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Healthcare
Special Issues
Management of Chronic Health Situations
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Management of Chronic Health Situations

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

Deadline for manuscript submissions: 31 May 2025 | Viewed by 7063

Special Issue Editors

Prof. Dr. Luís Sousa

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Guest Editor
1. Department of Nursing, School of Health Atlântica (ESSATLA), 2730-036 Oeiras, Portugal
2. Comprehensive Health Research Center (CHRC), 7000-811 Évora, Portugal
Interests: nursing; clinical examination; humor intervention; nursing diagnosis; stroke rehabilitation; spinal cord injury; respiratory rehabilitation; rehabilitation; exercise; quality of life
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Christoph De Oliveira Käppler

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Guest Editor
Faculty of Rehabilitation, Technical University of Dortmund, 44227 Dortmund, Germany
Interests: psychology; family psychology; family therapy;rehabilitation; emotional rehabilitation; child and youth rehabilitation
Dr. Fabiana Faleiros

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Guest Editor Assistant
Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Interests: rehabilitation; rehabilitation sciences; nursing; rehabilitation science; clinical nursing; nursing education; questionnaire; urinary incontinence; spinal cord injury; assistive technologies; assistive technology; spina bifida cystica; spina bifida occulta; participation; autonomy; neurogenic bowel; neurogenic urinary bladder; neurorehabilitation
Prof. Dr. Geyslane Albuquerque

E-Mail Website
Guest Editor Assistant
Nossa Senhora das Graças Faculty of Nursing, University of Pernambuco, Recife 50670-901, Brazil
Interests: nursing care; postnatal care; nursing; evidence-based practice; women's health; nursing education; maternal and child nursing; clinical decision making; public health nursing; advanced practice nursing; obstetric delivery; obstetric education; prenatal diagnosis; descriptive statistics; quantitative methods; quantitative research; validation; validation studies; neurogenic bowel; obstetrics; bowel elimination
Dr. Helena José

E-Mail Website
Guest Editor Assistant
School of Health Atlântica (ESSATLA), 2730-036 Oeiras, Portugal
Interests: older person health; medical-surgical nursing; chronic disease; chronic respiratory disease; cardiovascular disease; medication adherence; quality of life; humor intervention; health communication; simulation training
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Comorbidities associated with chronic diseases lead to functional, emotional, and disabling limitations, which implies constant management of symptoms and repercussions for both the patient and informal caregivers.

With this Special Issue, we intend to contribute to objective 3 of the 2030 Agenda regarding the Sustainable Development Goals. In this sense, we are looking for articles that focus on healthcare responses, which present more sustainable, equitable and inclusive solutions, both in the hospital and in the community and public health context, with special attention being paid to people with chronic illnesses and family caregivers who are experiencing health-illness transition processes, chronic disease management and rehabilitation.

This Special Issue aims to bring together scientific articles that provide information and promote the visibility of research being carried out on the subject.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

We look forward to receiving your contributions.

Prof. Dr. Luís Sousa
Prof. Dr. Christoph De Oliveira Käppler
Guest Editors

Dr. Fabiana Faleiros
Prof. Dr. Geyslane Albuquerque
Dr. Helena José
Guest Editor Assistants

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

  • sustainable development indicators
  • health equity
  • diversity, equity, inclusion
  • chronic disease
  • neurology
  • social vulnerability
  • health vulnerability
  • caregivers
  • family caregivers
  • informal caregivers
  • rehabilitation
  • rehabilitation nursing
  • nursing
  • adaptation, psychological
  • coping strategies
  • patient safety

