{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:17:08Z","timestamp":1787242628958,"version":"build-2736575974"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"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. Public Health"],"abstract":"\n Aims<\/jats:title>\n To comprehensively integrate existing research on narrative foreclosure among patients with chronic diseases, aiming to explore how the concept is described and whether its clinical manifestations differ across various disease contexts, as well as to summarize the associated factors and intervention strategies.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Scoping review.<\/jats:p>\n <\/jats:sec>\n \n Data sources<\/jats:title>\n Systematic searches were performed in seven databases (CNKI, Embase, PubMed, CINAHL, PsycINFO, Scopus, and Web of Science) from their inception until March 2025.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We followed the framework proposed by Arksey, O'Malley, and Levac. The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension. Research on narrative foreclosure in patients with chronic diseases was included, regardless of the specific setting in which it was conducted.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of nine studies were included, covering both cancer and other chronic diseases. The primary outcomes are as follows. The core concept of narrative foreclosure in the context of chronic diseases refers to a state in which individuals believe their life story has ended; however, its specific descriptions vary across chronic diseases such as asthma and depression. The clinical manifestations include negative emotions and maladaptive behaviors. Twelve associated factors were identified, including age, psychological factors (such as ego integrity and hope), social support, and educational level. Interventions targeting narrative foreclosure involved the application of hope theory, dignity therapy, meaning-centered approaches, and narrative nursing.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n At present, research on narrative foreclosure in the field of chronic diseases is limited. Narrative foreclosure has been proven to have adverse effects on disease management among patients with chronic diseases. Therefore, it is particularly important to pay attention to the clinical manifestations of patients' narrative foreclosure and to identify the factors that promote or hinder it. Additionally, existing intervention measures need further verification, and the concepts of positive psychology should be integrated into their design and implementation.<\/jats:p>\n <\/jats:sec>\n \n Registration number<\/jats:title>\n \n Our review protocol was prospectively registered on the Open Science Framework (OSF). Unique Identifier:\n 10.17605\/OSF.IO\/5RQKM<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1735227","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:19:10Z","timestamp":1767676750000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Narrative foreclosure among patients with chronic diseases: a scoping review"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhounan","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiya","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manyao","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueying","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiyue","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyu","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"B1","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":"B2","doi-asserted-by":"publisher","first-page":"1082183","DOI":"10.3389\/fpubh.2022.1082183","article-title":"Projecting the chronic disease burden among the adult population in the United States using a multi-state population model","volume":"10","author":"Ansah","year":"2022","journal-title":"Front Public Health."},{"key":"B3","unstructured":"The Top 10 Causes of Death.\n \n 2024"},{"key":"B4","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.mayocpiqo.2023.08.005","article-title":"The burden of chronic disease","volume":"8","author":"Hacker","year":"2024","journal-title":"Mayo Clin Proc Innov Qual Outcomes."},{"key":"B5","doi-asserted-by":"crossref","DOI":"10.4324\/9781003508175","volume-title":"Living with Chronic Illness: The Experience of Patients and Their Families.","author":"Anderson","year":"2024"},{"key":"B6","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s43045-023-00340-2","article-title":"Prevalence and correlates of stress, anxiety, and depression in patients with chronic diseases: a cross-sectional study","volume":"30","author":"Swathi","year":"2023","journal-title":"Middle East Curr Psychiatry."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/medhum-2021-012331","article-title":"Chronicling the chronic: narrating the meaninglessness of chronic pain","volume":"49","author":"Van Hout","year":"2023","journal-title":"Med Humanit."},{"key":"B8","first-page":"81","article-title":"When the story's over: Narrative foreclosure and the possibility of self-renewal","author":"Freeman","year":"2002","journal-title":"Lines of Narrative"},{"key":"B9","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/j.jaging.2011.01.003","article-title":"Narrative foreclosure in later life: preliminary considerations for a new sensitizing concept","volume":"25","author":"Bohlmeijer","year":"2011","journal-title":"J AGING Stud."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s11019-020-09959-7","article-title":"Narrative Foreclosure in the Context of Bio-health","author":"Yang","year":"2020","journal-title":"Med Philos"},{"key":"B11","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1089\/pmr.2022.0016","article-title":"Dignity conserving therapy: an intervention for addressing psychosocial and existential distress in patients with serious illness","volume":"3","author":"Weng","year":"2022","journal-title":"Palliat Med Rep."