Abstract
Chronic diseases such as heart disease, stroke, and diabetes, are leading causes of death globally that require long-term management. At present, the dominant approach to treatment typically prioritizes the relief of physical symptoms, with less attention given to addressing the emotional and psychological needs of patients. Therefore, the paper delves into the critical role of psychosocial interventions in the management of chronic diseases, particularly in addressing the emotional, psychological, and social challenges. In addition, it evaluates the efficacy of psychosocial interventions through a comprehensive systematic review of relevant studies, including systematic reviews and randomized controlled trials. The results show that interventions such as cognitive-behavioral therapy and social support networks significantly improved patients’ mood, self-management behaviors, and quality of life. However, individual response differences and issues of accessibility of interventions, especially in resource-poor settings, remain important challenges. This paper concludes that integrating psychosocial support into traditional medical care can significantly enhance the comprehensive management of chronic diseases, but further optimization and replication of interventions are needed to maximize their effectiveness.
Keywords
Chronic Diseases, Psychosocial Intervention, Healthcare, Integrated Care.
1.Introduction
The treatment of chronic diseases has always been a major issue worldwide, which has led to a growing realization that it is important to address not only the physical symptoms, but also the emotional, psychological and social aspects of the patient’s life. Recent studies have underscored the effectiveness of psychosocial interventions in combination with traditional medical therapies, demonstrating their capacity to mitigate psychological distress and enhance the overall quality of life for patients afflicted with chronic diseasea. Despite these advancements, gaps remain in fully understanding the long-term effectiveness of these interventions in different patient populations and at different levels of disease severity. Thus, the study aims to explore the impact of psychosocial interventions on chronic disease management by examining their effects on emotional support, self-management behaviors, and the use of electronic health tools. Through a comprehensive review of the existing literature, this research seeks to evaluate the effectiveness of these interventions and identify strategies for optimizing their application in clinical settings. In short, this study contributes to the advancement of knowledge in this field and provides insights to enhance the holistic care of chronically ill patients, with the ultimate goal of improving their well-being and health.
2.Conceptual Framework of Psychosocial Interventions
Broadly speaking, chronic diseases, defined as illnesses of one year or more duration that require ongoing medical care or limitations in daily living, cause 41 million deaths annually, accounting for 74% of global deaths. Heart Disease, Stroke, Respiratory Disease, Chronic Obstruction Pulmonary Disease (COPD) and Diabetes are known as the top five chronic diseases, which are often difficult to cure and may worsen over time. In recent years, the proportion of deaths due to chronic diseases has also been gradually increasing. In 2010, 67% of deaths worldwide were attributed to chronic diseases, and this rose to 74% in 2019 [1]. Traditional medical treatment focuses mainly on the physiological level, relying on drugs, surgery and other medical interventions to control symptoms and slow the progression of the disease. Although these methods are effective in relieving physical symptoms, they often ignore the emotional and psychological pressure of patients, causing many patients to face problems such as anxiety, depression and social isolation in the process of managing the disease. Recently, psychosocial interventions have received increasing attention, which combine traditional medical treatments with psychosocial interventions to comprehensively improve patients’ emotional well-being, social support, and quality of life through psychological counseling, support groups, stress management, and educational programs.
Psychosocial interventions are defined as any program that incorporates techniques designed to reduce psychosocial distress by reducing anxiety and depression and increasing social activity [2]. This intervention not only address individual psychological problems, such as anxiety, depression and stress, but focus on the impact of their social environment and relationships. In the treatment of chronic diseases, commonly used psychosocial intervention methods include cognitive behavioral therapy (CBT), cognitive restructuring, and communication development, with the main aim of identifying and changing negative thoughts or enabling patients to focus on their own strengths and expand their positive emotions [3]. Through these methods, patients can receive emotional support and practical coping strategies to better manage their condition and reduce the stress and negative emotions caused by the disease. The extant literature demonstrates a robust correlation between optimism and hope and a diminished impact of chronic disease, particularly in individuals with heart disease [4]. Psychosocial interventions that enhance patients’ mental health, cultivate positive attitudes toward life, and facilitate patients’ collaboration with their families and healthcare teams, thereby optimizing treatment outcomes.
