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Innovative Approaches to Chronic Disease Patient Care

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

Deadline for manuscript submissions: 31 July 2026 | Viewed by 6238

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Special Issue Editors

Dr. Manuel Pabón Carrasco

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Guest Editor

Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/Avenzoar, 41009 Seville, Spain
Interests: pain; nursing process; outcomes in health; complexity of care; meta-analysis; nursing healthcare; helycobacter pylori
Special Issues, Collections and Topics in MDPI journals

Dr. Rocío Cáceres-Matos

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Guest Editor Assistant

Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/Avenzoar, 41009 Seville, Spain
Interests: chronic pain; chronicity; pain management; nursing; gender and health; psychometry validation

Special Issue Information

Dear Colleagues,

In the context of chronic disease management, innovative approaches are playing a crucial role in improving patient care and optimizing outcomes across various areas of health sciences. These approaches aim not only to address the immediate physical needs of patients but also to integrate emotional, psychological, and social aspects, promoting a holistic and patient-centered model of care. Advances in personalized care and the integration of technologies are transforming how health professionals approach chronic disease management, offering new opportunities to enhance patients' quality of life.

In the literature, a wide range of innovative approaches are being applied across different health contexts. This diversity is a necessary response to the complex and varied needs of chronic disease patients; however, it also poses challenges for professionals in selecting the most appropriate interventions. The lack of standardized approaches and inconsistent evidence across studies limits the generalization of effective practices and hinders the large-scale implementation of care models.

This highlights the need to refine and adapt these approaches to make them more suitable for various clinical and cultural contexts. Ongoing research into innovative strategies will not only benefit patients but also health professionals and researchers. Developing universally accepted frameworks and guidelines would facilitate comparative studies and promote the widespread adoption of evidence-based practices across all areas of health sciences.

We are pleased to invite you to submit articles on innovative approaches to chronic disease patient care. In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following topics:

Systematic reviews and meta-analyses of innovative care models for chronic diseases.
Validation studies of new care approaches.
Research on the integration of technology in chronic disease management.
Comparative studies of different care models and their effectiveness.
Cross-sectional studies on the adaptation of innovative care approaches in various cultural or healthcare contexts.

We look forward to receiving your valuable contributions.

Dr. Manuel Pabón-Carrasco
Guest Editor

Dr. Rocío Cáceres-Matos
Guest Editor Assistant

Manuscript Submission Information

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

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

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

Keywords

chronicity
innovative strategies
innovative care models
multidisciplinarity

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Published Papers (6 papers)

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12 pages, 446 KB

Open AccessArticle

Frailty and Outcomes in Elderly ICU Patients: Insights from a Portuguese Cohort

by Eva Lourenço, Isabel Rodrigues, Mário Sampaio and Emília-Isabel Martins Teixeira-da-Costa

Healthcare 2025, 13(23), 3063; https://doi.org/10.3390/healthcare13233063 - 26 Nov 2025

Viewed by 171

Abstract

Background: Frailty is a key determinant of outcomes in critically ill elderly patients, but data from Portugal remain limited. To our knowledge, this is the first study to examine the prevalence and prognostic impact of frailty among elderly ICU patients in a Portuguese hospital setting. Objective: To determine the prevalence of frailty among elderly patients admitted to an intensive care unit (ICU) in southern Portugal and to examine its crude associations with illness severity, organ support, and mortality outcomes. Methods: We conducted a retrospective cohort study including 125 patients aged ≥ 65 years admitted to the polyvalent ICU of Hospital de Faro over the last six months of 2024. Data included demographics, comorbidities, Charlson Comorbidity Index (CCI), severity scores (SOFA, SAPS II, APACHE II), and frailty status assessed by the Clinical Frailty Scale (CFS). Outcomes were the need for organ support, ICU and hospital mortality, and length of stay. Results: Frailty (CFS ≥ 5) was identified in 30.4% of patients. Frail patients were older, had higher comorbidity burden (CCI), and presented with significantly higher severity scores at admission. They also required more invasive support, including vasopressors and invasive mechanical ventilation, while acute kidney injury (AKI) requiring renal replacement therapy (RRT) was similar between groups. ICU mortality was significantly higher among frail patients (50.0% vs. 31.0%), as was hospital mortality (76.3% vs. 33.3%). Length of ICU stay did not differ, although frail patients tended to have longer hospitalizations overall. Conclusions: Frailty was highly prevalent and strongly associated with increased severity, greater need for organ support, and higher mortality. Routine frailty assessment at ICU admission may enhance prognostic accuracy and support patient-centered decision-making. Full article

