Understanding healing: A comparative analysis in chronic diseases with leprosy—A scoping review

Background

Healing in leprosy has long been synonymous with bacteriological cure, often overlooking persistent disability, stigma, and psychosocial consequences. Insights from other chronic diseases may inform a broader understanding of healing. recovery.

Objectives

To map how healing is defined and experienced in leprosy, tuberculosis, HIV/AIDS, diabetes mellitus, and schizophrenia, and to identify conceptual and practical lessons relevant for post-cure leprosy care. Methods A scoping review was conducted following the Arksey and O’Malley framework and reported in accordance with PRISMA-ScR guidelines. PubMed and PsycINFO were searched for qualitative studies (January 2012–December 2022) in English language from low- and middle-income countries. Eligible studies explored definitions, determinants, or models of healing in the five conditions. Data were charted and thematically synthesized across physical, psychological, socioeconomic, socio-relational, and spiritual domains following the Joanna Briggs approach.

Results

Eighty-five studies met inclusion criteria (leprosy = 20, TB = 9, diabetes = 8, HIV = 36, schizophrenia = 12). Healing was most often defined as adaptation, resilience, or reintegration rather than cure. Across diseases, five interrelated dimensions—physical, psychological, socioeconomic, socio-relational, and spiritual—shaped recovery. Compared to other chronic conditions, leprosy literature remained largely biomedical, with limited exploration of psychosocial and spiritual healing.

Conclusions

Achieving zero leprosy requires person-centred care that embraces multidimensional healing. The proposed 5D Healing Framework offers a roadmap for integrating psychosocial, economic, and spiritual dimensions into post-cure leprosy services.