Effectiveness of Virtual Nurse Interventions in Chronic Disease Self-Management: A Systematic Review of Randomized Controlled Trials

Background: Chronic diseases require ongoing self-management, yet patients often struggle with knowledge, behavioral adherence, and emotional well-being. Virtual nurse interventions, digital systems simulating nurse–patient interactions, offer a potential strategy to support self-management. This review aimed to evaluate their effectiveness in improving health knowledge, behavioral outcomes, psychological well-being, and patient satisfaction. Methods: A systematic search of the Cochrane Library, PubMed, CINAHL, MEDLINE, and EMBASE was conducted for randomized controlled trials published between 2014 and April 2025. Studies involving adults with chronic diseases and virtual nurse interventions reporting outcomes on knowledge, behavior, psychological well-being, or patient satisfaction were included. Methodological quality was appraised using the Joanna Briggs Institute checklist. Due to heterogeneity in interventions and outcome measures, data were synthesized narratively. Results: Six trials with 533 participants were included. Virtual nurse interventions consistently improved disease-specific knowledge and psychological well-being, and were associated with high patient satisfaction. Evidence for behavioral adherence and clinical outcomes was limited and often not statistically significant. Conclusions: Virtual nursing enhances knowledge, emotional support, and psychological well-being in chronic disease self-management. Its long-term effects on behavioral change and clinical outcomes remain unclear. Nurse engagement, organizational support, and attention to digital literacy are essential to optimize implementation. Trial registration: PROSPERO CRD420251038439.