End-stage renal disease, a condition marked by the gradual and irreversible loss of kidney function, necessitates sustained and rigorous treatment regimens, including dialysis. This life-sustaining therapy requires consistent patient adherence to both clinical protocols and medication schedules. However, the concomitant presence of depression—a prevalent yet frequently under-addressed comorbidity in ESRD patients—often complicates adherence, leading to poorer health outcomes. Recognizing these intertwined challenges, researchers sought to explore how tele-based interventions, offering continuous care remotely, could enhance patient compliance.

The study recruited 549 participants from fifteen tertiary A-grade hospitals in Anhui Province, China, over a three-month period. These participants were rigorously screened to meet predefined inclusion and exclusion criteria to ensure the robustness of data. Employing covariance-based structural equation modeling (CB-SEM), the researchers analyzed the nuanced relationships among tele-based care, nurse-patient dynamics, health beliefs, and treatment adherence. Notably, the study introduced a multi-group comparison to elucidate differences between depressed and non-depressed dialysis patients, striving to unravel how mental health status might modulate the effectiveness of tele-based care.

Remarkably, the findings underscored a significant positive correlation between tele-based continuous care and treatment compliance across the dialysis cohort. This suggests that when patients receive consistent, remote healthcare engagement, they are more likely to adhere to their complex therapeutic regimens. Such an outcome is particularly salient in the context of chronic diseases, where ongoing monitoring and support are critical to sustained health improvements and avoidance of complications.

Delving deeper, the study investigated the roles of the nurse-patient relationship and patients’ health beliefs as potential mediators in this dynamic. While conventional wisdom often emphasizes the importance of rapport between healthcare provider and patient in fostering adherence, this research presented a nuanced perspective. In the overall dialysis population, the direct impact of the nurse-patient relationship on compliance was found to be statistically insignificant. This unexpected revelation challenges preconceived notions, suggesting that mere interpersonal connection may not directly translate to better treatment adherence in this context.

However, the narrative takes a compelling turn when patients are stratified by depression status. Among patients grappling with depression, tele-based continuous care exerted its positive influence on compliance exclusively through the enhancement of health beliefs—patients’ perceptions and attitudes towards their health and treatment. In other words, reinforcing patients’ confidence and understanding about their illness and treatment proved pivotal in encouraging adherence within the depressed subgroup.

Conversely, for patients without depression, tele-based continuous care positively affected compliance via multiple channels, excluding the nurse-patient relationship, which remained non-significant. This differential pathway is crucial, as it spotlights the distinctive psychological and behavioral mechanisms at play depending on the presence or absence of depression. It highlights the imperative of personalized care strategies that address both the mental health status and the cognitive frameworks of patients.

This profound insight carries broad implications for the design of telehealth programs in nephrology and beyond. Tele-based continuous care, by providing ongoing support and fostering positive health beliefs, can mitigate some of the barriers to treatment adherence intrinsic to both physical and psychological burdens. Importantly, it suggests that such interventions must be particularly tailored to bolster health belief systems in patients experiencing depression, which can often undermine motivation and compliance.

Furthermore, the study’s methodological rigor—utilizing structural equation modeling—enabled the disentanglement of complex, multi-layered relationships between variables. This analytical approach provides a more granular understanding of not only whether tele-based care works, but how and why it works differently across subgroups. Such knowledge is invaluable for healthcare providers and policymakers intent on optimizing intervention strategies and resource allocation.

The implications for public health policy are equally significant. As telehealth becomes increasingly ingrained in healthcare delivery frameworks worldwide, evidence-based validation of its efficacy across varied patient populations must guide integration efforts. Incorporating mental health considerations explicitly into telehealth protocols for chronic disease management is an emerging priority highlighted by this research.

Moreover, this study sheds light on the evolving role of nursing professionals in telehealth environments. While the nurse-patient relationship did not exhibit direct mediation effects in this particular setting, nurses remain vital interlocutors in delivering care, providing education, and addressing emergent issues remotely. Understanding how to maximize the impact of nurse engagement in telehealth remains an exciting frontier for further investigation.

In conclusion, the research published by Hong and colleagues in BMC Psychiatry advances our comprehension of the mechanisms through which tele-based continuous care influences treatment compliance in dialysis patients. By delineating how health beliefs mediate this relationship especially in depressed patients, the study advocates for integrating psychological support within telehealth models. As ESRD and mental health challenges continue to escalate globally, such insights offer a beacon for enhancing patient outcomes through innovative, patient-centered care strategies enabled by technology.

The findings invite broader discourse on the future of healthcare delivery, emphasizing the necessity for multidisciplinary approaches that bridge physical and mental health domains. Tele-based continuous care emerges not merely as a convenience but as a potent tool to surmount treatment barriers, particularly for vulnerable dialysis patients contending with depression. This research marks a pivotal step towards refining telemedicine practices to achieve holistic, effective chronic disease management in the digital era.

Subject of Research: Tele-based continuous care and treatment compliance in dialysis patients with and without depression, focusing on the mediating roles of nurse-patient relationship and health belief.