(This article belongs to the Special Issue Innovative Approaches to Chronic Disease Patient Care)

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15 pages, 591 KB

Open AccessArticle

Effectiveness of Blog Writing Intervention for Promoting Subjective Well-Being, Resilience, and Post-Traumatic Growth of Palliative Care Nurses

by Nasreen Lalani, Gulnar Ali, Kawther Hamash and Aracely Ines Jimenez Paladines

Healthcare 2025, 13(21), 2757; https://doi.org/10.3390/healthcare13212757 - 30 Oct 2025

Viewed by 414

Abstract

Background/Objectives: Palliative care nurses are at risk of burnout, trauma, and poor well-being. Expressive writing interventions are shown to promote self-reflection, personal growth, and resilience. A pilot study was designed to test the feasibility and use of a self-reflexive blog writing intervention to promote the subjective well-being, resilience, and personal growth of palliative care nurses during the COVID-19 pandemic. Methods: A sample of N = 144 registered nurses working in palliative care settings were enrolled in the study. Recruitment was performed using university alumni, nursing, and palliative care organization member listservs. Self-reported surveys such as the Subjective Well-Being Inventory (SUBI), Brief Resiliency Scale (BRS), and Post-traumatic Growth Inventory (PTGI) scales were used to evaluate study outcomes. Pre- and post-surveys were obtained at baseline, 4 weeks, and 6 weeks. Upon baseline survey completion, participants were randomly assigned to control and intervention groups. Participants in the intervention group were asked to write two weekly blog entries for a period of four weeks using a blog template on Qualtrics software. Descriptive statistical measures were used to evaluate the study outcomes and content analysis to analyze descriptive survey responses and blog narratives. Results: A total of N = 57 participants completed this study. Most participants were females (93%), White (89.5%), married (93%), and full-time employees (96.5%) and underwent PC training (93%). The findings indicate significant improvement in the subjective well-being (MD = 2.43, p < 0.05) and resilience scores (MD = 0.244, p < 0.05) in the intervention group. No significant changes were found in post-traumatic growth scores post-intervention. Most participants found blog writing as a supportive tool to reflect on their personal experiences and to ventilate their emotions and feelings. Conclusions: Self-reflexive blog writing is convenient and a potentially effective method for promoting the resilience and well-being of nurses. Future studies are needed to evaluate its effectiveness in a larger sample across different practice settings. Full article

(This article belongs to the Special Issue Innovative Approaches to Chronic Disease Patient Care)

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13 pages, 230 KB

Open AccessArticle

Hostility in the ICU Waiting Room: Extrapunitive and Intropunitive Reactions Among Family Members

by Zoe Konstanti, Fotios Tatsis, Konstantinos Stamatis, Foteini Veroniki, Georgios Papathanakos, Vasilios Koulouras and Mary Gouva

Healthcare 2025, 13(20), 2650; https://doi.org/10.3390/healthcare13202650 - 21 Oct 2025