3.Effectiveness of Psychosocial Interventions
Psychosocial interventions play a crucial role in the management of chronic diseases by addressing the comprehensive needs of patients beyond just physical symptoms. These interventions focus on improving patients’ emotional, psychological, and social well-being, which is often neglected in traditional medical treatments. They provide essential support to patients by helping them cope with the emotional impact of chronic illness, building psychological resilience and encouraging positive behavioral change. The effectiveness of psychosocial interventions can be seen in three main areas: providing emotional support and building psychological resilience, enhancing self-management behaviors, and using e-health interventions to improve patient prognosis.
3.1.Emotional Support and Psychological Resilience
Psychosocial interventions provide important emotional support to patients with chronic illnesses to help them cope with emotional challenges such as fear, anxiety, depression, and anger arising from their condition. These emotional supports help alleviate psychological stress and enhance patients, confidence and self-efficacy. In a recent study, Dear et al. conducted a systematic review and meta-analysis to assess the efficacy of a brief recall-based psychosocial intervention in reducing psychological distress in cancer patients. The study systematically searched the Cochrane Library, PubMed and Scopus databases for randomized controlled trials (RCTs) published in English up to November 27, 2022, and included 20 studies involving 1,744 cancer patients in the analysis. The interventions primarily focused on enhancing patients’ mental health by prompting them to reflect on positive life experiences through various reminiscence methods. The data indicated statistically significant improvements in levels of hope, anxiety, and depression immediately post-intervention and at one month follow-up, demonstrating lasting effects of the interventions. The meta-analysis revealed that brief reminiscence-based psychosocial interventions significantly reduced anxiety and depression symptoms, with pooled standardized mean differences (SMDs) of −.67 (95% CI: −1.05 to −0.29, p=0.001) for depression, and −0.51 (95% CI: −0.93 to −0.10, p=0.015) for anxiety at post-intervention. Furthermore, improvements in hope were evident with an SMD of 1.14 (95% CI: 0.70 to 1.58, p<0.001) after interventions, and these effects were sustained at one month follow-up, supported by similar findings for well-being. The results of the studies emphasize the potential of incorporating brief recall-based psychosocial interventions into routine cancer care to address significant psychosocial distress, which not only enhances psychological resilience, but promotes improvements in emotional and mental well-being in cancer patients, thereby demonstrating its effectiveness as a non-pharmacological treatment option [5].
3.2.Improvement in Self-Management Behaviors
Psychosocial interventions can greatly improve patients’ self-management behaviors and health outcomes by fostering robust social support networks, including family, friends, and community resources. The provision of adequate social support can serve to mitigate feelings of isolation and psychological distress, whilst simultaneously enhancing patients’ coping abilities. Martire et.al conducted a meta-analysis to assess the effectiveness of psychosocial interventions involving family members compared to standard medical care on various patient and caregiver outcomes, including depression, anxiety, relationship satisfaction, disability, and mortality. They selected randomized controlled trial studies published through October 2002 focusing on chronically ill patients and their family caregivers, ultimately identifying 70 eligible studies from an initial pool of 235 studies. Findings showed that patient-specific interventions significantly reduced depressive symptoms when only spouses were involved (effect size d=0.33), while no substantial effect was found in mixed family interventions (d=0.02). Additionally, these family interventions positively affected caregivers, yielding modest effects on reducing their depressive symptoms (d=0.10) and anxiety (d=0.14), particularly effective in populations without dementia (d=0.17). For patient mortality, the meta-analysis indicated a slight marginally significant effect (d=0.08), suggesting potential benefits, particularly among non-dementia patients (d=0.13). The main findings stated that engaging family members in therapeutic interventions can enhance not only the emotional well-being of patients but also relieve the burden on caregivers, underscoring the significant role families play in chronic illness management. Thus, targeted psychosocial interventions, especially those focused on spousal relationships, can lead to meaningful improvements in mental health outcomes for patients and their caregivers, leading to the proposal of a strategic approach to incorporating family involvement into chronic disease treatment programs [6].
