Abstract
Introduction: There are limited evidence-based studies examining barriers and facilitators to pain assessment and management in residents with advanced dementia in long-term care settings, with no studies conducted to date in the long-term care setting in Northern Ireland.
Aims: We aimed to explore care home nurses’ perspectives of facilitators of and barriers to providing optimum pain assessment and management to people with advanced dementia living in the nursing home setting in Northern Ireland.
Methods: One-to-one semi-structured interviews were conducted with nursing home nurses. Nurses who actively provided care to residents living with dementia, nursing home managers, regional managers, trainers who were registered nurses with the Nursing and Midwifery Council and who supported the provision of dementia care in a nursing home setting, and nursing home nurses who had completed their induction or preceptorship training were eligible to participate. Participants were recruited through the Queen’s University Belfast Care Home Research Community of Practice. An interview guide was developed and piloted with three nurses who met the eligibility criteria. Interviews were conducted using Microsoft Teams, audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Ethical approval was obtained from the Faculty of Medicine, Health and Life Sciences Research Ethics Committee, Queens University Belfast.
Results: Interviews were conducted with 10 nurses between November 2023 and June 2024. Reflexive thematic analysis generated six themes: (1) the crucial role of the nurse, (2) recognising and assessing pain, (3) pharmacological and non-pharmacological approaches, (4) communication with families and healthcare professionals, (5) training and resources, and (6) barriers and challenges in pain assessment and management.
Discussion/Conclusion: Nursing homes should implement standardised policies and protocols, enhance nurse education on pain assessment tools and management strategies, and promote interdisciplinary collaboration to enhance recognition and management of pain and ultimately improve the quality of life for residents with advanced dementia.