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

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.