Implementing Pain Management Approaches Among Patients With Dementia in an Acute Hospital Setting: A Scoping Review

Area of Science:

• Geriatric Medicine
• Nursing Research
• Pain Management

Background:

• Pain assessment and management in acute hospital settings for patients with dementia present significant challenges.
• Existing approaches often lack standardization and a person-centered focus, impacting the quality of care.

Purpose of the Study:

• To identify implemented pain management strategies for dementia patients in acute care.
• To evaluate the effectiveness of these approaches in pain assessment and management.

Main Methods:

• A systematic scoping review following the Joanna Briggs Institute framework and PRISMA-ScR guidelines.
• Searched MEDLINE, CINAHL, and WHO databases for studies from 2005-2023 on pain management in hospitalized dementia patients.
• Included primary and secondary research, extracting and synthesizing data using descriptive statistics.

Main Results:

• Fourteen studies were included, encompassing various research designs like cross-sectional, cohort, and interventional studies.
• Interventions primarily focused on validating pain assessment tools, such as the Pain Assessment in Advanced Dementia Scale (PAINAD).
• Awareness-raising and training sessions were the main strategies for implementing interventions.

Conclusions:

• A significant gap exists in standardized, person-centered pain management protocols for dementia patients.
• Validated pain assessment tools are available but do not inherently ensure effective pain relief.
• Interventions show promise but lack consistent evidence of systematic pain reduction; education alone is insufficient, necessitating organizational support for holistic, proactive care.