Psychological Factors in Wound Healing Management
Summary
Wound healing is a complex, multi-phase process influenced not only by biological and mechanical factors but also by psychological variables. Emotional stress, mood disturbances and maladaptive beliefs can activate the hypothalamic–pituitary–adrenal axis and sympathetic nervous system, leading to altered cytokine production, impaired angiogenesis and delayed tissue repair. Depression and anxiety may reduce adherence to dressing changes and compression therapies, while negative illness perceptions can undermine self-care behaviours. Conversely, positive coping strategies, social support and interventions that foster mindfulness and stress reduction have been shown to modulate inflammatory mediators, enhance local growth factor release and accelerate epithelialisation. Integrating psychosocial assessment into clinical pathways promotes personalised interventions, such as cognitive restructuring, relaxation techniques and patient education, thereby optimising both physiological repair mechanisms and overall quality of life.
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Technical terms
Psychological stress: The perceived emotional or cognitive strain arising from external demands, which can trigger neuroendocrine responses that impair tissue repair.
Illness perceptions: The individual’s cognitive and emotional beliefs about a health condition, including expectations of duration, consequences and controllability, which influence coping and adherence.
Mindfulness-Based Stress Reduction: A structured eight-week programme that cultivates present-moment, non-judgemental awareness to reduce psychological distress and modulate inflammatory processes.
Cytokines: Small signalling proteins released by immune and other cells that regulate inflammation, cell proliferation and phases of wound healing.
References
- Stress, Illness Perceptions, Behaviors, and Healing in Venous Leg Ulcers. Biopsychosocial Science and Medicine (2017).
- The effect of Mindfulness-Based Stress Reduction on wound healing: a preliminary study. Journal of Behavioral Medicine (2017).
- GAMBARAN STRES PASIEN GANGREN DIABETIK DI RUMAH SAKIT SANTAELISABETH MEDAN TAHUN 2023. Jurnal Ilmiah PANNMED (Pharmacist Analyst Nurse Nutrition Midwivery Environment Dentist) (2023).
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