Understanding psychological wellbeing in the context of delayed wound healing: a scoping review

What is it about?

Background Patients with delayed wound healing (DWH) experience psychological challenges that can hinder recovery, creating a detrimental cycle. The complex and multifaceted nature of psychological wellbeing, coupled with the heterogeneity of measurement tools used in chronic wound research, highlights the necessity for a more comprehensive understanding of the psychological facets of DWH. Aim This scoping review aimed to synthesise evidence on psychological wellbeing components and their influencing factors in adults with DWH. Methods Databases (Scopus, MEDLINE, CINAHL, EMBASE, ProQuest Global, PsycINFO) were searched for studies on adults (18+) with wounds persisting ≥4 weeks. Exclusions included pediatric, burn, malignant, and amputation-related wounds. Data extraction followed a dual-reviewer process, with synthesis guided by Ryff’s psychological wellbeing framework. Results Of 47 included studies, most were from Asia (31.9%); none were from Africa. Quantitative designs dominated (89.4%), with no psychological interventions identified. Fourteen instruments assessed wellbeing, primarily measuring quality of life (n=43), depression (n=14), and anxiety (n=12). Autonomy was frequently impacted by pain and mobility, while self-acceptance and personal growth were rarely examined. Conclusions Standardised tools are needed to assess psychological wellbeing in DWH. Future research should prioritise underrepresented dimensions (such as personal growth, purpose) to inform targeted interventions. Implications for clinical practice Clinicians should manage wound symptoms and adopt holistic assessments that include psychological wellbeing domains, beyond quality of life, such as self-acceptance and personal growth, to improve patient-centered care and healing outcomes. Early screening for depression and anxiety, alongside tailored support, may help break the cycle of psychological distress and delayed healing.

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