Ingelson Beverley, Dahlke Sherry, O'Rourke Hannah, Low Gail
University of Alberta, Edmonton, Alberta, Canada.
Pain Manag Nurs. 2024 Apr;25(2):104-112. doi: 10.1016/j.pmn.2023.10.004. Epub 2023 Nov 13.
Hospitalized persons living with dementia often experience unrelieved pain. Unmanaged pain during hospitalization has a significant negative effect on quality of life for persons living with dementia. Despite the central role of nurses in pain management, little is known about how nurses manage pain in this patient population in the hospital environment.
A scoping review explored the nurses' pain management practices when caring for persons living with dementia in a hospital setting.
DATA SOURCES AND REVIEW/ANALYSIS METHODS: After an extensive search for all available evidence on how nurses manage pain in hospitalized persons living with dementia, data were extracted on pain management methods that included assessment, intervention, effectiveness of pain management, and the barriers nurses encountered when managing pain. A descriptive content analysis was used to extract data from qualitative studies.
Six articles published between 2016 and 2021 met the inclusion criteria; four utilized qualitative methods, and the others used mixed-methods and quantitative study designs. A narrative description of the findings was summarized after data were categorized into pain management data elements and barriers nurses encountered when managing pain. Barriers were grouped into the subcategories of communication challenges (nurse to patient), information sharing (nurse to nurse), lack of knowledge, time constraints, and nursing stressors.
We identified six articles that met our inclusion criteria, highlighting a noticeable gap in the literature. Managing pain in this population is complex and lacks organizational support. Review findings indicate that pain management methods lack consistency and standardization, making it difficult to assess their effectiveness. Nurses also described knowledge deficits resulting in practice gaps that, when combined with barriers and challenges, result in underrecognized and undermanaged pain.
