Table 2.
Multidimensional pain scales included in the review and the items related to spirituality or religion
| Scale | Item | Dimension | Definition used* | Does it have a possible contaminated item?** | Methodological Quality*** STROBE |
|---|---|---|---|---|---|
| Chronic Pain Coping Questionnaire | 1. I pray for my pains to disappear | Religion | organized system of beliefs, practices and symbols | No | 19/22 |
| 2. I pray for strength and guidance regarding the problem | Religion | organized system of beliefs, practices and symbols | No | ||
| 3. I pray to be healed | Religion | organized system of beliefs, practices and symbols | No | ||
| 4. I use faith to alleviate my pains | Spirituality | relationship to the sacred or transcendent, which may (or may not) lead to or arise from the development of religious rituals | No | ||
| 5. I ask God to relieve me of my pains | Spirituality | relationship to the sacred or transcendent, which may (or may not) lead to or arise from the development of religious rituals | No | ||
| 6. When I am in pain, I try to talk to someone and tell them what is happening to me. This helps me cope with it | Spirituality | persons seek ultimate meaning, purpose … experience relationship to self, family, others, | Yes | ||
| 22. I think I must have strength and not falter | Spirituality | understanding answers to ultimate questions about life, about meaning OR seek ultimate meaning, purpose | Yes | ||
| 29. I talk to a professional (doctor, psychologist, priest, etc.) about the problem to help me cope with it | Religion | organized system of beliefs, practices and symbols (e.g., priest) | No | ||
| West Haven Yale Multidimensional Pain Inventory | 12. How much suffering do you experience because of your pain? | Spirituality | understanding answers to ultimate questions about life, about meaning OR seek ultimate meaning, purpose | Yes | 20/22 |
| Pain Catastrophizing Scale | 2. I feel like I can't go on anymore because of the pain | Spirituality | understanding answers to ultimate questions about life, about meaning OR seek ultimate meaning, purpose | Yes | 20/22 |
| 5. I feel like I can't endure the pain any longer | Spirituality | understanding answers to ultimate questions about life, about meaning OR seek ultimate meaning, purpose | Yes | ||
| Pain Self-Efficacy Questionnaire | No items | 18/22 | |||
| Spanish Pain Questionnaire | Fear: 1. Fearful 2. Frightful 3.Terrifying | Spirituality | understanding answers to ultimate questions about life, about meaning OR seek ultimate meaning, purpose | Yes | 19/22 |
| Punishment 1.Punishing 2. Grueling 3. Cruel 4. Vicious 5. Killing | Spirituality | understanding answers to ultimate questions about life, about meaning OR seek ultimate meaning, purpose | Yes | ||
| Affective: 1. Nagging 2.Nauseating 3. Agonizing 4. Dreadful 5. Torturing | Spirituality | understanding answers to ultimate questions about life, about meaning OR seek ultimate meaning, purpose | Yes | ||
| Psychological Pain Scale | 5. My pain makes my life dark | Spirituality | understanding answers to ultimate questions about life, about meaning OR seek ultimate meaning, purpose | Yes | 19/22 |
| 8. It hurts because I feel empty | Spirituality | understanding answers to ultimate questions about life, about meaning OR seek ultimate meaning, purpose | Yes | ||
| 9. My soul hurts | Spirituality | understanding answers to ultimate questions about life, about meaning OR seek ultimate meaning, purpose | No | ||
| Edmonton Symptom Screening Questionnaire | No items: there is a study incorporating a spiritual pain item in the Edmonton Symptom Questionnaire. But this was not examined in the Spanish reality | 18/22 | |||
| Brief Pain Inventory | No items | 19/22 |
*Definitions used: Religion (Koenig) is an organized system of beliefs, practices and symbols designed (a) to facilitate closeness to the transcendent and (b) to foster an understanding of one's relationship and responsibility to others in living together in a community. Spirituality (Koenig) is the personal quest for understanding answers to ultimate questions about life, about meaning and about relationship to the sacred or transcendent, which may (or may not) lead to or arise from the development of religious rituals and the formation of community – REFERENCE: Koenig HG. Research on religion, spirituality and mental health: a review. Can J Psychiatry. 2009 May;54(5):283–91. https://doi.org/10.1177/070674370905400502. PMID: 19,497,160
Spirituality (Puchalski) is a dynamic and intrinsic aspect of humanity through which persons seek ultimate meaning, purpose and transcendence, and experience relationship to self, family, others, community, society, nature and the significant or sacred. – REFERENCE: Puchalski CM, Vitillo R, Hull SK, Reller N. Improving the spiritual dimension of whole person care: reaching national and international consensus. J Palliat Med. 2014 Jun;17(6):642–56. https://doi.org/10.1089/jpm.2014.9427. Epub 2014 May 19. PMID: 24,842,136; PMCID: PMC4038982
**Contaminated items were assessed using previous JORH publications. Some spirituality items were considered contaminated if they were overlapped with indicators of good mental health, psychological well-being and social connections, providing tautological problems. REFERENCES: Koenig, H.G., & Carey, L.B. (2024). Religion, Spirituality and Health Research: Warning of Contaminated Scales. Journal of Religion and Health, 63 (5). And Koenig, H.G. & Carey, L.B. (2025). Approaches for Analyzing the Relationship Between Spirituality and Health Using Measures Contaminated with Indicators of Mental and Social Health. Journal of Religion and Health 64 (1)
***1 = recommendation contained in the study, 0 = recommendation not included NA = not applicable