Chronic Illness, Diversity, and Cultural Competence

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

Deadline for manuscript submissions: 30 April 2027 | Viewed by 3196

Special Issue Editors


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Guest Editor
Medical School, University of Nicosia, Nicosia 2417, Cyprus
Interests: chronic illness experience; labelling and stigma; diversity and cultural competence; social determinants of health; medical education; qualitative research
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Nursing, National and Kapodistrian University of Athens, 11517 Athens, Greece
Interests: nursing ethics and law; vulnerable populations (people with disabilities, immigrants/refugees, the elderly, etc.); health education
Special Issues, Collections and Topics in MDPI journals

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Guest Editor Assistant
Nursing, University of Nicosia, Nicosia 2417, Cyprus
Interests: chronic illness and nursing care; diversity and cultural competence; nursing education; qualitative research
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There is growing evidence that a significant proportion of people report living with a chronic condition, making long-term illness a major challenge in today’s diverse and multicultural societies. In this context, the diversity and cultural competence of healthcare professionals have been recognized as essential for ensuring patient satisfaction, treatment adherence, and improved health outcomes. Given that individuals with chronic conditions require ongoing interactions with healthcare providers, the importance of cultural competence and diversity becomes even more critical.

This Special Issue invites researchers, educators, and scholars to submit original research or review articles exploring the intersections of chronic illness, diversity, and cultural competence. Submissions may address chronic illness in the context of various forms of diversity, including but not limited to cultural and ethnic background, socio-economic status, education, age, sexual and gender identities, lifestyle, and disability. Contributions should focus on diversity and cultural competence or other related competencies and skills, such as structural competence, intercultural communication, cultural awareness, cultural humility, cultural sensitivity, cultural empathy, and cultural intelligence. The submissions should be pertinent to the following healthcare fields:

  • Health assessment;
  • Medication management;
  • Long-term outcomes and adherence to therapy;
  • Early diagnosis, ethics, and clinical communication;
  • The use of AI technology in healthcare;
  • Socio-economic burden;
  • Health policy;
  • Treatment;
  • Training and development of healthcare professionals;
  • Working with interpreters and health outcomes.

Prof. Dr. Costas S. Constantinou
Dr. Venetia Sofia Velonaki
Guest Editors

Dr. Monica Nikitara
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

  • chronic illness
  • diversity
  • cultural competence
  • health outcomes
  • treatment

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Published Papers (3 papers)

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Research

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16 pages, 245 KB  
Article
Molding the Pain into Porcelain: The Silent Resilience of Arthritic Hands in Hong Kong’s Ceramic Studios
by Alice Yip, Wai Ping Cecilia Li Tsang, Jeff Yip, Chi Kong Calvin Yip, Man Ho Tim Li, Zoe Tsui, Ka Man Rachel Yip, Ka Wing Gavin Lee and Shuk Yu Maria Hung
Healthcare 2026, 14(8), 1069; https://doi.org/10.3390/healthcare14081069 - 17 Apr 2026
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Abstract
Background/Objectives: Globally, rheumatoid arthritis (RA) patients struggle to meet the expectation of being active in their daily lives. The burden on these individuals is twofold, including physical limitations and emotional stress, which make looking after themselves a major challenge. Supporting self-management requires more [...] Read more.
Background/Objectives: Globally, rheumatoid arthritis (RA) patients struggle to meet the expectation of being active in their daily lives. The burden on these individuals is twofold, including physical limitations and emotional stress, which make looking after themselves a major challenge. Supporting self-management requires more than just offering strategies; it requires fitness. Whether we are proposing new daily habits or creative outlets like ceramic workshops, it is essential to tap into the patient’s perspective to understand exactly what kind of support will resonate with them. This study explored how ceramic workshops can help people with RA to build resilience and improve their well-being. Methods: Using a phenomenological study design, we interviewed 16 patients with RA in Hong Kong who engaged in ceramic workshops. These participants were selected through purposive sampling, and their insights were gathered via semi-structured interviews. We applied Colaizzi’s seven-step method to analyze the findings. Results: Four key themes emerged: (i) embodied manageability; (ii) clear comprehension of body limits; (iii) the meaningfulness of creating art; and (iv) supporting resilience. Conclusions: This study reveals that effective self-management support should prioritize patient-driven needs, particularly peer interaction and high-demand creative pursuits such as ceramic workshops. Full article
(This article belongs to the Special Issue Chronic Illness, Diversity, and Cultural Competence)

