{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:26:02Z","timestamp":1787199962343,"version":"build-2736575974"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:p>The growing burden of chronic diseases has increased interest in both psychological distress and positive psychological functioning among people living with chronic conditions. In this context, flourishing may be understood as the capacity to maintain positive functioning, meaning, social connectedness, and personal growth while adapting to long-term illness. This narrative review examines the conceptualization, theoretical foundations, current evidence, measurement instruments, and factors associated with flourishing in chronic disease populations. Insights from Keyes\u2019 Mental Health Continuum, the complete state model of mental health, the PERMA model, and evidence on contextual and psychological factors are integrated to propose a model-informed conceptual framework for future research and intervention development. The proposed framework emphasizes the complementary goals of reducing psychological distress and strengthening positive psychological resources, thereby broadening chronic disease care from symptom control toward patient-centred approaches that also support positive functioning, adaptation, and self-management. Further empirical research is required to evaluate the conceptual validity, feasibility, and applicability of this framework across chronic disease populations.<\/jats:p>","DOI":"10.3389\/fpsyg.2026.1915817","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:15:48Z","timestamp":1787199348000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Flourishing in chronic disease care: a narrative review and proposed conceptual framework"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhenzhen","family":"Feng","sequence":"first","affiliation":[{"name":"Sichuan Provincial People\u2019s Hospital, University of Electronic Science and Technology of China","place":["Chengdu, China"]},{"name":"School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Yang","sequence":"additional","affiliation":[{"name":"Sichuan Provincial People\u2019s Hospital, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1037\/rep0000425","article-title":"Flourishing after traumatic spinal cord injury: results from a multimethod study","volume":"67","author":"Allaire","year":"2022","journal-title":"Rehabil. Psychol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e073782","DOI":"10.1136\/bmjopen-2023-073782","article-title":"Well-being and flourishing mental health in adults with inflammatory bowel disease, multiple sclerosis and rheumatoid arthritis in Manitoba, Canada: a cross-sectional study","volume":"13","author":"Almweisheer","year":"2023","journal-title":"BMJ Open"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e12761","DOI":"10.1111\/bjhp.12761","article-title":"Self-compassion and psychological distress in chronic illness: a meta-analysis","volume":"30","author":"Baxter","year":"2025","journal-title":"Br. J. Health Psychol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5502\/ijw.v6i3.526","article-title":"The PERMA-profiler: a brief multidimensional measure of flourishing","volume":"6","author":"Butler","year":"2016","journal-title":"Int. J. Wellbeing"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/15347354241249935","article-title":"The flourishing scale: psychometric properties in breast Cancer patients","volume":"23","author":"Cerezo","year":"2024","journal-title":"Integr. Cancer Ther."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3969\/j.issn.1671-8933.2025.06.002","article-title":"The mediating role of coping styles in the relationship between benefit finding and flourishing among postoperative patients with thyroid cancer","volume":"24","author":"Chonglong","year":"2025","journal-title":"J. Clin. Nurs."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s11205-009-9493-y","article-title":"New well-being measures: short scales to assess flourishing and positive and negative feelings","volume":"97","author":"Diener","year":"2010","journal-title":"Soc. Indic. Res."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e0291722","DOI":"10.1371\/journal.pone.0291722","article-title":"Flourishing mental health despite disabling chronic pain: findings from a nationally representative sample of Canadians with arthritis","volume":"18","author":"Fuller-Thomson","year":"2023","journal-title":"PLoS One"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1080\/13607863.2018.1481926","article-title":"Flourishing despite a cancer diagnosis: factors associated with complete mental health in a nationally-representative sample of cancer patients aged 50 years and older","volume":"23","author":"Fuller-Thomson","year":"2019","journal-title":"Aging Ment. Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"82","DOI":"10.3870\/j.issn.1001-4152.2025.11.082","article-title":"Status of flourishing among patients with diabetic retinopathy and its influencing factors","volume":"40","author":"Gang","year":"2025","journal-title":"J. Nurs. Sci."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2561","DOI":"10.1002\/cam4.4636","article-title":"Flourishing in head and neck cancer survivors","volume":"11","author":"Harris","year":"2022","journal-title":"Cancer Med."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"102587","DOI":"10.1016\/j.cpr.2025.102587","article-title":"Dyadic coping and relationship satisfaction among couples with a chronic illness: a meta-analytical actor-partner interdependence model","volume":"119","author":"Hou","year":"2025","journal-title":"Clin. Psychol. Rev."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3870\/j.issn.1001-4152.2025.05.011","article-title":"The status quo of flourishing and its influencing factors among postoperative patients with thyroid cancer","volume":"40","author":"Huili","year":"2025","journal-title":"J. Nurs. Sci."