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Challenges in Health and Nursing Care Within the Community-Based Integrated...
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Challenges in Health and Nursing Care Within the Community-Based Integrated Care System

A Special Issue of Healthcare (ISSN 2227-9032) belonging to the section "Chronic Care".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 3103

Editor

Dr. Małgorzata Lesińska-Sawicka

E-Mail Website
Guest Editor
Nursing Department, State University of Applied Science, 62-500 Konin, Poland
Interests: nursing; cultural competence; holistic care; community care; integrated care systems

Special Issue Information

Dear Colleagues,

The growing complexity of health care systems and the increasing needs of aging populations highlight the importance of community-based integrated care. This approach emphasizes continuity, coordination, and person-centeredness across health and nursing care services, aiming to improve both accessibility and quality of care. Nurses play a crucial role in such systems, bridging clinical practice, social support, and health education within communities.

This Special Issue, “Challenges in Health and Nursing Care Within the Community-Based Integrated Care System”, aims to explore the strategies, innovations, and barriers related to the implementation of integrated care at the community level. It seeks to provide a platform for sharing evidence-based practices, policy perspectives, and educational initiatives that strengthen collaboration across disciplines and settings.

In this Special Issue, original research articles, reviews, and case studies are welcome. Submissions may include, but are not limited to, the following areas:

  • Models of community-based integrated care;
  • Nursing roles and competencies in integrated systems;
  • Interdisciplinary collaboration and communication;
  • Patient and family engagement in care processes;
  • Health policy and system-level challenges;
  • Education and training for integrated health and nursing care.

We look forward to receiving your valuable contributions.

Dr. Małgorzata Lesińska-Sawicka
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

  • community-based integrated care
  • nursing care
  • health care challenges
  • interdisciplinary collaboration
  • patient-centered care
  • health policy
  • nursing competencies
  • holistic care

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

Published Papers (3 papers)

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Research

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16 pages, 566 KB  
Article
Assessing Continuity of Care for Postpartum Women in Standard and Home Visiting Service Delivery Models: Insights from a Lithuanian Study
by Ilona Tamutienė, Vaida Auglytė, Milda Naginevičiūtė, Rita Buitvydė and Aurelija Blaževičienė
Healthcare 2026, 14(4), 477; https://doi.org/10.3390/healthcare14040477 - 13 Feb 2026
Cited by 1 | Viewed by 755
Abstract
Introduction: A woman’s health and her child’s development are greatly affected by the responsiveness and support of the health system throughout the postpartum period. While various scholars have analysed the qualities of continuity of care and their effects during that phase, this [...] Read more.
Introduction: A woman’s health and her child’s development are greatly affected by the responsiveness and support of the health system throughout the postpartum period. While various scholars have analysed the qualities of continuity of care and their effects during that phase, this article aims to reveal women’s experiences of postpartum care by analysing the impact of continuity of care through home visiting (HVCoC) versus standard care. Methods: Semi-structured interviews have been conducted in a qualitative study with 19 mothers of children under 1 year of age, who meet at least one criterion, such as living in poverty, being under 18 while giving birth, lacking permanent housing, residing in crisis centres due to domestic violence, or giving birth for the first time. All participants of the study have received either standard care or continuity of care through home visiting within the HVCoC model project. Results: The study has shown that women’s postpartum care experiences depend on the service delivery model. The standard care model, compared with the HVCoC model, has led to negative experiences for women across three dimensions: Relational, informational, and management continuity of care. Conclusions: While existing research has concluded that adequate postpartum support is related to the continuity of care model, this study’s findings reveal how different care organisation models affect the value women receive from their healthcare. Decision makers should develop postnatal care services that ensure continuity of care throughout pregnancy and the postpartum period by providing access to the same healthcare specialist for ongoing care. Full article
(This article belongs to the Special Issue Challenges in Health and Nursing Care Within the Community-Based Integrated Care System)
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12 pages, 513 KB  
Article
Perceived Fatigue and Associated Psychological Factors in Patients with Myasthenia Gravis
by Weronika Jung-Plath, Marcelina Skrzypek-Czerko, Agata Zdun-Ryżewska, Małgorzata Bilińska and Wioletta Mędrzycka-Dąbrowska
Healthcare 2026, 14(3), 342; https://doi.org/10.3390/healthcare14030342 - 29 Jan 2026
Viewed by 1023
Abstract
Introduction: Myasthenia gravis (MG) is a chronic autoimmune disorder in which fatigue represents one of the most burdensome symptoms. This multidimensional manifestation extends beyond neuromuscular fatigability and has a substantial impact on daily functioning, mental health, and quality of life. The present [...] Read more.
Introduction: Myasthenia gravis (MG) is a chronic autoimmune disorder in which fatigue represents one of the most burdensome symptoms. This multidimensional manifestation extends beyond neuromuscular fatigability and has a substantial impact on daily functioning, mental health, and quality of life. The present study aimed to evaluate the perception of fatigue in patients with MG, with particular emphasis on its interference with everyday activities and the extent to which it is understood by others. Methods: The study included 67 MG patients (61.2% women, mean age 53 years) treated at the Neurology Outpatient Department of the University Clinical Center in Gdańsk. Data were collected using an author-developed survey and standardized instruments: Chalder Fatigue Scale (CFQ), MG-ADL, MG-QoL15, HADS-M, Mini-COPE, and ACDS. Results: More than 70% of patients reported constant or frequent fatigue. Higher fatigue severity was positively associated with functional impairment (MG-ADL) and lower quality of life (MG-QoL15). More than 70% of patients reported constant or frequent fatigue. Higher fatigue severity was moderately associated with greater functional impairment and poorer quality of life. The extent to which fatigue interfered with daily life was associated with higher levels of depressive symptoms, poorer self-rated health, and less favorable disease-related perceptions (acceptance and influence). In contrast, perceiving fatigue as being better understood by others was associated with lower anxiety and depression and more favorable disease-related perceptions (acceptance, control, understanding), while it was not significantly related to fatigue severity, functional status, or quality of life. Conclusions: Fatigue in myasthenia gravis is a prevalent symptom, closely related to functional impairment and reduced quality of life. Different aspects of fatigue perception show distinct psychosocial correlates, highlighting the importance of considering subjective and social dimensions of fatigue alongside its severity. These findings support the relevance of psychosocial factors in the comprehensive care of patients with MG. Full article
(This article belongs to the Special Issue Challenges in Health and Nursing Care Within the Community-Based Integrated Care System)
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Other