},{"key":"B12","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1525\/maq.2007.21.3.324","article-title":"The meaning of the present: Hope and foreclosure in narrations about people with severe brain damage","volume":"21","author":"Antetius","year":"2007","journal-title":"Med Anthropol Q."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1353\/nib.2023.0039","article-title":"Being the spiritual ferryman of terminally cancer patients: a psychological nursing experience of a narrative foreclosure case","author":"Li","year":"2023","journal-title":"Narrat Med"},{"key":"B14","volume-title":"Narrative and Freedom","author":"Morson","year":"1994"},{"key":"B15","unstructured":"Cole\n TR\n \n \n New York, NY\n Springer Pub\n Voices and Visions of Aging: Toward a Critical Gerontology.\n \n 1993"},{"key":"B16","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1123\/JAPA.2012-0300","article-title":"Learning to run from narrative foreclosure: one woman's story of aging and physical activity","volume":"22","author":"Griffin","year":"2014","journal-title":"J AGING Phys Act."},{"key":"B17","article-title":"Hindsight: the promise and peril of looking backward","author":"Freeman","year":"2010"},{"key":"B18","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: towards a methodological framework","volume":"8","author":"Arksey","year":"2005","journal-title":"Int J Soc Res Methodol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1186\/1748-5908-5-69","article-title":"Scoping studies: advancing the methodology","volume":"5","author":"Levac","year":"2010","journal-title":"Implement Sci."},{"key":"B20","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann Intern Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"E66","DOI":"10.5888\/pcd10.120239","article-title":"Defining and measuring chronic conditions: imperatives for research, policy, program, and practice","volume":"10","author":"Goodman","year":"2013","journal-title":"Prev Chronic Dis."},{"key":"B22","doi-asserted-by":"publisher","first-page":"4","DOI":"10.21061\/gen.47.3.2","article-title":"In Praise of Adventure: Changing the Narrative of Later Life","volume":"47","author":"Randall","year":"2023","journal-title":"Generations"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e12244","DOI":"10.1111\/nin.12244","article-title":"Narrative intelligence in nursing: Storying patient lives in dementia care","volume":"25","author":"Witham","year":"2018","journal-title":"Nurs Inq."},{"key":"B24","doi-asserted-by":"publisher","first-page":"53","DOI":"10.16390\/j.cnki.issn1005-7287.2024.03.014","article-title":"Chinese version of narrative foreclosure scaleand its reliability and validity in patients with secondary hyperparathyroidism","volume":"19","author":"Yin","year":"2024","journal-title":"Psychol Mon."},{"key":"B25","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1080\/13607863.2014.896865","article-title":"The development and initial validation of the narrative foreclosure scale","volume":"18","author":"Bohlmeijer","year":"2014","journal-title":"AGING Ment Health."},{"key":"B26","doi-asserted-by":"publisher","first-page":"230071","DOI":"10.1183\/16000617.0170-2022","article-title":"Nonpharmacological management of psychological distress in people with COPD","volume":"32","author":"Volpato","year":"2023","journal-title":"Eur Respir Rev."},{"key":"B27","unstructured":"Brooks\n R\n \n \n Sydney, NSW\n University of Sydney\n Therapeutic Narrative Illness Writing and the Quest for Healing.\n \n 2004"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1674","DOI":"10.1177\/0269215517708821","article-title":"Why do patients decline participation in offered pulmonary rehabilitation?","volume":"31","author":"Mathar","year":"2017","journal-title":"A qualitative study Clin Rehabil."},{"key":"B29","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1186\/s12913-021-06814-5","article-title":"Exploring the barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: a qualitative study","volume":"21","author":"Sami","year":"2021","journal-title":"BMC Health Serv Res."},{"key":"B30","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1177\/0963721413475622","article-title":"Narrative identity","volume":"22","author":"McAdams","year":"2013","journal-title":"Curr Dir Psychol Sci."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2386829","DOI":"10.1080\/20008066.2024.2386829","article-title":"How do young men narrate the redemption story of a sexual assault perpetrator?","volume":"15","author":"Delker","year":"2024","journal-title":"Eur J Psychotraumatology."},{"key":"B32","article-title":"Man's search for meaning","author":"Frankl","year":"1985","journal-title":"Simon and Schuster."},{"key":"B33","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/978-94-007-6527-6_9","article-title":"Emotions and meaning in life: a motivational perspective","volume-title":"The Experience of Meaning in Life.","author":"Tang","year":"2013"},{"key":"B34","doi-asserted-by":"publisher","first-page":"2680","DOI":"10.21037\/jtd-23-413","article-title":"Analysis of risk factors for negative emotions in patients with severe pneumonia and their impact on prognosis","volume":"15","author":"Tai","year":"2023","journal-title":"J Thorac Dis."},{"key":"B35","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1111\/jan.14605","article-title":"Relationships among hope, meaning in life, and post-traumatic growth in patients with chronic obstructive pulmonary disease: a cross-sectional study","volume":"77","author":"Wang","year":"2021","journal-title":"J Adv Nurs."},{"key":"B36","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1681\/ASN.0000000000000341","article-title":"Decision-making engagement preferences among older adults with CKD","volume":"35","author":"Gonzales","year":"2024","journal-title":"J Am Soc Nephrol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"363","DOI":"10.47772\/IJRISS.2025.917PSY0033","article-title":"Distress tolerance and hopelessness as predictors of adherence to treatment among recovering drug users in recovering drug users in uyo, akwa ibom state","volume":"9","author":"Christopher","year":"2025","journal-title":"Int J Res Innov Soc Sci."