Study protocol for an integrative theory review of the concept of unidentified pain

Most definitions of pain require individuals experiencing pain to report their pain. There are three groups who may not always report pain including those who: (1) lack the cognitive ability to verbally communicate their pain and also lack a proxy/surrogate to report pain for them; (2) lack the cognitive ability to verbally communicate their pain but have a proxy to report the pain; and (3) have the cognitive ability to verbally report pain but are unable or unwilling to do so. Clinicians may not be able to determine which patients are at risk for unidentified pain. Therefore, in this study, we present a protocol for an integrative review with the aim of identifying existing theoretical approaches to understanding unidentified pain.

We propose a systematic overview of the existing theoretical approaches to understanding 'unidentified pain'. We will use Campbell and colleagues' criteria for systematic reviews of theory and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Our search will be broad to cover theoretical approaches to 'unidentified pain' using MEDLINE, CINAHL, Embase and Google Scholar. Covidence systematic review software will be used for data extraction and analysis. Then, qualitative content analysis will take place. The content analysis will be presented as a narrative.

No human or animal subjects will be involved. The results are to be published in peer-reviewed journals and presented at conferences in the USA and internationally.