Page 45 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

18 Chapter 1. Psychosocial Consequences of Wounds

learning from others in a similar situation, by reducing social
isolation they may well influence the physical healing process.

Conclusion

This chapter has demonstrated, albeit briefly, the importance of
taking a holistic approach to wound care. A patient’s emotional,
social and psychological needs are as central to practice as their
physical needs. The psychosocial factors explored include limita-
tions to daily activities, stress, depression, anxiety, embarrass-
ment, changes to self identity and social isolation. Many of these
consequences stem from the physical aspects of having a chronic
wound such as pain, exudate, malodour, restricted mobility, sleep
disturbance and lack of energy. However focusing on simply
treating the physical wound is likely to be ineffective, since psy-
chosocial factors can impede the healing process. Furthermore,
aspects of the treatment itself may exacerbate some of these
psychosocial features. In addition, maladaptive changes in
behaviour may result from reduced psychosocial health, includ-
ing poor eating habits and increased smoking and drinking, all
of which are known to impair healing and may also increase
wound severity. It is therefore not unexpected that patients with
wounds have a significantly poorer quality of life compared to
the general population. From a clinical perspective, it is there-
fore important to recognise psychological and social aspects of
living with a chronic wound, and to develop comprehensive
approaches to care that prioritise the needs of the individual
patient in order to ensure that wound care is optimised.

References

Alexander SJ. Time to get serious about assessing–and managing–
psychosocial issues associated with chronic wounds. Curr Opin
Support Palliat Care. 2013;7(1):95–100.
Altemus M, Rao B, Dhabhar FS, Ding W, Granstein RD. Stress- induced
changes in skin barrier function in healthy women. J Invest
Dermatol. 2001;117(2):309–17.