Promoting Physical and Psychological Well-being in People With Chronic Wounds: Pathways to Resilience

After participating in this educational activity, the participant will:Explain the impact of psychological stressors on wound healing.Identify interventions to assess and promote resilience in individuals with chronic wounds.Describe the impact of chronic wounds on psychological health.The prevalence of chronic wounds and their impact on physical, psychological, and social well-being continues to escalate. Optimal outcomes rely on the ability of clinicians to work collaboratively with patients and care partners to plan and implement holistic, individualized treatments. Physical health is heavily impacted by wound status and the patients' capacity to engage in usual daily activities. Functional limitations carry a host of consequences, including adverse effects on patients' sense of meaning and purpose in life, self-esteem, and body image. Negative emotions, fear, and loss of autonomy can create challenges to mental well-being, with higher rates of depression and anxiety reported in people with chronic wounds as compared with the general population. These challenges are exacerbated by stigma, patients' reluctance to disclose psychological symptoms, and clinicians' lack of preparation in assessing and addressing mental, as well as physical health. Psychological stress carries physiological consequences that can contribute to healing delays. These consequences can be offset by cognitive behavioral interventions, a strong therapeutic alliance, and peer support. Integrative, individualized plans of care are improved by shared decision-making and the application of social and behavioral theory to provide insight regarding patients' abilities and willingness to actively engage in collaborative wound management. Resilience, or the ability to productively cope with adversity, mediates the psychological burden associated with chronic wounds. The purpose of this targeted, narrative review of the literature is to assist clinicians in assessing the physiological consequences of delayed healing and promoting resilience in people with chronic wounds.