Aims: Numerous measures exist that assess dimensions of spirituality and religiosity in health, theological and social settings. In this review, we aim to identify and evaluate measures assessing factors relating to spirituality and religiosity in clinical settings. Methods: A systematic literature search was conducted using PubMed, EMBASE and PsycINFO databases with search terms relating to spirituality, religiosity that also included well-being, needs, distress and beliefs used in self-reporting and clinician-administered measures. Only articles relating to the validation and subsequent administration of measures used in clinical settings were eligible for review. Results: Of 75 measures selected for initial screening, 25 had been validated and used in clinical settings and were reviewed for this study. Most measures were validated in oncological and palliative care settings where the Functional Assessment of Chronic Illness Therapy Spiritual Well-being (FACIT-Sp12) and the World Health Organization Quality of Life Spiritual, Religious and Personal Beliefs (WHOQOL-SRPB) were most validated and frequently used. Only six measures were found that assessed spiritual distress and/or the needs of which only two had been investigated more than twice. Two measures assessing spirituality and religious beliefs in healthcare staff were also reviewed. Conclusions: This review provides a current summary of measures evaluating several dimensions of spirituality and religiosity used in clinical settings. Currently there is a lack of reliable measures evaluating spiritual needs and distress.

Context: Virtual and augmented imagery are emerging technologies with potential to reduce the severity and impact of neuropathic pain in people with spinal cord injury (SCI). Objective: We aimed to identify and discuss studies using virtual and augmented reality applications for the management of neuropathic pain in people with spinal cord injury. Methods (data sources, data extraction): A systematic literature search was conducted using PRISMA scoping review guidelines. Articles were searched in PubMed, Embase and Web of Science databases using search terms relating to SCI, virtual and augmented reality and neuropathic pain. With no strong evidence for visual imagery in the treatment of pain in SCI patients, we selected exploratory, feasibility and more rigorous methodologies such as randomized controlled trials and case-control studies. We only selected studies evaluating the effects of visual imagery on neuropathic pain at or below the spinal cord injury level. Results: Of 60 articles located, we included nine articles involving 207 participants. All studies were exploratory using head-mounted devices or 3D and 2D screens with virtual walking or limb movement imagery. Outcomes included pain sensitivity, motor function and body ownership. Eight of the nine studies reported significant reductions in neuropathic pain intensity. However, given small sample sizes in all studies, results may be unreliable. Conclusion: Although the number of studies and individual sample sizes are small, these initial findings are promising. Given the limited options available for the effective treatment of neuropathic SCI pain and early evidence of efficacy, they provide valuable incentive for further research.

Evidence-based practice (EBP) is a clinical decision-making framework that supports quality improvement in healthcare. While osteopaths are key providers of musculoskeletal healthcare, the extent to which osteopaths engage in EBP is unclear. Thus, the aim of this cross-sectional study was to investigate UK osteopaths’ attitudes, skills and use of EBP, and perceived barriers and facilitators of EBP uptake. UK-registered osteopaths were invited to complete the Evidence-Based Practice Attitude and Utilisation Survey (EBASE) online. Of the 5200 registered osteopaths in the UK, 9.9% (517/5200) responded to the invitation, and 7.2% (375/5200) completed the EBASE (< 20% incomplete answers). The demographic characteristics of the survey sample were largely similar to those of the UK osteopathy workforce. The osteopaths reported overall positive attitudes towards EBP, with most agreeing that EBP improves the quality of patient care (69.3%) and is necessary for osteopathy practice (76.5%). The majority reported moderate-level skills in EBP, and most (80.8%) were interested in improving these skills. Participating osteopaths typically engaged in EBP activities 1–5 times over the last month. Barriers to EBP uptake included a lack of time and clinical evidence in osteopathy. Main facilitators of EBP included having access to online databases, internet at work, full-text articles, and EBP education materials. UK osteopaths were generally supportive of evidence-based practice, had moderate-level skills in EBP and engaged in EBP activities infrequently. The development of effective interventions that improve osteopaths’ skills and the incorporation of EBP into clinical practice should be the focus of future research.

Context: Pain management in palliative care remains inadequate; the development of innovative therapeutic options is needed. Objectives: To determine the feasibility and preliminary effectiveness for larger randomised controlled trials of 3D head-mounted (HMD) virtual reality (VR) for managing cancer pain (CP) in adults. Methods: Thirteen people receiving palliative care participated in a single-session randomised cross-over trial, after which they completed a qualitative semi-structured interview. We also compared the effects of 3D HMD VR and 2D screen applications on CP intensity and levels of perceived presence. Feasibility was assessed with recruitment, completion rates and time required to recruit target sample. Results: Although recruitment was slow, completion rate was high (93%). Participants reported that the intervention was acceptable and caused few side effects. Although participants reported significantly reduced CP intensity after 3D HMD VR (1.9 ± 1.8, P = .003) and 2D screen applications (1.5 ± 1.6, P = .007), no significant differences were found between interventions (−.38 ± 1.2, 95% CI: −1.1–.29, P = .23). Participants reported significantly higher levels of presence with the 3D HMD VR compared to 2D screen (60.7 ± SD 12.4 versus 34.3 ± SD 17.1, mean 95% CI: 16.4–40.7, P = .001). Increased presence was associated with significantly lower pain intensity (mean 95% CI: −.04–−0.01, P = 0.02). Conclusions: Our preliminary findings support growing evidence that both 3D and 2D virtual applications provide pain relief for people receiving palliative care. Given the relative lack of cybersickness and increasing access to portable VR, we suggest that larger clinical studies are warranted.

Although virtual reality VR is shown to have short-term analgesic effects in acute pain settings, its long-term efficacy with chronic pain conditions has not been established. This scoping review aims to provide a summary of VR approaches explored in chronic primary and secondary pain conditions as defined by the International Association for the Study of Pain. A systematic literature search in Ovid PubMed and Ovid Embase was conducted between January 5-10^th 2021 using the Arksey and O’Malley six-step scoping review criteria. Articles were searched using search terms and keywords relating to ICD-defined primary and secondary chronic pain conditions, virtual reality, virtual illusion, distraction and effects on levels of pain. Of 2118 articles located, 44 were included covering a range of primary and secondary chronic pain conditions, using a variety of different computer screen and headset protocols including gaming, mindfulness, exercise, relaxation and proprioceptive skills. Studies show virtual reality to be an effective analgesic intervention for people with chronic pain. Given user satisfaction and lack of side effects such as cybersickness and relief of comorbid symptoms, VR has the potential as a worthwhile adjunct to chronic pain management programmes, thus enabling patients to take control of their symptoms.