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Healthcare
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Health Promotion and Chronic Illness: Future Challenges and Opportunities
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Health Promotion and Chronic Illness: Future Challenges and Opportunities

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

Deadline for manuscript submissions: closed (25 September 2025) | Viewed by 7101

Special Issue Editor

Dr. Federica Dellafiore

E-Mail Website
Guest Editor
Department of Life Health Sciences and Health Professions, Link Campus University, Via del Casale di San Pio V, 44, 00165 Rome, Italy
Interests: cancer nursing; chronic disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Chronic diseases are the leading causes of death and disability in high-income countries. Globally, more than 70% of deaths are due to chronic diseases, and their annual treatment cost is estimated to be USD 4.5 trillion, which is expected to rise further by 2030. Most chronic diseases are caused by four modifiable and unhealthy behaviors: smoking, poor nutrition, physical inactivity, and excessive alcohol use. They are associated with disability and premature death. Accordingly, worldwide health promotion policies are urgently needed, to support people in modifying unhealthy behaviors and avoiding illnesses, suffering, and early death. According to WHO, health promotion enables people to increase their control over, and improve, their health. Since the first International Conference on Health Promotion, held in Ottawa in 1986, progress has been made: professionals and policymakers have recognized the need for an approach integrating thinking and practice in order to foster comprehensive and coherent action in these complex areas. However, there is still work to do. There are still too many unresolved questions. The field of health promotion involves promising and achievable actions to guide the efficacy of healthcare systems. It is now at a turning point and requires a paradigmatic framework revolution to guide thinking, practice, research, and evidence.

We are pleased to invite you to contribute papers on primary and secondary research projects on future challenges and opportunities in health promotion in chronic illness settings. Specifically, this Special Issue will show the essential role of health promotion in chronic disease care and the positive impact of healthy behaviors on chronic illness patients' outcomes at every stage in their illness.

For this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: primary studies, of both qualitative and quantitative design, or secondary research using different review methodologies, regarding health promotion and/or chronic illness.

I look forward to receiving your contributions.

Dr. Federica Dellafiore
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-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

  • health promotion
  • public health
  • nursing
  • chronic illness
  • cardiovascular illness

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Published Papers (4 papers)

