Pain management for people with dementia: A cross-setting systematic review and meta-ethnography

Smith, Toby O. ORCID: https://orcid.org/0000-0003-1673-2954, Lockey, Dawn, Johnson, Helen, Rice, Lauren, Heard, Jay and Irving, Lisa (2023) Pain management for people with dementia: A cross-setting systematic review and meta-ethnography. British Journal of Pain, 17 (1). pp. 6-22. ISSN 2049-4637

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Abstract

BACKGROUND: Pain management for people with dementia is challenging. There is limited understanding on the experiences of pain management from people with dementia, but also from those who support them. This study synthesised the qualitative evidence to explore the perspectives of people with dementia, their family, friends, carers and healthcare professionals to pain management. METHODS: A systematic literature review was undertaken of published and unpublished literature databases (to 01 November 2021). All qualitative research studies reporting the perspectives of people with dementia, their family, friends, carers and healthcare professionals to managing pain were included. Eligible studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative appraisal tool. A meta-ethnography analysis approach was adopted, with findings assessed against the GRADE-CERQual framework. RESULTS: Of the 3994 citations screened, 33 studies were eligible. Seven themes were identified from the data. There was moderate evidence from six studies indicating inequity of pain management for people with dementia. There was moderate evidence from 22 studies regarding anxieties on cascading pain information. There was moderate evidence from nine studies that familiarisation of the person with pain, their preferences, routines and behaviours were key factors to better pain management. Consistently, carers and healthcare professionals had a low opinion of the management of pain for people with dementia, with tensions over the ‘best’ treatment options to offer. This was associated with poor training and understanding on how pain ‘should’ be managed. CONCLUSION: The findings highlight the challenges faced by people with dementia and pain, and those who support them. Improvements in education for people who support these individuals would be valuable across health and social care pathways. Supporting family members and relatives on pain experiences and treatment options could improve awareness to improve quality of life for people with dementia and pain and those who support them.

Item Type:	Article
Uncontrolled Keywords:	pain,discomfort,cognitive impairment,agitation,care home,qualitative
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User:	LivePure Connector
Date Deposited:	05 Jul 2022 10:30
Last Modified:	19 Oct 2023 03:21
URI:	https://ueaeprints.uea.ac.uk/id/eprint/85949
DOI:	10.1177/20494637221119588

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