of life. Full article
(This article belongs to the Special Issue Quality of Life and Health Promotion in Chronic Illness or Critical Medical Conditions: Implications for Integrated Health Care Delivery)
26 pages, 1815 KB  
Article
Towards the Improvement of Patient Experience Evaluation Items for Patient-Centered Care in Head and Neck Cancer: A Qualitative Comparative Study
by Eun-Jeong Kim, Yoo-Ri Koo and Inn-Chul Nam
Healthcare 2024, 12(12), 1164; https://doi.org/10.3390/healthcare12121164 - 8 Jun 2024
Viewed by 1735
Abstract
Owing to long-term treatment, frequent consultations, and complications, the evaluation of patients with head and neck cancer (HNC) must be improved. This study explored an opportunity for improving patient experience (PE) evaluation of patients with HNC to achieve a patient-centered, integrative evaluation model [...] Read more.
Owing to long-term treatment, frequent consultations, and complications, the evaluation of patients with head and neck cancer (HNC) must be improved. This study explored an opportunity for improving patient experience (PE) evaluation of patients with HNC to achieve a patient-centered, integrative evaluation model based on patient needs. The study comprised four phases: (1) a systematic literature review of PE factors for patient quality of life (QoL) and establishment of PE factor categories as a framework, (2) a review of current cancer or HNC PE evaluation tools, (3) identification of potential PE evaluation items based on patient needs by conducting user research, and (4) suggestion of integrative HNC PE evaluation items through expert validation. As a result, the 39 potential items were initially identified from the literature review and user research. After conducting two survey rounds with experts, 25 items were suggested as HNC PE evaluation items. These underscore the importance of highlighting the patient’s participation, the medical staff’s comprehensive information delivery, empathy, and collaborative communication, the hospital’s support of communication channels, the medical environment for patient emotional support, the education program, and systematic patient satisfaction data management. PE evaluation items that consider the diverse perspectives of stakeholders involved in HNC treatment and factors of comprehensive PE will contribute to improving HNC patient-centered care (PCC). Full article
(This article belongs to the Special Issue Quality of Life and Health Promotion in Chronic Illness or Critical Medical Conditions: Implications for Integrated Health Care Delivery)
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21 pages, 631 KB  
Article
Perceptions and Experiences of Parents of Burn-Injured Children during Hospital Stay: A Need for Integrated Care
by Martim Santos, Ana Ferraz, Maria Garcia and M. Graça Pereira
Healthcare 2024, 12(6), 614; https://doi.org/10.3390/healthcare12060614 - 8 Mar 2024
Cited by 10 | Viewed by 3940
Abstract
Pediatric burn injuries are a critical medical condition that triggers a series of ongoing multifactorial stressors that affect both children and their families. To inform healthcare research and clinical practice, this study aimed to understand and describe the perceptions and experiences of the [...] Read more.
Pediatric burn injuries are a critical medical condition that triggers a series of ongoing multifactorial stressors that affect both children and their families. To inform healthcare research and clinical practice, this study aimed to understand and describe the perceptions and experiences of the parents of burn-injured children during hospital stay. Forty-six parents (thirty-eight mothers) of forty-six children (eighteen girls) with a mean age of 2.28 years (SD = 1.52) answered ten open-ended questions. This qualitative study was conducted in a referral hospital in the northern region of Portugal. Qualitative data were analyzed using an inductive content analysis. Five key themes emerged from the data analysis: diving into the crisis of the child burn injury, being together and in good hands, becoming aware of an uncertain future, enhancing supportive care and environment, and finding ways to guide parents. Qualitative findings underlined the pressing need for integrated care within this context. Parents were significantly burdened and distressed during the inpatient phase. These parents should be included in the integrated care plan starting from admission. Understanding and addressing parents’ healthcare needs and psychosocial adjustment difficulties is paramount to the development of future intervention programs and the delivery of suitable integrated healthcare. Full article
(This article belongs to the Special Issue Quality of Life and Health Promotion in Chronic Illness or Critical Medical Conditions: Implications for Integrated Health Care Delivery)
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