Page 225 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

200 Chapter 8. Family, Friends and Social Support

can just be one friend- as long as it is a close and supportive
friendship- or a large series of good supportive relationships.
Holt-Lunstad et al. ( 2010 ) reported that people who were less
socially integrated had higher mortality rates. Studies have
suggested that those with low levels of social support have
higher mortality rates – from cardiovascular disease (e.g.
Brummett et al. 2001 ; Frasure-Smith et al. 2000 ; Everson-Rose
and Lewis 2005 ) or from cancer (e.g. Hibbard and Pope 1993 )
and infectious diseases (e.g. Lee and Rotheram-Borus 2001 ).
Furthermore, an overview of longitudinal studies has shown a
continuous increased mortality associated with a lack of social
support and weak social ties (Quick et al. 1996 ). Subsequent
studies have confirmed that reliable links exist between social
support and better physical health (e.g. Uchino 2004 ; Holt-
Lunstad et al. 2010 ).
In terms of wound healing a series of ground breaking
studies in the 1990s and beyond have demonstrated a clear
relationship between psychological stress and wound heal-
ing (e.g. Kiecolt-Glaser et al. 1995 and see Chap. 3 ). For
example, in a classic study Kiecolt-Glaser and colleagues
( 1995 ) explored wound healing in two groups: a control
group (healthy women) and a group (n = 13) of women car-
ing for a demented relative. The assumption was that the
care-givers were under more stress than the control group
and this stress would delay wound healing. Wound healing
was explored using a punch biopsy- a method used to create
a small wound- and the time taken to heal recorded. There
was a significant difference between the two groups with
those care-givers taking 25 % longer (approximately a
week) than the control group. These studies have been
repeated on many occasions (Kiecolt-Glaser et al. 2002 ) and
the relationship between stress and wound healing is well
recognised.
In contrast to these deleterious effects of stress on wound
healing a number of studies have indicated that social sup-
port can improve wound healing. However, many of these
are with animal models of stress and social support
(e.g. Detillion et al. 2004 ) and the link to relevant human