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18 pages, 1370 KB  
Systematic Review
Quality of Life and Mental Health Among Families Caring for Children with Medical Complexity: A Scoping Review
by Ana Suárez-Carrasco, Álvaro León-Campos, Maria José Peláez-Cantero, Silvia García-Mayor and Bibiana Pérez-Ardanaz
Healthcare 2026, 14(9), 1124; https://doi.org/10.3390/healthcare14091124 - 22 Apr 2026
Viewed by 684
Abstract
Background: Families caring for children with medical complexity (CMC) face sustained psychosocial demands that may impair health-related quality of life (HRQoL) and mental health. A clear map of how these outcomes are assessed and which factors shape them is needed to guide family-centered [...] Read more.
Background: Families caring for children with medical complexity (CMC) face sustained psychosocial demands that may impair health-related quality of life (HRQoL) and mental health. A clear map of how these outcomes are assessed and which factors shape them is needed to guide family-centered care. Methods: We conducted a scoping review following the Joanna Briggs Institute guidelines, and reports were prepared according to the PRISMA guidelines. Searches were conducted in PubMed, CINAHL, and EMBASE (January 2011 to December 2023) to find studies reporting on health-related quality of life (HRQoL) and/or mental health outcomes (anxiety, depression, burden) of family members and/or caregivers of CMC, including operationalization based on complex chronic condition (CCC) classifications, technology dependency, or the Pediatric Medical Complexity Algorithm (PMCA). Two reviewers independently screened records and recorded data, and the findings were synthesized narratively and thematically. Results: Sixty-seven studies met the inclusion criteria and spanned cross-sectional, cohort, case–control, pre–post and qualitative designs across conditions such as epilepsy, congenital heart disease, cerebral palsy, technology dependence and cancer. Common measures were PedsQL™ Family Impact Module, SF-36/12, HADS, Beck inventories and Zarit burden scales. Across the included studies, caregivers, predominantly mothers, frequently reported poorer HRQoL and higher levels of anxiety, depressive symptoms, or burden than comparison groups when these were available. Six recurrent themes emerged: (1) gendered caregiving with disproportionate maternal burden; (2) socio-economic gradients and financing models shaping outcomes; (3) culture, religion and spirituality as coping resources; (4) family and social support buffering distress; (5) school participation and coordinated services potentially reducing burden; and (6) interdependence between caregiver and child outcomes. Conclusions: Heterogeneous CMC definitions, outcome measures, and study designs limited comparability across studies. The mapped evidence suggests that family HRQoL and mental health outcomes are shaped by interacting clinical, social, and contextual factors. These findings may inform more family-centered and equity-oriented approaches to care. Future research should harmonize CMC definitions, standardize outcome measures, and prospectively evaluate multicomponent interventions. Full article
(This article belongs to the Special Issue Challenges in Health and Nursing Care Within the Community-Based Integrated Care System)
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