3.3.Adoption of Electronic Health Interventions
Psychosocial interventions, particularly those that utilize electronic health tools, can guide patients in actively changing their behavior and improving self-management by providing personalized psychological support and lifestyle guidance tailored to their specific needs. And research has shown that electronic health interventions can also provide personalized psychological support and lifestyle guidance for patients, effectively improving their physical and mental health. Zhang et.al conducted a randomized controlled trial to assess the efficacy and acceptability of an internet delivered transdiagnostic psychological intervention designed for individuals with chronic health conditions. A total of 676 participants were randomly assigned to either an 8-week treatment group or a waitlist control group, with treatment consisting of five core lessons, homework tasks, additional resources, and weekly contact with a psychologist. Primary outcomes included changes in depression, anxiety, and disability at multiple time points: pre-treatment, post-treatment, and follow-ups at 3 and 12 months. Results indicated significant improvements in the treatment group, with depression decreasing by 3.61 points (between-group effect size d=0.47), anxiety decreasing by 1.97 points (d=0.32), and disability reducing by 3.71 points (d=0.17) compared to the control group, with all differences statistically significant (p<0.001) at post-treatment. These improvements were generally maintained at the follow-ups, showcasing high treatment satisfaction with 86% of participants reporting they were satisfied or very satisfied with the program and a notable treatment completion rate of 69% among those who started the intervention. The results of the studies indicate that transdiagnostic interventions delivered via the Internet are an effective method for addressing the psychological adjustment of individuals with chronic illnesses. This is achieved by providing them with accessible and tailored support, which has been shown to significantly reduce symptoms of depression and anxiety while improving overall life satisfaction and health-related quality of life. As such, the potential of online therapeutic approaches to improve mental health outcomes for individuals facing the double burden of chronic diseases and psychological distress [7].
4.Challenges and Strategies in Implementing Psychosocial Interventions
The above analysis highlights the significant impact of psychosocial interventions on improving the well-being of people with chronic diseases, which provide a complementary approach to traditional medical care by addressing the emotional, psychological, and social dimensions of health. The practical effects of these interventions are multifaceted, demonstrating substantial improvements in mental health, emotional resilience, and social support networks. However, despite these positive outcomes, there are limitations to the effectiveness of psychosocial interventions.
Firstly, a major challenge is the variation in individual responses to these interventions. Factors such as the severity of the illness, the patient’s psychological state, and the level of social support available can all influence the efficacy of the intervention. a study by Li et al found that patients with less severe symptoms of heart disease showed significantly more improvement from cognitive behavioral therapy (CBT) compared to those with more advanced conditions, highlighting the need for tailored interventions based on individual health status [8]. The possibility exists that the advantages gained in the short term may be lost over time unless continued assistance is provided, as sustained behavioral and emotional change requires continuous reinforcement. It is essential that interventions facilitate a transition from the initial phase of change to the maintenance phase, thereby supporting long-term health behaviors [9]. According to research, although psychological interventions can improve quality of life in the short term, only some of them maintain their effectiveness after 12 months [10]. Finally, the accessibility and scalability of these interventions represent a significant limitation. In resource-poor settings, there is often a critical shortage of mental health professionals. This makes it difficult to find sufficient personnel to deliver these specialized interventions [11]. In addition, comprehensive psychosocial programs require significant funding and resource support, which are often limited in resource-poor settings [12].
To optimize the effectiveness of psychosocial interventions, several strategies are recommended. First, intervention programs tailored to the severity of the patient’s condition, psychological state, and social support system can improve treatment outcomes [3], which requires consideration of the patient's unique psychological, social, and cultural context and can enhance the relevance and impact of the intervention. For example, according to a study of Hispanic breast cancer patients, a culturally adapted positive mindfulness program resulted in notably lower anxiety levels compared with a standard intervention [13]. Second, the advancement of integrated care models that integrate medical treatment with psychosocial support is vital to addressing the heterogeneous needs of patients with chronic diseases. For example, people with diabetes receive both medical treatment to control blood glucose and weekly sessions with a psychologist to manage stress and anxiety and improve overall health through a holistic approach. Additionally, by utilizing mobile applications or remote therapy technologies, it is possible to overcome geographical and resource limitations and provide remote support, monitor progress, and implement interventions in an economically efficient manner [14]. For example, innovative integrated health and social care models in Italy utilizes mobile APPs to facilitate coordination and enhance quality of life and treatment adherence for patients with chronic diseases [15]. These online platforms should be designed to be user-friendly and culturally sensitive to ensure that the needs of different patient groups are met.