Viewed by 387

Abstract

Background/Objectives: Families of ICU patients endure intense psychological strain. While anxiety and depression are well documented, less attention has been given to hostility—expressed both outwardly as anger and inwardly as guilt or self-criticism. Hostility, however, often shapes the climate of the ICU waiting room and the collaboration between families and staff. This study examined the levels and forms of hostility among ICU relatives, focusing on demographic predictors that may influence extrapunitive and intropunitive reactions. Methods: A cross-sectional study was conducted between June 2018 and December 2019 with 215 family members of ICU patients. Hostility was assessed using the Hostility and Direction of Hostility Questionnaire (HDHQ). Descriptive statistics, t-tests, ANOVAs, and multivariate regression analyses were performed to examine the effects of age, gender, and education on hostility subscales. Results: Male relatives exhibited higher acting-out hostility (M = 4.80, SD = 2.63) compared with female relatives (M = 4.12, SD = 2.21; t(216) = 1.96, p = 0.05, Cohen’s d = 0.28). Relatives with lower educational attainment showed significantly higher total hostility (β = −1.23, 95% CI [−1.78, −0.67], p < 0.001) and greater self-criticism (β = −0.44, 95% CI [−0.84, −0.03], p = 0.037). Younger age was associated with increased acting-out hostility (β = −0.029, 95% CI [−0.055, −0.002], p = 0.035). The regression models explained 12–26% of the variance across subscales (R² range = 0.12–0.26). These findings suggest two vulnerability trajectories: an externalized (extrapunitive) pattern in younger men and a broad internalized (intropunitive) pattern in relatives with lower education. Conclusions: Hostility in ICU families emerges in two distinct trajectories: externalized anger among young men and broad hostility in relatives with lower education. Recognizing these patterns is vital for preventing conflict, addressing hidden guilt and self-blame, and developing subgroup-sensitive interventions. The ICU waiting room is a space not only of fear and uncertainty but also of anger, guilt, and fragile attempts at psychological survival—dimensions that deserve systematic attention in both clinical practice and research. Full article

(This article belongs to the Special Issue Innovative Approaches to Chronic Disease Patient Care)

16 pages, 237 KB

Open AccessArticle

Impact on Health, Resources, and Satisfaction: A Qualitative Study of Primary Health Care Case-Management Nurses

by María José Molina-Gil, María Dolores Guerra-Martín and Rocío De Diego-Cordero

Healthcare 2025, 13(9), 974; https://doi.org/10.3390/healthcare13090974 - 23 Apr 2025

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Abstract

The aging population and the increasing prevalence of chronic diseases necessitate new healthcare models. Case-Management Nurses (CMNs) emerge as a promising alternative to enhance patient care. Objective: To explore CMNs’ perceptions of the impact on health, resources, and professional satisfaction. Methods: A qualitative study using semi-structured interviews was conducted with CMNs from a southern Spanish province. This study adheres to the Standards for Reporting Qualitative Research (SRQR). The population consisted of 61 CMNs. Three analytical categories of a theoretical or deductive nature were identified, directly related to this study’s objective. This study was approved by the Andalusian Biomedical Research Ethics Committee (Code: 1139-N-22) and conducted in accordance with the Declaration of Helsinki. Data analysis was performed using ATLAS.ti. Results: The sample was comprised of 31 CMNs (24 women). The mean age was 56.3 years. A total of 12 CMNs had more than 20 years of experience. Interviews were conducted between October and November 2022. Within each category, different emerging subcategories were identified: 1. Impact on health: Patients and caregivers. 2. Impact on resources: Computer tools, effectiveness/efficiency of the CMNs, and material resources. 3. Impact on professional satisfaction: Positive professional satisfaction and negative professional satisfaction. Conclusions: The findings suggest that the practice of CMNs in primary care improves the health and quality of life of patients and their caregivers while reducing healthcare resource utilization. CMNs reported high levels of job satisfaction. These findings support the implementation of this care model to optimize the management of chronic patients in home and residential care settings. However, larger-scale quantitative studies are needed to confirm these results and explore their generalizability. Full article

(This article belongs to the Special Issue Innovative Approaches to Chronic Disease Patient Care)

