Nurses' Beliefs About Pain Assessment in Dementia: A Qualitative Study Informed by the Theory of Planned Behaviour

Abstract

ABSTRACTAimTo explore registered nurses' beliefs regarding pain assessment in people living with dementia.DesignA descriptive exploratory qualitative study informed by the Theory of Planned Behaviour.MethodsOnline semi‐structured in‐depth interviews were conducted from January to April 2023 with a purposive sample of 15 registered nurses caring for people with dementia. Following transcription, data were analysed using direct content analysis.FindingsRegistered nurses believe pain assessment improves the well‐being of people with dementia and informs and evaluates practice. However, there is a possibility of misdiagnosing pain as agitation or behavioural problems, leading to inaccurate pain management. Interpersonal factors, such as registered nurses' knowledge and experience, beliefs and motivation to improve care provision, were the primary facilitators of pain assessment. Physical and behavioural dimensions of the pain of the dementia syndrome were the most reported barriers to pain assessment. Registered nurses reported that multidisciplinary team members expect them to do pain assessments. Most did not experience disapproval when performing pain assessments.ConclusionRegistered nurses hold beliefs about pain assessment benefits, consequences, enablers, barriers, approvals and disapprovals regarding dementia. The findings could inform interventions to enhance pain assessment practices.Implications for the Profession and/or Patient CarePolicymakers should provide education opportunities for registered nurses to improve their knowledge, skills and beliefs about pain assessment in dementia. Future research should develop and implement multidisciplinary, multifaceted pain assessment protocols to enhance the accuracy of pain assessment practices.ImpactPain is underassessed in dementia, and this could stem from registered nurses' beliefs about pain assessment in dementia. The findings could inform interventions to enhance pain assessment beliefs and practices.Reporting MethodThis study adhered to the COREQ criteria.Patient or Public ContributionRegistered nurses caring for people living with dementia participated as interview respondents.