5.Conclusion
In conclusion, psychosocial interventions play a pivotal role in the comprehensive management of chronic diseases. While traditional medical treatments effectively address the physiological aspects of these conditions, psychosocial interventions provide essential support by addressing emotional, psychological, and social dimensions of health. And the integration of these interventions has been shown to significantly enhance overall patient well-being, strengthen emotional resilience, improve self-management behaviors, and reinforce social support networks. Despite these evident benefits, challenges such as individual variability in response, the need for sustained interventions, and issues of accessibility and scalability persist. Addressing these challenges requires strategic measures, including the development of personalized intervention plans, integrated care models, and the application of technology to broaden the reach of these interventions. The continuous improvement and expansion of psychosocial interventions can facilitate the delivery of more effective and comprehensive care for individuals with chronic diseases, which has the potential to improve the quality of life and treatment outcomes for these patients.
References
[1]. Thomas, S.A., Browning, C.J., et al. (2023) Transforming global approaches to chronic disease prevention and management across the lifespan: integrating genomics, behavior change, and digital health solutions. Frontiers in public health, 11.
[2]. Bessell, A. and Moss, T.P. (2007) Evaluating the effectiveness of psychosocial interventions for individuals with visible differences: a systematic review of the empirical literature. Body Image, 4(3): 227-238.
[3]. Akyirem, S., et al. (2022) Psychosocial interventions for adults with newly diagnosed chronic disease: A systematic review. Journal of Health Psychology, 27(7):1753-1782.
[4]. Schiavon, C.C., et al. (2017) Optimism and Hope in Chronic Disease: A Systematic Review. Frontiers in Psychology, 7: 2022-2022.
[5]. Dear, B.F., et al. (2022) The Chronic Conditions Course: A Randomised Controlled Trial of an Internet-Delivered Transdiagnostic Psychological Intervention for People with Chronic Health Conditions. Psychotherapy and Psychosomatics, 91(4), 265-276.
[6]. Martire, L M., et al. (2004) Is It Beneficial to Involve a Family Member? A Meta-Analysis of Psychosocial Interventions for Chronic Illness. Health Psychology, 23(6): 599-611.
[7]. Zhang, S., et al. (2024) The effectiveness of brief reminiscence‐based psychosocial interventions for cancer patients: A systematic review and meta‐analysis. Journal of Clinical Nursing, 33(7): 2775-2796.
[8]. Li, Y.N., et al. (2021) Effectiveness of cognitive behavioral therapy-based interventions on health outcomes in patients with coronary heart disease: A meta-analysis. World Journal of Psychiatry, 11(11): 1147-1166.
[9]. Raihan, N. and Cogburn, M. (2023). Stages of Change Theory. National Library of Medicine.
[10]. Anderson, N. and Ozakinci, G. (2018) Effectiveness of psychological interventions to improve quality of life in people with long-term conditions: rapid systematic review of randomised controlled trials. BMC Psychology, 6(1): 11-11.
[11]. Bird, V.J., et al. (2022) Implementing psychosocial interventions within low and middle-income countries to improve community-based care for people with psychosis-A situation analysis. Frontiers in Psychiatry, 13: 807259-807259.
[12]. McGinty, E.E., et al. (2024) Scaling Interventions to Manage Chronic Disease: Innovative Methods at the Intersection of Health Policy Research and Implementation Science. Prevention Science, 25: 96-108.
[13]. Juarez-Reyes, M., et al. (2024) A Randomized Controlled Trial of a Culturally Adapted, Community-Based, Remotely Delivered Mindfulness Program for Latinx Patients With Breast Cancer is Acceptable and Feasible While Reducing Anxiety. Global Advances in Integrative Medicine and Health.
