Guidance for medical staff reminds employees of the responsibility to deliver spiritual care in its broadest sense, respecting the dignity, humanity, individuality and diversity of the people whose cultures, faiths and beliefs coexist in society. This is no small or simple task, and although GPs (family practitioners) have been encouraged to deliver spiritual care, we suggest this is proving to be challenging and needs further careful debate. This literature review critiques and analyses existing studies and points to four categories of attitude to spiritual care, and two related but distinct concepts of spirituality in use by GPs. Our aims were to search for, summarise and critique the qualitative literature regarding general practitioners’ views on spirituality and their role in relation to spiritual care. An integrative review was made by a multidisciplinary team using a critical realism framework. We searched seven databases and completed thematic and matrix analyses of the qualitative literature. A number of good-quality studies exist and show that some but not all GPs are willing to offer spiritual care. Four patterns of attitude towards delivering spiritual care emerge from the studies which indicate different levels of engagement with spiritual care: embracing, pragmatic, guarded and rejecting. Further research is needed to identify whether these four views are fixed or fluid, whether training in spiritual care modifies these and whether they relate to patterns of care in practice, or patient outcomes. The authors suggest that some of the difference in viewpoint relate to the lack of clear philosophical framework. The authors suggest critical realism as having potential to facilitate interdisciplinary research and create clearer concepts of spiritual care for GPs.

Background: GPs have a wide range of attitudes to spirituality which contribute to variations in the spiritual care they report to practice. Aim/Objective: To assess concepts of spirituality and their application in a sample of GPs trainers. To explore statistically the relationship between personal spiritual affiliation, attitudes to, and reported practice of, spiritual care. To examine whether GP trainers consider training in spiritual care to be adequate. Methods: Questionnaire: 87 GP trainers at a GP trainer's workshop using Likert scale responses. Multinomial trend tests to analyse the relationships between "concept of spirituality" and attitude to, or practice of, spiritual care. Cluster and latent class analysis to investigate whether groups of GPs are categorically different from each other. Results: GPs considered spirituality to be a meaningful, useful but unclear concept. 7/87 stated they did not wish involvement in spiritual care, 24 had reservations, 40 were pragmatically willing and 11 expressed keenness. 31/87 report they tend not to discuss spiritual matters. Only 9/87 reported receiving adequate training in spiritual care. Latent class analysis suggests two thirds are pragmatic supporters of spiritual care and one third are tentative sceptics. Conclusion: GPs vary widely in their attitude to and practice of spiritual care. Two distinct groups were identified-tentative sceptics and pragmatic supporters. Training for spiritual care is perceived to be inadequate.

BackgroundLittle is known about how the concept of spirituality is understood and applied by GPs.AimTo provide a detailed description of how GPs understand the concept of spirituality and apply this with patients.Design & settingNineteen Scottish GPs were interviewed about their perceptions of the concept of spirituality and how they apply this in practice.MethodAn approach informed by grounded theory was used to identify and summarise common themes.ResultsSeven concepts concerning spirituality emerged, some of which are previously unrecognised. Four attitudes to spiritual care and four patterns of spiritual care were identified.ConclusionGPs have varying views on what spirituality is, and these relate partly to individual beliefs and experiences. These create considerable variation in the delivery of spiritual care.

Recent work exploring GPs' attitudes to spirituality and spiritual care reveals that we are in an interesting period of development. Guidance from a range of sources including the UK National Health Service and the General Medical Council encourages person-centred approaches to spirituality and recognition of patients' spiritual dimension and concerns.(1-3).

Purpose – The purpose of this paper is to provide a review of the use of wearable technologies that focuses on applications that tackle sensory and communication deficits, physical disabilities and alarm and activity monitoring. It is intended to promote the introduction of more wearable approaches to providing assistive technologies because of their benefits in utilisation and aesthetic appeal. Design/methodology/approach – The approach involves a comparison of different types of portable device in order to identify different groups that may be beneficial to different application areas. Recent advances are then considered for each area. Findings – The work demonstrates that the use of wearable AT device is increasing due to improvements in materials, battery power and connected intelligence such as smartphones. They will allow new devices to be introduced that are smaller, lighter and more usable. Practical implications – Utilisation of assistive technologies is likely to improve as wearable devices become the norm across a wide range of applications Social implications – Approaches to improving the Quality of Life of people with disabilities through an extended use of assistive technologies will be enhanced by the increased range of devices available and by their performance. Originality/value – To the best of the authors’ knowledge, this is the first review of wearable devices that has focused on the needs of people who have rehabilitation and/or social care needs. Its value lies in encouraging manufacturers and designers to use wearable approaches to solving some of the problems facing vulnerable people.