Facilitators, Barriers, and Solutions in Pain Management for Older Adults with Dementia

Abstract

Background: Although qualitative studies have been conducted to identify barriers and facilitators that influence the pain management of older adults with dementia, as far as we know, only a very recent study (Andrews et al., 2019) has used participatory action research (PAR) as a methodology for studying pain management. It allows nurses to examine and improve their practice based on their realities and within their context.

Aim: To reflect on nursing practice and identify facilitators and barriers in the management of pain in older adults with dementia and to propose actions for improvement.

Design: We used qualitative participatory action research.

Participants/settings: Ten nurses from the geriatric acute care unit of a university hospital in Spain were recruited through convenience sampling.

Methods: Data were generated through a written questionnaire and three focus groups.

Results: One of the main facilitators the participants identified was professional experience. The main barriers they identified were lack of knowledge and skills and lack of time. The participants proposed two main improvements: (1) a training program consisting of three courses (pain evaluation and management, dementia and pain, and pharmacology) and (2) the creation of a specific register for nurses to record patients' pain.

Conclusions: Involving nurses directly in research on their practices can result in precise proposals for improvements based on their needs and oriented toward improving the quality of care. Moreover, our results confirm previous findings in other countries.