Overen Caroline Kreppen, Larsson Maria, Hummelvoll Hillestad Adelheid, Karlsson Ingela, Eriksen Siren
Lovisenberg Diaconal University College, Lovisenberggata 15B, Oslo 0456, Norway Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden.
Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden.
Palliat Care Soc Pract. 2025 Jan 6;19:26323524241308589. doi: 10.1177/26323524241308589. eCollection 2025.
Pain is a common symptom in people with dementia living in nursing homes, but cognitive impairment, including language and communication difficulties, challenges pain assessment and the ability to self-report pain.
This study aimed to identify and summarize patterns, advances, and gaps in research literature describing pain assessment in people with dementia living in nursing homes.
We conducted a scoping review following Arksey and O'Malley's methodological framework.
Systematic searches were conducted in CINAHL, Embase, MEDLINE, and PsycINFO. We included studies describing pain expressions in people with dementia and/or healthcare personnel assessment of pain in people with dementia, in a nursing home context. Charted data included demographics, methodological descriptions, ethical and quality assessment and relevant findings. Relevant findings were summarized using thematic analysis, and an overview of patterns, advances, and gaps in the research literature is presented.
Thirty-nine studies were included. The results describe three patterns: (1) pain awareness; (2) suspected pain and (3) pain mapping. Collectively, these patterns constitute a process of pain assessment, integrating pain expressions of people with dementia. Important perspectives on self-reporting are touched upon in several of the included studies, though direct descriptions of attempts to capture the residents' own experience of pain are sparse.
This scoping review provides a comprehensive description of pain assessment in people with dementia living in nursing homes as a process in three steps. We identified several knowledge gaps in the understanding of this process and provide concrete recommendations for further research. The results underpin the importance of pain assessment approaches that incorporate the flexibility to meet residents' varying and potentially fluctuating ways of communicating pain.
This scoping review is registered in the Open Science Framework (https://osf.io/8kaf5/).
疼痛是养老院中痴呆症患者的常见症状，但认知障碍，包括语言和沟通困难，对疼痛评估及自我报告疼痛的能力构成挑战。
本研究旨在识别并总结描述养老院中痴呆症患者疼痛评估的研究文献中的模式、进展和差距。
我们按照阿克西和奥马利的方法框架进行了一项范围综述。
在护理学与健康领域数据库（CINAHL）、荷兰医学文摘数据库（Embase）、医学期刊数据库（MEDLINE）和心理学文摘数据库（PsycINFO）中进行了系统检索。我们纳入了在养老院环境中描述痴呆症患者疼痛表现和/或医护人员对痴呆症患者疼痛评估的研究。梳理的数据包括人口统计学信息、方法描述、伦理和质量评估以及相关研究结果。使用主题分析法对相关研究结果进行了总结，并呈现了研究文献中的模式、进展和差距概述。
纳入了39项研究。结果描述了三种模式：（1）疼痛意识；（2）疑似疼痛；（3）疼痛映射。总体而言，这些模式构成了一个疼痛评估过程，整合了痴呆症患者的疼痛表现。在一些纳入研究中涉及了自我报告的重要观点，不过直接描述捕捉居民自身疼痛体验尝试的内容较少。
本范围综述全面描述了养老院中痴呆症患者疼痛评估是一个分三步的过程。我们在对这一过程的理解中发现了几个知识空白，并为进一步研究提供了具体建议。研究结果强调了疼痛评估方法的重要性，这些方法应具备灵活性，以适应居民表达疼痛的不同且可能波动的方式。
本范围综述已在开放科学框架（https://osf.io/8kaf5/）中注册。