Article Title: Tele-based continuous care and treatment compliance in dialysis patients with and without depression: the serial mediating effect of nurse-patient relationship and health belief

Article References:
Hong, W., Cheng, G., Ma, Y. et al. Tele-based continuous care and treatment compliance in dialysis patients with and without depression: the serial mediating effect of nurse-patient relationship and health belief. BMC Psychiatry 25, 1090 (2025). https://doi.org/10.1186/s12888-025-07534-4

Image Credits: AI Generated

DOI: 13 November 2025

The study takes a comprehensive look at the journey from awareness to adoption of Internet Medical Services, demonstrating that the shift in healthcare delivery is profound. As the population ages and the prevalence of chronic diseases increases, traditional healthcare systems struggle to meet the rising demands. This is where IMS come into play, providing patients with access to medical consultations, treatment options, and health management tools online. This transition is not only reshaping patient care but also encouraging healthcare providers to innovate and adapt to meet ever-evolving patient needs.

Utilization of IMS among patients with chronic diseases highlights several critical factors including accessibility, convenience, and the ability to receive care from the comfort of home. The study reveals that as awareness of these services grows, patients feel more empowered to take charge of their health. They can seek medical advice via telehealth platforms without the inconvenience of travel or long wait times. This access to timely medical consultation is particularly crucial for those managing chronic conditions, where timing and consistency in treatment can significantly impact long-term health outcomes.

Furthermore, trust in technology plays a vital role in the acceptance of IMS. The researchers found that many patients hesitate to adopt these services due to concerns about the quality of care they may receive online compared to in-person visits. However, as the technology used in these services improves and telehealth becomes a more standard practice, patients are gradually beginning to develop more confidence in these alternatives. This growing trust is essential, as it not only impacts individual patients’ decisions but also influences the wider healthcare system’s transformation.

The findings of this study suggest that education and outreach are paramount in promoting IMS. Many patients remain unaware of the options available to them in the digital space. Targeted campaigns focusing on the benefits and functionalities of Internet Medical Services can bridge this gap. Health authorities and providers can play an important role in disseminating information, using various communication channels to ensure that patients have access to the knowledge required to make informed decisions about their healthcare.

One of the most significant advantages of IMS is the customization it offers to patient care. The study illustrates a notable trend where patients with chronic conditions can tailor their health management to their lifestyle, preferences, and specific health needs. For instance, personalized apps allow users to track symptoms, schedule medication reminders, and even connect with healthcare providers in real-time. This high degree of personalization not only enhances adherence to treatment but also empowers patients, allowing them to take an active role in their health management.

The implications of enhanced patient engagement through IMS are profound. They can lead to improved health outcomes, reduced healthcare costs, and increased patient satisfaction. Chronic disease management is particularly resource-intensive, and internet-based solutions can alleviate some of the burden from traditional healthcare systems. Moreover, the ability to access real-time data about their health empowers patients to make more informed decisions, leading to a shared responsibility for their care between patients and healthcare providers.

Despite the many benefits, the study acknowledges the challenges that still exist in the widespread adoption of IMS. Digital literacy remains an issue, as a portion of the population, especially older adults, may struggle to navigate online platforms. Additionally, regulatory concerns regarding patient data security and confidentiality continue to be significant barriers. Trust is critical in healthcare, and any concerns regarding the safety of personal health information can stifle the growth of these valuable online services.

Moreover, the divide in internet access further complicates the picture. In urban areas, patients are likely to have better access to high-speed internet and technological resources. However, rural populations may face significant challenges in accessing IMS, exacerbating health disparities. Therefore, it is crucial for policymakers to ensure equity in access to these digital health services to prevent a two-tiered healthcare system from emerging.

The future of Internet Medical Services appears bright, particularly as advancements in technology make these platforms more efficient and user-friendly. As artificial intelligence and machine learning continue to evolve, their integration into IMS can enhance patient interaction and further streamline service delivery. Virtual reality and augmented reality technologies could also provide new, immersive ways of educating patients and offering interactive health consultations.

The research emphasizes a culture of continuous feedback and improvement in the adoption of IMS. Patient experiences, opinions, and outcomes must be assessed continually to refine and optimize these services. Ensuring that patient voices are heard and considered in the development of these services will be key to growing trust and effectively meeting their needs.

In summary, the study by Qiu and colleagues casts a hopeful light on the evolution of Internet Medical Services within the context of chronic disease management in China. This transformation represents more than just a shift in service delivery; it embodies a reimagining of patient care, where empowerment, accessibility, and personalization are at the forefront of healthcare innovations. As society moves toward a more integrated digital health ecosystem, it will be essential to address the evolving needs of patients while promoting the benefits of technology-driven care.

Ultimately, the journey from awareness to adoption of Internet Medical Services is a multi-faceted process that requires the collaboration of patients, healthcare providers, and policymakers. By leveraging digital platforms and harnessing the power of technology, the healthcare landscape can continue to adapt and improve, making strides toward a healthier future for all patients, particularly those grappling with the complexities of chronic diseases.

Subject of Research: Utilization of Internet Medical Services among Chinese patients with chronic disease.

Article Title: From awareness to adoption: a panoramic perspective on the utilization of Internet Medical Services among Chinese patients with chronic disease.

Article References:

Qiu, R., Song, R., Wu, X. et al. From awareness to adoption: a panoramic perspective on the utilization of Internet Medical Services among Chinese patients with chronic disease.
BMC Health Serv Res 25, 1415 (2025). https://doi.org/10.1186/s12913-025-13601-z

Image Credits: AI Generated

DOI: 10.1186/s12913-025-13601-z

Keywords: Internet Medical Services, chronic disease management, digital healthcare, telehealth, patient empowerment, healthcare accessibility, patient engagement, digital literacy, technology integration.