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Research

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14 pages, 367 KB  
Article
Clinical, Biochemical, and Psychological Predictors of Metabolic Syndrome in Climacteric Women
by Mauricio Sánchez-Barajas, Marysol García-Pérez, Teodoro Córdova-Fraga and María-Raquel Huerta-Franco
Healthcare 2025, 13(24), 3214; https://doi.org/10.3390/healthcare13243214 - 8 Dec 2025
Viewed by 543
Abstract
Background/Objectives: To identify clinical, biochemical, and psychological factors associated with metabolic syndrome (MS) in climacteric women and to determine independent predictors of MS across menopausal stages. Methods: A cross-sectional study was conducted in 225 women (perimenopausal, n = 75; early postmenopausal, n [...] Read more.
Background/Objectives: To identify clinical, biochemical, and psychological factors associated with metabolic syndrome (MS) in climacteric women and to determine independent predictors of MS across menopausal stages. Methods: A cross-sectional study was conducted in 225 women (perimenopausal, n = 75; early postmenopausal, n = 75; late postmenopausal, n = 75). Anthropometry, clinical history, and fasting laboratory tests were obtained. Psychological measures included perceived stress (Perceived Stress Scale, PSS), anxiety symptoms (Short Health Anxiety Inventory, SHAI-18), and depressive symptoms (Hamilton–Bech–Rafaelsen Scale). Results: Perimenopausal women had higher BMI than both postmenopausal groups (33 ± 5 vs. 30 ± 5 and 29 ± 4 kg/m2; F = 13.39, p < 0.001). Waist/hip ratio showed a modest group effect (F = 6.34, p = 0.002), being higher in perimenopause versus late postmenopause (p = 0.001). Significant group differences were observed in lipid and glucose profiles across menopausal stages. Total cholesterol (F = 4.86, p = 0.009), HDL cholesterol (F = 7.12, p = 0.001), and non-HDL cholesterol (F = 8.13, p < 0.001) differed significantly, as confirmed by post hoc Tukey HSD tests, with higher total and non-HDL cholesterol levels in early and late postmenopausal women compared with the perimenopausal group, and higher HDL cholesterol levels in early postmenopausal women compared with the perimenopausal group. Fasting glucose showed a significant difference (H = 9.89, p = 0.007, Kruskal–Wallis test), with higher median levels in perimenopausal (127 mg/dL) than in early postmenopausal women (97 mg/dL, p = 0.003, Mann–Whitney U). Perceived stress was highest in early postmenopause (61.3%) compared with late postmenopause (48.0%) and perimenopause (34.7%), χ2 = 10.68, p = 0.0048, while anxiety and depression did not differ. Logistic regression analyses identified perceived stress and depressive symptoms as significant predictors of metabolic syndrome under different diagnostic definitions. Higher perceived stress was inversely associated in the psychological model (aOR = 0.62; 95% CI 0.43–0.88; p = 0.008) but positively related in the clinical model including fasting glucose and blood pressure (aOR = 1.54; 95% CI 1.07–2.22; p = 0.021). In the combined model, both fasting glucose and perceived stress remained independent predictors (p < 0.05), under-scoring the contribution of psychological factors to metabolic risk. Conclusions: Among climacteric women, perceived stress and cardiometabolic factors (systemic arterial hypertension, Type 2 DM, and elevated fasting glucose) are independent predictors of metabolic syndrome. Early identification and integrated management of stress and metabolic risks may help reduce the burden of metabolic syndrome across menopausal stages. Full article
(This article belongs to the Special Issue Health Promotion and Chronic Illness: Future Challenges and Opportunities)
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24 pages, 319 KB  
Article
Interprofessional Collaboration in Primary Healthcare: A Qualitative Study of General Practitioners’ and Family and Community Nurses’ Perspectives in Italy
by Federica Dellafiore, Luca Guardamagna, Sihame Haoufadi, Alice Cicognani, Angela De Mola, Benedetta Mazzone, Giulia Occhini, Antonio Brusini and Giovanna Artioli
Healthcare 2025, 13(21), 2794; https://doi.org/10.3390/healthcare13212794 - 4 Nov 2025
Cited by 1 | Viewed by 1811
Abstract
Background: The growing burden of chronic illnesses calls for integrated and sustainable models of Primary Healthcare (PHC) that emphasize health promotion and patient-centered care. Interprofessional collaboration between General Practitioners (GPs) and Family and Community Nurses (FCNs) is a strategic approach to enhancing continuity [...] Read more.
Background: The growing burden of chronic illnesses calls for integrated and sustainable models of Primary Healthcare (PHC) that emphasize health promotion and patient-centered care. Interprofessional collaboration between General Practitioners (GPs) and Family and Community Nurses (FCNs) is a strategic approach to enhancing continuity of care and supporting individuals in adopting healthy behaviors across the trajectory of chronic conditions. This study aims to explore the experiences and perspectives of GPs and FCNs in Italy, with the goal of identifying the barriers, enablers, and transformative dynamics that can inform future PHC models. Methods: A qualitative study was conducted with four focus groups with 21 participants (8 GPs and 13 FCNs) from three Italian regions, carried out between March and November 2023. Data were analyzed using Reflexive Thematic Analysis (RTA) following Braun and Clarke’s framework. Ethical approval was obtained from the University of Parma (Protocol No. 0266537—21 October 2022). Results: Four themes and sixteen subthemes were identified: (1) barriers to effective collaboration (role ambiguity, limited time, structural misalignments); (2) facilitators of collaboration (openness, mutual recognition, shared goals); (3) team-building processes (phases of trust development, shared values, reflective problem-solving); and (4) transformation of work practices (improved patient outcomes, flexible methodologies, integrated care strategies). Conclusions: Interprofessional collaboration between GPs and FCNs enhances the capacity of PHC to address the complex needs of people with chronic conditions. Aligning relational, organizational, and structural factors is essential for sustainable, health-promoting care models. Tailored training, protected time, and shared spaces are critical to foster teamwork, promote patient empowerment, and ensure continuity of care in chronic illness management. Full article
(This article belongs to the Special Issue Health Promotion and Chronic Illness: Future Challenges and Opportunities)
17 pages, 245 KB  
Article
Cameroonian Physiotherapists’ Practice, Confidence, and Perception of Health Promotion for People at Risk or with Cardiovascular Diseases: A Qualitative Study
by Etienne Ngeh Ngeh, Rachel Young, Christopher Kuaban, Sionnadh McLean, Ben W. Strafford and Joanne Lidster
Healthcare 2025, 13(10), 1172; https://doi.org/10.3390/healthcare13101172 - 17 May 2025
Viewed by 1299
Abstract
Background: Cardiovascular diseases (CVDs) and their risk factors are increasing with associated disability and mortality burden globally, especially in low- and middle-income countries, including Cameroon. Physiotherapist-led health promotion (PLHP) interventions provide opportunities to improve health and reduce this burden. Understanding physiotherapists’ practice, confidence, [...] Read more.
Background: Cardiovascular diseases (CVDs) and their risk factors are increasing with associated disability and mortality burden globally, especially in low- and middle-income countries, including Cameroon. Physiotherapist-led health promotion (PLHP) interventions provide opportunities to improve health and reduce this burden. Understanding physiotherapists’ practice, confidence, and perception is crucial for designing effective, context-specific PLHP interventions. Methods: This qualitative study explored physiotherapists’ practice, perceptions, and confidence in delivering PLHP to pwCVDs in Cameroon. Results: Sixteen participants completed the interviews, and analyses of the transcripts generated three main themes, which included (1) the perception of physiotherapists’ roles in health promotion (HP), (2) current practice of PLHP, and (3) competence in the delivery of PLHP. Physiotherapists believe that delivering HP interventions in practice is within their professional role. Current HP practice was limited to exercise, physical activity, and dietary/nutritional interventions. Participants reported a lack of knowledge and formal training in PLHP delivery. Conclusions: Despite intense interest in HP, HP practice among physiotherapists is limited in scope, is under-resourced, and is limited by a lack of confidence in delivering behavioural change interventions. These findings are relevant for the design of appropriate clinical training and policies for the care of pwCVDs. Full article
(This article belongs to the Special Issue Health Promotion and Chronic Illness: Future Challenges and Opportunities)