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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13 pages, 243 KiB  
Article
Effects of Diabetes Knowledge and Attitudes Toward Internet Health Information on e-Health Literacy in Middle-Aged Patients with Diabetes
by Minsung Lee and Jaelan Shim
Healthcare 2025, 13(5), 512; https://doi.org/10.3390/healthcare13050512 - 27 Feb 2025
Viewed by 624
Abstract
Background/Objectives: Effective diabetes self-management requires useful knowledge and health-related literacy based on a positive attitude toward seeking health information on the Internet. Therefore, this study aimed to determine the relationship of e-health literacy (eHL) with diabetes knowledge and attitudes toward internet health [...] Read more.
Background/Objectives: Effective diabetes self-management requires useful knowledge and health-related literacy based on a positive attitude toward seeking health information on the Internet. Therefore, this study aimed to determine the relationship of e-health literacy (eHL) with diabetes knowledge and attitudes toward internet health information in middle-aged patients with diabetes and to identify factors influencing patient eHL. Methods: This descriptive correlational study included 185 middle-aged patients with diabetes being followed-up with in the outpatient endocrinology department at a South Korean university hospital between 14 January and 29 February 2024. Data were collected using self-report structured questionnaires and were analyzed using IBM SPSS 27.0. Results: eHL was positively correlated with diabetes knowledge (r = 0.31, p < 0.001) and attitudes toward internet health information (r = 0.62, p < 0.001). Diabetes knowledge was also positively correlated with attitudes toward internet health information (r = 0.25, p < 0.001). Attitudes toward internet health information (β = 0.55, p = <0.001), diabetes knowledge (β = 0.13, p = 0.040), and drinking status (β = 0.12, p = 0.044) were significant variables affecting eHL. Conclusions: The most influencing factor in eHL in middle-aged patients with diabetes is the patient’s attitudes toward internet health information; diabetes knowledge was identified as a significant predictor. To improve eHL in middle-aged patients with diabetes, it is important to develop nursing intervention strategies to help promote diabetes knowledge and positive attitudes toward internet health information. Healthcare providers should continuously monitor patients to ensure they acquire and utilize correct information. Full article
(This article belongs to the Special Issue Management of Chronic Health Situations)
16 pages, 262 KiB  
Article
Early Recognition of Loneliness and Frailty in Relation to Chronic Disease Self-Management: A Quantitative Cross-Sectional Study
by Mateja Lorber, Nataša Mlinar Reljić, Sergej Kmetec and Barbara Kegl
Healthcare 2025, 13(3), 266; https://doi.org/10.3390/healthcare13030266 - 29 Jan 2025
Viewed by 990
Abstract
Background: Chronic disease significantly influences mental health, identity, and self-esteem. It is deeply interconnected with loneliness, frailty, stress, mental health, and the ageing process, forming a complex and interrelated dynamic. The aim was to find an association between loneliness, frailty, mental health, and [...] Read more.
Background: Chronic disease significantly influences mental health, identity, and self-esteem. It is deeply interconnected with loneliness, frailty, stress, mental health, and the ageing process, forming a complex and interrelated dynamic. The aim was to find an association between loneliness, frailty, mental health, and the patient’s self-management. Methods: A cross-sectional study was conducted between October 2023 and May 2024. A total of 605 patients with chronic disease took part in the research, of whom 67% were female and 33% were male. In total, 71% of participating patients lived in a home environment, and 19% lived in retirement homes. Results: 605 respondents with chronic disease participated in the study and were recruited using a purposive sampling method. Participants were drawn from healthcare settings, including primary care centres, outpatient clinics, and nursing homes, to increase representativeness. The study achieved a response rate of 55% after distributing 1100 questionnaires. Data were analysed with SPSS Statistics 25.0 using descriptive and inferential statistical methods, including non-parametric tests (Kruskal–Wallis test, Mann–Whitney U test) and Spearman’s correlation. The main results showed that patients who self-rated their chronic disease as well- or very well-managed (81%) were less frail (p < 0.001), less lonely (p < 0.001), and had better mental health (p = 0.015). Significant associations were found between frailty, loneliness (rs = 0.428, p < 0.001), and lower mental health (rs = 0.185, p < 0.001). In addition, frequent social contact was associated with lower frailty and loneliness (p < 0.001). Conclusions: Without adequate assessment and support from the healthcare system, patients may face challenges in meeting their needs, which can contribute to loneliness, frailty, and mental health decline. It is crucial to acknowledge that every individual with a chronic disease, regardless of age, education level, or condition, must actively participate in managing their chronic disease. Recognising the importance of self-management and its impact on mental health is essential to mitigating the negative effects of chronic disease on a patient’s quality of life. Full article
(This article belongs to the Special Issue Management of Chronic Health Situations)
18 pages, 1950 KiB  
Article
Pilot Implementation of a Primary Care Disease Management Concept for Venous Leg Ulceration: Results of a Mixed-Methods Process Evaluation
by Thomas Fleischhauer, Regina Poß-Doering, Nina Sander, Gunter Laux, Michel Wensing, Joachim Szecsenyi and Jonas D. Senft
Healthcare 2024, 12(24), 2552; https://doi.org/10.3390/healthcare12242552 - 18 Dec 2024
Viewed by 1724
Abstract
Background: Within the project “Ulcus Cruris Care”, a disease management intervention to improve general practice care for patients with venous leg ulcer was developed, comprising online teaching for practice teams, standardized patient education, and case management. Implementation of the intervention was piloted and [...] Read more.
Background: Within the project “Ulcus Cruris Care”, a disease management intervention to improve general practice care for patients with venous leg ulcer was developed, comprising online teaching for practice teams, standardized patient education, and case management. Implementation of the intervention was piloted and evaluated via a process evaluation. This study aims to evaluate contentedness with the intervention, implementation effort, implementation determinants, intervention fidelity, and perceived intervention effects using a mixed-methods process evaluation. Methods: The mixed-methods process evaluation explored the views of general practitioners, medical assistants and patients regarding the intervention components. Data were collected through semi-structured telephone interviews and a survey questionnaire. Qualitative data were first analyzed inductively, followed by a deductive–inductive approach based on the Theoretical Domains Framework. Survey data were analyzed descriptively. Results: Participants (n = 21) reported a strong contentedness with the intervention, high intervention fidelity, low implementation effort, and a change in perception of compression therapy as the central treatment element. Healthcare professionals emphasized increased patient education and patient and family involvement. Patients reported feeling better informed and empowered to take an active role in their treatment, primarily due to increased knowledge and skills in compression therapy. As a result, they were more content with their care and reported positive experiences with wound healing since trial participation. Conclusions: The Ulcus Cruris Care intervention can lead to a noticeable change in knowledge and potentially influence practice teams’ approach to venous leg ulcer management, facilitating a significantly more frequent use of compression therapy in VLU care. A confirmatory evaluation of potential effects in a definitive RCT seems warranted. Full article
(This article belongs to the Special Issue Management of Chronic Health Situations)
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12 pages, 551 KiB  
Article
Analysis of Urinary Incontinence in the Neurogenic Bladder and Its Relationship with the Satisfaction and Lifestyle of People with SCI
by Lorena Gomes Neves Videira, Letícia Noelle Corbo, Marla Andreia Garcia de Avila, Giovana Pelosi Martins, Soraia Dornelles Schoeller, Christoph Kappler and Fabiana Faleiros
Healthcare 2024, 12(15), 1501; https://doi.org/10.3390/healthcare12151501 - 29 Jul 2024
Viewed by 1646
Abstract
One of the most common complications of neurogenic bladder secondary to spinal cord injury (SCI) is urinary incontinence, which is possibly related to bladder-emptying methods and changes in quality of life. This study aimed to identify the occurrence of this complication in adults [...] Read more.
One of the most common complications of neurogenic bladder secondary to spinal cord injury (SCI) is urinary incontinence, which is possibly related to bladder-emptying methods and changes in quality of life. This study aimed to identify the occurrence of this complication in adults with SCI and analyze its relationship with bladder-emptying methods, satisfaction, and lifestyle. This is a quantitative, exploratory, and cross-sectional study. The variables were collected using the Bowel and Bladder Treatment Index during a telephone interview with 290 participants from February to November 2021. According to the results, 70% of the participants were male and 74.1% performed clean intermediate catheterization (CIC) as the main bladder-emptying method. Moreover, 55.6% were considered incontinent in the last year. Emptying by normal urination and bladder reflex triggering had a statistically significant relationship with urinary incontinence. A statistical association was observed between all the variables of satisfaction and lifestyle with urinary incontinence. Although CIC reduced urine leakage, a considerable number of participants still presented with frequent urine leakage. Urinary incontinence had a negative impact on satisfaction with the bladder-emptying method, effectiveness of bladder management, quality of life, and personal and social relationships. Full article
(This article belongs to the Special Issue Management of Chronic Health Situations)
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Review

