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

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.

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.

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.

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.

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.