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17 pages, 1457 KB  
Systematic Review
The Mechanism by 18 RCTs Psychosocial Interventions Affect the Personality, Emotions, and Behaviours of Paediatric and Young Adult Cancer Patients: A Systematic Review
by Xiao Liu, Honglin Chen, Natalie Joubert and Heli Tiirola
Healthcare 2025, 13(10), 1094; https://doi.org/10.3390/healthcare13101094 - 8 May 2025
Cited by 1 | Viewed by 2440
Abstract
Background/Objectives: Psychosocial interventions bring mental and social benefits to paediatric and young adult patients. Gaining insight into the optimal psychosocial intervention strategies and their process mechanisms can contribute to the deepening of practice in this field. Methods: This systematic review evaluates [...] Read more.
Background/Objectives: Psychosocial interventions bring mental and social benefits to paediatric and young adult patients. Gaining insight into the optimal psychosocial intervention strategies and their process mechanisms can contribute to the deepening of practice in this field. Methods: This systematic review evaluates the psychosocial interventions that promote adaptability, resilience, and positive changes among paediatric and young adult patients. Following the Cochrane guidelines, the literature from 2000 to 2024 was reviewed, focusing on randomised controlled trials (RCTs). Results: Eighteen studies were included and analysed using a logic model framework. Therapeutic interventions that involved the reframing of cognition activities shaped personality changes, including resilience and adaptation, requiring significant investment, and they were influenced by individual characteristics and background. Process-oriented activities, such as art-, play-, and music-based therapies, improved emotional well-being and were affected by pain, cognitive abilities, and language skills. Behavioural changes are best achieved through interactive interventions, particularly group-based and parent-involved approaches, which improve social integration and physical abilities. Conclusions: Psychosocial interventions lead to positive changes in paediatric and young adult patients in terms of personality, emotion, and behaviour. Although the sample size for the behavioural changes is insufficient, understanding the mechanisms underlying these interventions benefits practice. Full article
(This article belongs to the Special Issue Health Promotion and Chronic Illness: Future Challenges and Opportunities)
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