Nurses’ Knowledge and Attitudes Dementia Pain Assessment in NHs

Summary

As the population of older people continues to rise, there is an increased effort to improve the quality of life for geriatric patients living with dementia. However, in dementia, traditional methods of assessing pain are irrelevant and nurses must have knowledge in identifying other pain indicators such as behavioral and mood changes in patients. Currently, there is a dearth of knowledge on the use of such tools. Nurses’ knowledge and attitude have a significant influence on the quality of care offered to people living with dementia. Burns and McIlfatrick, (2015) study sought to ascertain nurses’ attitude and knowledge toward pain assessment in dementia patients.

As has been observed in several geriatric studies, pain is prevalent in older people and may often be underdiagnosed in dementia care (Atee et al., 2017). People living with dementia usually lose their ability to self-report pain and it is the responsibility of the nurse to assess pain and provide effective therapy to improve the quality of life of these patients. A dearth of knowledge due to poor nurse training often impedes the diagnosis and management of dementia in people living with dementia. The cross-sectional survey explored a sample 96 registered nurses in the UK on their knowledge in pain assessment and management in people living with dementia. The study found that nurses had insufficient knowledge on the choice of analgesics and the safety of opioids in the management of pain. However, the major hindrance towards pain assessment in dementia patients was lack of medical support, understaffing of dementia care centers which increased workload pressures among the nurse population caring for dementia patients. In lieu, of the finding, the study recommends improvement in nurses’ educational program as well as provisions of guidance for nurses caring for dementia patients. Coordination in the pain assessment and management with medical teams could also improve the quality of life for dementia patients in nursing homes.

Discussion

Dementia care often present new challenges for nurses as the assessment and management of pain. Nurses’ knowledge and attitude are critical factors towards improved management of pain in geriatric patients living with dementia. However, nurses’ knowledge has often been overlooked in caring for people living with dementia. The current study emphasizes the need for training for nurses caring for dementia patients and even suggests the provisions of guidance for pain assessment which has been attributed as a prevalent condition for geriatric patients in the nursing homes. The current study corroborates other similar studies that have identified the need for interprofessional collaboration in the provision of care to dementia patients, especially in pain assessment and management where nurses’ knowledge may be insufficient (Corbett et al., 2016). Although, nurses reported that they are able to use behavioral and mood cues in assessing pain in dementia patients, this knowledge was attributed to the experience of the nurse. This further, illustrates the lack of adequate training to improve nurses’ knowledge and attitude in assessing and managing pain in people living with dementia. Insufficient knowledge translates to lack of confidence when caring for dementia patients which may compromise the quality of care such as distinguishing pain from other complications in geriatric patients. In addition, the study recommended the development of evidence-based guidelines on pain assessment in dementia patients.

Demerits of the study

The low response rate (32/96) of 33% puts into questions the reliability and validity of the study. Further research needs to increase the scope of the study by widening the sample size and incorporating other research methods such as mixed methods research to ensure the study alleviates any potential bias in the findings.