Exploring the potential of virtual reality for the self-management of chronic pain: A scoping review of its use to address health literacy.

BACKGROUND: Individuals with low health literacy struggle to manage long-term conditions. Addressing pain-related health competencies is important in the management of chronic pain. Virtual reality may be a useful tool for empowering sustainable health-related stratgies due to its unique ability to engage users in artificial environments. OBJECTIVES: The aim of this scoping review was to explore existing research on the use of virtual reality as a tool to promote health literacy in people with chronic pain. DESIGN: Scoping Review guided by framework proposed by Arksey & O'Malley. METHOD: Articles related to "pain", "virtual reality" and "health literacy" were searched in four electronic databases: CINAHL, PubMed, Embase and PsycINFO using a formal search strategy. Studies were categorised based on intervention content using the Health Literacy Pathway Model which encompasses health knowledge, self-management skills, health communication and information seeking. RESULTS: Thirteen studies met the inclusion criteria. Several elements of pain related health literacy were not addressed in the research. Interventions addressed health knowledge, self-management skills, decision making and featured content aiming to address emotional barriers to pain-related health literacy. Other components including active information seeking and use, actively communicating with health professionals and seeking and negotiating treatment options, were not explicitly addressed. CONCLUSION: There is heterogeneity in existing research exploring the use of VR to support people with chronic pain. Existing VR tools to address pain-related health literacy do not cover several key components of health literacy. More research is required before a robust assessment of efficacy can be undertaken.

An evaluation of a one-day pain science education event in a high school setting targeting pain related beliefs, knowledge, and behavioural intentions.

BACKGROUND: Persistent pain is a common condition affecting one in four UK adults. Public understanding of pain is limited. Delivering pain education within schools may improve public understanding in the longer term. OBJECTIVE: To evaluate the impact of a one-day Pain Science Education (PSE) event on sixth form/high school students' pain beliefs, knowledge and behavioural intention. METHODS: Exploratory, single-site, mixed-methods, single-arm study involving secondary school students ≥16 years old attending a one-day PSE event. Outcome measures included the Pain Beliefs Questionnaire (PBQ), Concepts of Pain Inventory (COPI-ADULT), a vignette to assess pain behaviours; and thematic analysis of semi-structured interviews. RESULTS: Ninety (mean age 16.5 years, 74% female) of the 114 attendees, agreed to participate in the evaluation. PBQ scores improved on the Organic beliefs subscale [mean difference -5.9 (95% CI -6.8, -5.0), P < 0.01] and Psychosocial Beliefs subscale [1.6 (1.0, 2.2) P < 0.01]. The COPI-Adult revealed an improvement [7.1 (6.0-8.1) points, P < 0.01] between baseline and post intervention. Pain behavioural intentions improved post education for work, exercise, and bed rest related activities (p < 0.05). Thematic analysis of interviews (n = 3) identified increased awareness of chronic pain and its underpinning biology, beliefs that pain education should be widely available, and that pain management should be holistic. CONCLUSIONS: A one-day PSE public health event can improve pain beliefs, knowledge and behavioural intentions in high school students and increase openness to holistic management. Future controlled studies are needed to confirm these results and investigate potential long-term impacts.

The El Salvador earthquakes of january and february 2001 : Context, characteristics and implications for seismic risk

The small Central American republic of El Salvador has experienced, on average, one destructive earthquake per decade during the last hundred years. The latest events occurred on 13 January and 13 February 2001, with magnitudes Mw 7.7 and 6.6, respectively. The two events, which were of different tectonic origin, follow the patterns of the seismicity of the region although neither event has a known precedent in the earthquake catalogue in terms of size and location. The earthquakes caused damage to thousands of traditionally built houses and triggered hundreds of landslides, which were the main causes of fatalities. The earthquakes have clearly demonstrated trends of increasing seismic risk in El Salvador due to rapid population expansion in areas of high shaking and landslide hazard, exacerbated by deforestation and uncontrolled urbanisation. The institutional mechanisms required for the control of land use and building practice are very weak and present a major obstacle to risk mitigation.(AU)