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12 pages, 1356 KiB  
Review
Understanding Barriers to Hepatitis C Antiviral Treatment in Low–Middle-Income Countries
by Rashmi Venkatesh, Andrew S. Huang, Kiya Gurmessa and Edbert B. Hsu
Healthcare 2025, 13(1), 43; https://doi.org/10.3390/healthcare13010043 - 30 Dec 2024
Viewed by 1188
Abstract
Background: Direct-acting antiviral agents (DAAs) have significantly reduced Hepatitis C Virus (HCV) transmission and improved health outcomes since their FDA approval in 2011. Despite these advances, over 70 million people remain untreated globally, with a disproportionately high burden in low- and middle-income [...] Read more.
Background: Direct-acting antiviral agents (DAAs) have significantly reduced Hepatitis C Virus (HCV) transmission and improved health outcomes since their FDA approval in 2011. Despite these advances, over 70 million people remain untreated globally, with a disproportionately high burden in low- and middle-income countries (LMICs). Methods: Through a structured search of open access informational sources and an informal peer-reviewed literature review, HCV treatment barriers were identified, compiled, and analyzed. Current challenges to HCV treatment were organized by themes and summarized as recommendations for LMICs. Results: Key obstacles to HCV treatment in LMICs are identified, with the underdiagnosis and undertreatment of the disease linked to inadequate funding and healthcare infrastructure for screening and testing, poor awareness among healthcare providers, and the misinformation and stigmatization of HCV disease. Discussion: Recommendations for LMICs to attenuate treatment obstacles include distributing educational media, implementing mobile clinics, and fostering international partnerships. The successful implementation of these interventions has been demonstrated in developed countries. Conclusions: To achieve the WHO’s goal of eliminating HCV as a public health threat by 2030, concerted efforts are needed by LMICs to reduce gaps in care and ensure that all patients are afforded access to testing and treatment. Full article
(This article belongs to the Special Issue Management of Chronic Health Situations)
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