Review

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13 pages, 426 KB  
Review
Multidimensional Determinants of Food and Nutritional Insecurity Among Older Adults: A Scoping Review
by Pedro Lima, Eliane Rezende, Carmem Piagge, Estefanía Canedo and Maria Lucia Robazzi
Healthcare 2026, 14(10), 1396; https://doi.org/10.3390/healthcare14101396 - 20 May 2026
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Abstract
Background/Objectives: Food and nutritional insecurity (FNI) is a major social determinant of health that disproportionately affects older adults, with significant implications for their health, nutrition, and well-being. In this context, this scoping review aims to map and synthesize the available scientific evidence [...] Read more.
Background/Objectives: Food and nutritional insecurity (FNI) is a major social determinant of health that disproportionately affects older adults, with significant implications for their health, nutrition, and well-being. In this context, this scoping review aims to map and synthesize the available scientific evidence on the main determinants of FNI among older adults, considering socioeconomic, health-related, functional, psychosocial, and structural factors. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute methodology and reported following the PRISMA-ScR guidelines. A comprehensive search was performed across eight databases (PubMed/MEDLINE, EMBASE, Scopus, Web of Science, CINAHL, LILACS, ProQuest, and Google Scholar), up to November 2024. Original studies addressing FNI in individuals aged ≥60 years were included. Study selection and data extraction were conducted independently by two reviewers, with disagreements resolved by consensus. Results: Of 5897 records identified, 15 studies met the inclusion criteria. FNI in older adults was described as a multifactorial phenomenon associated with low income, limited education, social isolation, widowhood, chronic diseases, functional limitations, depressive symptoms, and poor housing conditions. Structural determinants, including institutional racism, gaps in social protection systems, and barriers to accessing food assistance programs, were also reported. Considerable heterogeneity in measurement instruments highlights the complexity of assessing FNI in this population. Conclusions: Addressing FNI in older adults requires moving beyond isolated interventions toward integrated, intersectoral strategies that tackle its underlying social and structural drivers. Strengthening social protection systems, reducing access barriers, and promoting equity-oriented policies are essential to ensure adequate nutrition and support healthy and dignified aging. Full article
(This article belongs to the Special Issue Chronic Illness, Diversity, and Cultural Competence)
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Other

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17 pages, 325 KB  
Systematic Review
Healthcare Professionals’ Cultural Competence in Diabetes Care: A Systematic Review
by Monica Nikitara, Achonwa Esther Mba, Evangelos Latzourakis and Costas S. Constantinou
Healthcare 2025, 13(22), 2910; https://doi.org/10.3390/healthcare13222910 - 14 Nov 2025
Cited by 1 | Viewed by 2010
Abstract
Background: Culturally diverse patients with diabetes often face barriers that contribute to poor outcomes. Providing culturally sensitive care requires awareness of how cultural beliefs influence management, yet no standard model of cultural competency exists, underscoring the need for further research. Aims: To evaluate [...] Read more.
Background: Culturally diverse patients with diabetes often face barriers that contribute to poor outcomes. Providing culturally sensitive care requires awareness of how cultural beliefs influence management, yet no standard model of cultural competency exists, underscoring the need for further research. Aims: To evaluate the level of cultural competence among healthcare professionals in caring for patients with diabetes, and to assess the impact of cultural competence training on their ability to deliver culturally sensitive, patient-centered care. Methodology: A systematic review was conducted of primary research articles published between 2015 and 2025 that examined the cultural competence of healthcare providers in diabetes care, described relevant training programs, and evaluated their impact. The databases searched included Medline, CINAHL, ProQuest, and the Nursing and Allied Health Database. Result: A total of 15 studies were included in the review. Seven assessed the cultural competence of diabetes care providers, reporting moderate to high levels of awareness and sensitivity but noting gaps in communication and cultural knowledge. Eight studies evaluated training interventions, all of which demonstrated improvements in provider attitudes and self-perceived competence. Some also reported better patient outcomes, particularly among high-risk groups. However, the long-term effects were inconsistent, and no single assessment tool proved universally effective. Conclusion: This systematic review suggests that the cultural competence of healthcare providers in diabetes care remains limited, although some evidence indicates that interventions can enhance competence. The findings may assist researchers in selecting appropriate measures to evaluate cultural competence in diabetes care. Full article
(This article belongs to the Special Issue Chronic Illness, Diversity, and Cultural Competence)
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