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Interventions to reduce psychological stress may\nhave the potential to improve self-care and greatly reduce the morbidity and mortality associated\nwith DFU. This review is focused on the consequences of psychological stress in wound healing\nand reflects on the effects of currently used psychological stress-reducing interventions in patients\nwith DFU, proposing new applications for currently used stress-reduction interventions.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results:<\/jats:title>\n<jats:p>Stress is a natural and fundamental survival mechanism that becomes harmful when chronic.\nDFU is associated with high levels of anxiety and chronic psychological stress. Chronic stressinduced\ncortisol and adrenaline release impair wound healing, independently of the stressor. Psychological\nstress-reducing interventions, such as relaxation with guided imagery, biofeedback-assisted\nrelaxation, mindfulness-based strategies, and hypnosis, can lead to a reduction in perceived\nstress and improve wound healing by reducing wound inflammation and pain while improving\nglycemic control. All stress reduction interventions also lead to pain relief and improved patient\u2019s\nquality of life.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion:<\/jats:title>\n<jats:p>Psychological stress-reducing interventions are promising adjuvant therapies for\nDFU. Their clinical application can improve self-care by tackling patient\u2019s expectations, anxieties,\nand fears. They can also help patients manage stress and pain while reducing wound inflammation\nand improving wound healing.<\/jats:p>\n<\/jats:sec>","DOI":"10.2174\/1573399817666210806112813","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T04:39:30Z","timestamp":1628483970000},"update-policy":"https:\/\/doi.org\/10.2174\/bsp_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Stress-Reducing Psychological Interventions as Adjuvant Therapies for\nDiabetic Chronic Wounds"],"prefix":"10.2174","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6264-3632","authenticated-orcid":true,"given":"Eug\u00e9nia","family":"Carvalho","sequence":"first","affiliation":[{"name":"Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal"},{"name":"Institute of Interdisciplinary Research, University of Coimbra, Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0260-8741","authenticated-orcid":true,"given":"Isadora","family":"Pombeiro","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7817-0881","authenticated-orcid":true,"given":"Jo\u00e3o","family":"Moura","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7987-2562","authenticated-orcid":true,"given":"M. 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