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1444012","DOI":"10.3389\/fphar.2024.1444012","article-title":"Medication non-adherence: reflecting on two decades since WHO adherence report and setting goals for the next twenty years","volume":"15","author":"Kardas","year":"2024","journal-title":"Front Pharmacol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"e25","DOI":"10.2105\/AJPH.2014.302041","article-title":"Self-management: a comprehensive approach to management of chronic conditions","volume":"104","author":"Grady","year":"2014","journal-title":"Am J Public Health."},{"key":"B40","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1891\/1541-6577.26.2.108","article-title":"Self-management support in chronic illness care: a concept analysis","volume":"26","author":"Kawi","year":"2012","journal-title":"Res Theory Nurs Pract."},{"key":"B41","first-page":"2","article-title":"On changes in Chinese family structure","volume":"3","author":"Fei","year":"1982","journal-title":"Tianjin Soc Sci."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1057\/s41599-024-02870-4","article-title":"Parental emotional warmth and adolescent internet altruism behavior: a moderated mediation model","volume":"11","author":"Zhou","year":"2024","journal-title":"Humanit Soc Sci Commun."},{"key":"B43","first-page":"121","article-title":"A brief discussion on the transformation of Chinese families: Issues and countermeasures","volume":"6","author":"Gao","year":"2024","journal-title":"Daqing Soc Sci."},{"key":"B44","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1080\/08854726.2021.2015055","article-title":"Addressing spiritual needs in palliative care: proposal for a narrative and interfaith spiritual care intervention for chaplaincy","volume":"29","author":"Wierstra","year":"2023","journal-title":"J Health Care Chaplain."},{"key":"B45","doi-asserted-by":"publisher","first-page":"101493","DOI":"10.1016\/j.copsyc.2022.101493","article-title":"Emotional and spiritual hope: back to the future","volume":"49","author":"Scioli","year":"2023","journal-title":"Curr Opin Psychol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s10902-014-9504-9","article-title":"Growth motivation toward two paths of eudaimonic self-development","volume":"16","author":"Bauer","year":"2015","journal-title":"J Happiness Stud."},{"key":"B47","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1023\/A:1023910315561","article-title":"Rumination reconsidered: a psychometric analysis","volume":"27","author":"Treynor","year":"2003","journal-title":"Cogn Ther Res."},{"key":"B48","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1093\/abm\/kaaa060","article-title":"The double-edged sword of reflective pondering: the role of state and trait reflective pondering in predicting depressive symptoms among women with breast cancer","volume":"55","author":"Wang","year":"2021","journal-title":"Ann Behav Med."},{"key":"B49","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1037\/cou0000740","article-title":"\u201cToo much of a burden\u201d: Lived experiences of depressive rumination in early adulthood","volume":"71","author":"Ciobotaru","year":"2024","journal-title":"J Couns Psychol."},{"key":"B50","volume-title":"Quit Ruminating and Brooding: How Worry and Ruminating Work and What to do to Overcome Them","author":"Wadstr\u00f6m","year":"2020"},{"key":"B51","doi-asserted-by":"publisher","first-page":"579","DOI":"10.4314\/ejhs.v30i4.13","article-title":"Explaining the process of spiritual healing of critically-ill patients: a grounded theory study","volume":"30","author":"Rafii","year":"2020","journal-title":"Ethiop J Health Sci."},{"key":"B52","doi-asserted-by":"publisher","first-page":"1371110","DOI":"10.3389\/fpubh.2024.1371110","article-title":"The relationship between spiritual health and quality of life among COVID-19 patients with long-term complications in the post-coronavirus era","volume":"12","author":"Safarabadi","year":"2024","journal-title":"Front Public Health."},{"key":"B53","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1089\/jpm.2019.0376","article-title":"\u2018Connection': the integration of a person-centered narrative intervention into the electronic health record: an implementation study","volume":"23","author":"Coats","year":"2020","journal-title":"J Palliat Med."},{"key":"B54","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1186\/s12885-025-13587-1","article-title":"Trends in symptom severity and complexity in patients undergoing radiation therapy","volume":"25","author":"Yannitsos","year":"2025","journal-title":"BMC Cancer."},{"key":"B55","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1145\/3461778.3462143","article-title":"\u201cI wrote as if I were telling a story to someone I knew\u201d: designing chatbot interactions for expressive writing in mental health","author":"Park","year":"2021","journal-title":"Proceedings of the 2021 Designing Interactive Systems Conference (DIS '21)"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2024.2302980","article-title":"A systematic review of artificial intelligence-powered (AI-powered) chatbot intervention for managing chronic illness","author":"Khairandish","year":"2024","journal-title":"Ann Med"},{"key":"B57","doi-asserted-by":"publisher","first-page":"115","DOI":"10.57417\/jaalr.2.3_115","article-title":"A literature review of psychological narratology in the clinical domain: artificial intelligence and robots to assist individuals with disabilities","volume":"2","author":"Seino","year":"2021","journal-title":"J Adv Artif Life Robot."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1735227\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:19:16Z","timestamp":1767676756000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1735227\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":57,"alternative-id":["10.3389\/fpubh.2025.1735227"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1735227","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]},"article-number":"1735227"}}