Exploring Pain Management for People Living With Dementia in Acute Care Settings Using the COM-B Framework to Guide...

Area of Science:

• Geriatric Medicine
• Healthcare Management
• Nursing Research

Background:

• Pain is prevalent and often under-recognized in people living with dementia (PLWD) within acute care settings.
• Inconsistent pain management in PLWD necessitates understanding behavioral, contextual, organizational, and clinical practice factors.

Purpose of the Study:

• To establish a baseline of pain management for PLWD in acute hospitals.
• To identify factors influencing pain management practices to inform the implementation of the DOTS approach.

Main Methods:

• A multiple-methods study using the COM-B framework and Medical Research Council guidelines.
• Data collection involved staff surveys (n=148), interviews with healthcare staff (n=6), and patient documentation review (n=50).
• The study was conducted across five wards in two UK acute hospitals.

Main Results:

• Healthcare staff reported high perceived capability, opportunity, and motivation for pain management.
• Qualitative data revealed barriers including knowledge gaps and inconsistent use of pain assessment tools.
• Documentation review showed deficits in recording pain history and timely analgesia administration.

Conclusions:

• A significant discrepancy exists between self-reported readiness and actual clinical practice in pain management for PLWD.
• Interventions must focus on enhancing staff capability and implementing system-level processes for effective pain management.