12 pages, 557 KB

Open AccessArticle

Effectiveness of an Early Intervention in Mild Hyponatremia to Prevent Accidental Falls in Hospitalized Older Adults—A Crossover Ecological Clinical Trial

by Carmen Lobo-Rodríguez, Azucena Pedraz-Marcos, Juan Francisco Velarde-García, Elena Calderari Fernández, Carmen Gadea-Cedenilla, Margarita Medina-Torres, Mª Nieves Moro-Tejedor, Leonor Sánchez García and Ana Mª García-Pozo

Healthcare 2025, 13(8), 865; https://doi.org/10.3390/healthcare13080865 - 10 Apr 2025

Cited by 1 | Viewed by 1166

Abstract

Background: Falls in hospitalized patients cause injuries of varying severity and even death. There is a link between falls and low blood sodium levels in older patients. Identifying and treating hyponatremia could help prevent falls and reduce hospital stays. The purpose of this study was to evaluate the effectiveness of the correction of hyponatremia on reducing the incidence of falls and the mean stay of hospitalized patients aged more than 65 years. Methods: A crossover ecological clinical trial was conducted in adult hospitalization units of a hospital in Madrid (Spain) over 12 months. Patients meeting inclusion criteria were divided into two randomized groups. The intervention was applied in two six-month phases, alternating between groups with a 15-day washout period. Early diagnosis and treatment of hyponatremia were implemented in the intervention group, while the control group received standard care. Primary outcomes included fall incidence and length of hospital stay. Data were collected using REDCap and analyzed with SPSS v.21. Statistical significance was set at p < 0.05 (ClinicalTrials identifier of the manuscript: NCT03265691). Results: A total of 1925 patients were included (408 intervention, 1517 control). Fall incidence was significantly lower in the intervention group (6.7 vs. 9.8, p = 0.000). Hyponatremia was corrected in 72% of cases. No significant differences were found in functional scores. The intervention effectively reduced falls compared to standard care. Conclusions: Early hyponatremia treatment reduces falls and hospital stay in older patients, supporting its inclusion in fall prevention strategies. Full article

(This article belongs to the Special Issue Innovative Approaches to Chronic Disease Patient Care)

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18 pages, 2318 KB

Open AccessSystematic Review

Dropout Rate of Participants with Cancer in Randomized Clinical Trials That Use Virtual Reality to Manage Pain—A Systematic Review with Meta-Analysis and Meta-Regression

by Cristina García-Muñoz, María-Dolores Cortés-Vega and Patricia Martínez-Miranda

Healthcare 2025, 13(14), 1708; https://doi.org/10.3390/healthcare13141708 - 16 Jul 2025

Viewed by 1296

Abstract

Background/Objectives: Virtual reality has emerged as a promising intervention for pain management in individuals with cancer. Although its clinical effects have been explored, little is known about participant adherence and dropout behavior. This systematic review and meta-analysis aimed to estimate the pooled dropout rate in randomized controlled trials using virtual reality to treat cancer pain; assess whether dropout differs between groups; and explore potential predictors of attrition. Methods: We conducted a systematic search of PubMed, Web of Science, Scopus, and CINAHL up to April 2025. Eligible studies were randomized trials involving cancer patients or survivors that compared VR interventions for pain management with any non-VR control. Proportion meta-analyses and odds ratio meta-analyses were performed. Heterogeneity was assessed using the I² statistic, and meta-regression was conducted to explore potential predictors of dropout. The JBI appraisal tool was used to assess the methodological quality and GRADE system to determine the certainty of evidence. Results: Six randomized controlled trials were included (n = 569). The pooled dropout rate was 16% (95% CI: 8.2–28.7%). Dropout was slightly lower in VR groups (12.7%) than in controls (21.4%), but the difference was not statistically significant (OR = 0.94; 95% CI: 0.51–1.72; I² = 9%; GRADE: very low). No significant predictors of dropout were identified. Conclusions: VR interventions appear to have acceptable retention rates in oncology settings. The pooled dropout estimate may serve as a reference for sample size calculations. Future trials should improve reporting practices and investigate how VR modality and patient characteristics influence adherence. Full article

(This article belongs to the Special Issue Innovative Approaches to Chronic Disease Patient Care)

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