{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T08:03:41Z","timestamp":1789632221922,"version":"build-2803163510"},"reference-count":58,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UID\/01662"],"award-info":[{"award-number":["UID\/01662"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["PTDC\/PSI\u2010GER\/28163\/2017"],"award-info":[{"award-number":["PTDC\/PSI\u2010GER\/28163\/2017"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Stress and Health"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Diabetic foot ulcer (DFU) healing is a complex and slow process that depends on several factors such as the patient's physical health. However, psychological factors such as distress, which are commonly reported by patients with DFU, may also influence DFU development and recurrence. This pilot randomised control trial (RCT) assesses the effectiveness of progressive muscle relaxation and hypnosis on DFU healing and quality of life (QoL) in distressed patients. Sixty\u2010nine patients who received standard care treatment were randomly assigned to one of four groups: muscle relaxation (TG1), hypnosis (TG2), neutral sessions (active control: ACG), and no intervention (passive control: PCG). Primary outcomes were both DFU healing and QoL. Secondary outcomes were perceived stress, psychological morbidity, and illness (DFU) representations. Patients were assessed at baseline (T0), 2\u00a0months after the baseline (T1), and 4\u00a0months later (T2). Regarding primary outcomes, comparisons between groups showed significant differences only in DFU healing: TG1, TG2, and ACG reported more improvements than PCG at T1, while TG1 showed more improvements than TG2 and PCG at T2. Results for secondary outcomes revealed less threatening DFU\u00a0representations in TG1 compared to TG2 and ACG, and more psychological morbidity in TG2 than TG1, both at T1. Within\u2010group analysis in primary outcomes showed DFU healing and physical QoL improvement in all groups, DFU\u2010related QoL improvement in all groups except PCG, and an increase in mental QoL only in TG2 and ACG. Regarding secondary outcomes, results showed a decrease in DFU's representations only in TG1, and a significant decrease in stress and psychological morbidity in TG1, TG2, and ACG. Results suggest that both stress\u2010reduction interventions should be included in the multidisciplinary treatment and rehabilitation plan for distressed patients with DFU(s).<\/jats:p>","DOI":"10.1002\/smi.70029","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T08:52:39Z","timestamp":1743843159000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of Relaxation and Hypnosis Interventions in Distressed Patients With Chronic Diabetic Foot Ulcers: A Longitudinal Pilot Randomised Controlled Trial"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7987-2562","authenticated-orcid":false,"given":"M. Gra\u00e7a","family":"Pereira","sequence":"first","affiliation":[{"name":"Psychology Research Center (CIPsi) School of Psychology University of Minho  Braga Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarida","family":"Vila\u00e7a","sequence":"additional","affiliation":[{"name":"Psychology Research Center (CIPsi) School of Psychology University of Minho  Braga Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Pedras","sequence":"additional","affiliation":[{"name":"Angiology &amp; Vascular Surgery Department Centro Hospitalar Universit\u00e1rio Porto (CHUP)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism Department of Medicine Centro Hospitalar Universit\u00e1rio do Porto (CHUP)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavita","family":"Vedhara","sequence":"additional","affiliation":[{"name":"Division of Primary Care University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Jesus","family":"Dantas","sequence":"additional","affiliation":[{"name":"Department of Surgery Centro Hospitalar T\u00e2mega e Sousa  Penafiel Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Lopes","sequence":"additional","affiliation":[{"name":"Portuguese Association of Clinical Hypnosis and Hypnoanalysis (APHCH)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Faria","sequence":"additional","affiliation":[{"name":"Department of Mathematics Centre of Mathematics (CMAT) Minho University  Guimar\u00e3es Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pchj.591"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010019\u20100367\u20105"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.21870"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053\u2010200321170\u201000004"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010018\u20104711\u20104"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10\u20101779"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2015.1070851"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/pas0000626"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2012.09.002"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.enfcli.2019.04.022"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.5430\/cns.v5n1p35"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13569"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpsp.2012.12.007"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870440802578961"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12906\u2010017\u20101806\u20100"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12906\u2010020\u201003129\u20106"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010018\u20104607\u2010z"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1586\/ern.09.140"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.15199"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27854"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06\u20102043"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734620929892"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.4254"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.35975\/apic.v27i3.1720"},{"key":"e_1_2_12_26_1","first-page":"219","volume-title":"Handbook of Psychology and Health","author":"Leventhal H.","year":"2020"},{"key":"e_1_2_12_27_1","unstructured":"Marques J. 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