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1007\/s11205-011-9966-7","article-title":"Flourishing across Europe: application of a new conceptual framework for defining well-being","volume":"110","author":"Huppert","year":"2013","journal-title":"Soc. Indic. Res."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"207","DOI":"10.2307\/3090197","article-title":"The mental health continuum: from languishing to flourishing in life","volume":"43","author":"Keyes","year":"2002","journal-title":"J. Health Soc. Behav."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1037\/0022-006X.73.3.539","article-title":"Mental illness and\/or mental health? Investigating axioms of the complete state model of health","volume":"73","author":"Keyes","year":"2005","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1177\/13591053241260288","article-title":"Flourishing in life in patients with inflammatory bowel disease: the role of illness identity and health-related quality of life","volume":"30","author":"Kr\u00f6meke","year":"2025","journal-title":"J. Health Psychol."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2385","DOI":"10.1097\/JS9.0000000000002260","article-title":"Burden and attributable risk factors of non-communicable diseases and subtypes in 204 countries and territories, 1990-2021: a systematic analysis for the global burden of disease study 2021","volume":"111","author":"Li","year":"2025","journal-title":"Int. J. Surg."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3390\/healthcare11152131","article-title":"Perspectives on aging and quality of life","volume":"11","author":"Noto","year":"2023","journal-title":"Healthcare"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"12","DOI":"10.19738\/j.cnki.psy.2025.05.003","article-title":"Potential profile analysis and influencing factors of flourish in young and middleaged breast cancer patients","volume":"20","author":"Ran","year":"2025","journal-title":"Psychosom. Med."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1293943","DOI":"10.3389\/fpsyg.2024.1293943","article-title":"Measurement of flourishing: a scoping review","volume":"15","author":"Rule","year":"2024","journal-title":"Front. Psychol."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1111\/famp.12632","article-title":"The couple flourishing measure","volume":"60","author":"Sanri","year":"2021","journal-title":"Fam. Process"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.wss.2023.100144","article-title":"Flourishing with chronic illness(es) and everyday stress: experiences from Soweto, South Africa","volume":"4","author":"Schmidt-Sane","year":"2023","journal-title":"Wellbeing Space Soc."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1159\/000533263","article-title":"Depression and anxiety trajectories in chronic disease: a systematic review and meta-analysis","volume":"92","author":"Scott","year":"2023","journal-title":"Psychother. Psychosom."},{"key":"ref25","volume-title":"Flourish: a Visionary New Understanding of Happiness and Well-Being","author":"Seligman","year":"2011"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"414","DOI":"10.4300\/JGME-D-22-00480.1","article-title":"Narrative reviews: flexible, rigorous, and practical","volume":"14","author":"Sukhera","year":"2022","journal-title":"J. Grad. Med. Educ."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"36","DOI":"10.3969\/j.issn.1009-8399.2024.09.009","article-title":"Mediating role of coping mode in the relationship between benefit finding and flourishing experi-ence in hemodialysis patients","volume":"24","author":"Tianyu","year":"2024","journal-title":"Shanghai Nurs."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"8148","DOI":"10.1073\/pnas.1702996114","article-title":"On the promotion of human flourishing","volume":"114","author":"VanderWeele","year":"2017","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1136\/jech-2023-220553","article-title":"Flourishing and the scope of medicine and public health","volume":"78","author":"VanderWeele","year":"2024","journal-title":"J. Epidemiol. Community Health"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1667","DOI":"10.1001\/jama.2019.3035","article-title":"Reimagining health-flourishing","volume":"321","author":"VanderWeele","year":"2019","journal-title":"JAMA"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1037\/0022-3514.64.4.678","article-title":"Two conceptions of happiness: contrasts of personal expressiveness (eudaimonia) and hedonic enjoyment","volume":"64","author":"Waterman","year":"1993","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1510","DOI":"10.3969\/j.issn.1672-9676.2025.10.015","article-title":"Research progress on influencing factors of frailty in maintenance haemodialysis patients","volume":"22","author":"Yin","year":"2025","journal-title":"Nurs. Pract. Res."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1186\/s12888-025-07624-3","article-title":"The relationship between flourishing, social support, and regulatory emotional self-efficacy in maintenance hemodialysis patients: a network analysis","volume":"25","author":"Zeng","year":"2025","journal-title":"BMC Psychiatry"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1480308","DOI":"10.3389\/fpsyt.2025.1480308","article-title":"Flourishing and its influencing factors among maintenance hemodialysis patients in Shanghai, China: a cross-sectional study","volume":"16","author":"Zeng","year":"2025","journal-title":"Front. Psych."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1915817\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:15:53Z","timestamp":1787199353000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1915817\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":34,"alternative-id":["10.3389\/fpsyg.2026.1915817"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2026.1915817","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]},"article-number":"1915817"}}