title: Time to get serious about assessing - and managing - psychosocial issues associated with chronic wounds.
abstract: OBJECTIVE
  This article comprises a review of the literature published during the period January 2011 to June 2012 on the topic of the psychosocial impact of wounds and strategies to manage them.
  
  
  RESULTS
  There is a growing discussion of the reciprocal link between psychological influences and wound healing. Although the mechanisms underlying these influences are not well understood, evidence from the reviewed literature adds to the existing body of evidence demonstrating that negative psychological states can impair immune function and wound healing. Despite this recognition, there are still few studies that provide strategies to address the identified psychosocial issues associated with wounds, particularly those of chronic duration.
  
  
  CONCLUSIONS
  A wide range of psychosocial factors likely to be associated with a wound have been identified. The importance of understanding the nature and extent of their impact is illustrated by the patients' experiences of living with a chronic wound which they rate as serious as cancer or myocardial infarction. Although there is currently limited evidence on which to base management strategies, it is recommended that interventions should commence with a comprehensive individualized assessment which can then inform the development of an appropriate management plan that includes the identified psychosocial issues.
authors.affiliation: University of Western Sydney, Penrith, New South Wales, Australia. susan.alexander@uws.edu.au
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Alexander
mesh_terms: D002908:Chronic Disease; D016206:Databases, Bibliographic; D019468:Disease Management; D006694:Holistic Health / Q000592:standards; D006801:Humans; D011788:Quality of Life / Q000523:psychology*; D018434:Sickness Impact Profile; D013315:Stress, Psychological / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D014945:Wound Healing / Q000276:immunology; D014947:Wounds and Injuries / Q000276:immunology / Q000523:psychology* / Q000628:therapy