[14]. Cardol, C.K., et al. (2021) Detecting and Treating Psychosocial and Lifestyle-Related Difficulties in Chronic Disease: Development and Treatment Protocol of the E-GOAL eHealth Care Pathway. International Journal of Environmental Research and Public Health, 18/
[15]. Gavaldà-Espelta, E., et al. (2023) Innovative Health and Social Integrated Care Model Effectiveness to Improve Quality Care for Chronic Patients: A Single Group Assignment Clinical Trial. International Journal of Integrated Care, 23(4): 2–2.
Cite this article
Xu,W. (2024).An Analysis of the Role of Psychosocial Interventions in the Management of Chronic Diseases.Communications in Humanities Research,50,9-14.
Data availability
The datasets used and/or analyzed during the current study will be available from the authors upon reasonable request.
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References
[1]. Thomas, S.A., Browning, C.J., et al. (2023) Transforming global approaches to chronic disease prevention and management across the lifespan: integrating genomics, behavior change, and digital health solutions. Frontiers in public health, 11.
[2]. Bessell, A. and Moss, T.P. (2007) Evaluating the effectiveness of psychosocial interventions for individuals with visible differences: a systematic review of the empirical literature. Body Image, 4(3): 227-238.
[3]. Akyirem, S., et al. (2022) Psychosocial interventions for adults with newly diagnosed chronic disease: A systematic review. Journal of Health Psychology, 27(7):1753-1782.
[4]. Schiavon, C.C., et al. (2017) Optimism and Hope in Chronic Disease: A Systematic Review. Frontiers in Psychology, 7: 2022-2022.
[5]. Dear, B.F., et al. (2022) The Chronic Conditions Course: A Randomised Controlled Trial of an Internet-Delivered Transdiagnostic Psychological Intervention for People with Chronic Health Conditions. Psychotherapy and Psychosomatics, 91(4), 265-276.
[6]. Martire, L M., et al. (2004) Is It Beneficial to Involve a Family Member? A Meta-Analysis of Psychosocial Interventions for Chronic Illness. Health Psychology, 23(6): 599-611.
[7]. Zhang, S., et al. (2024) The effectiveness of brief reminiscence‐based psychosocial interventions for cancer patients: A systematic review and meta‐analysis. Journal of Clinical Nursing, 33(7): 2775-2796.
[8]. Li, Y.N., et al. (2021) Effectiveness of cognitive behavioral therapy-based interventions on health outcomes in patients with coronary heart disease: A meta-analysis. World Journal of Psychiatry, 11(11): 1147-1166.
[9]. Raihan, N. and Cogburn, M. (2023). Stages of Change Theory. National Library of Medicine.
[10]. Anderson, N. and Ozakinci, G. (2018) Effectiveness of psychological interventions to improve quality of life in people with long-term conditions: rapid systematic review of randomised controlled trials. BMC Psychology, 6(1): 11-11.
[11]. Bird, V.J., et al. (2022) Implementing psychosocial interventions within low and middle-income countries to improve community-based care for people with psychosis-A situation analysis. Frontiers in Psychiatry, 13: 807259-807259.
[12]. McGinty, E.E., et al. (2024) Scaling Interventions to Manage Chronic Disease: Innovative Methods at the Intersection of Health Policy Research and Implementation Science. Prevention Science, 25: 96-108.
[13]. Juarez-Reyes, M., et al. (2024) A Randomized Controlled Trial of a Culturally Adapted, Community-Based, Remotely Delivered Mindfulness Program for Latinx Patients With Breast Cancer is Acceptable and Feasible While Reducing Anxiety. Global Advances in Integrative Medicine and Health.
[14]. Cardol, C.K., et al. (2021) Detecting and Treating Psychosocial and Lifestyle-Related Difficulties in Chronic Disease: Development and Treatment Protocol of the E-GOAL eHealth Care Pathway. International Journal of Environmental Research and Public Health, 18/
[15]. Gavaldà-Espelta, E., et al. (2023) Innovative Health and Social Integrated Care Model Effectiveness to Improve Quality Care for Chronic Patients: A Single Group Assignment Clinical Trial. International Journal of Integrated Care, 23(4): 2–2.