RNNarrative ReviewNursing open2026

Implementing Pain Management Approaches Among Patients With Dementia in an Acute Hospital Setting: A Scoping Review.

Faisal Mahama, Donna Brown, Deirdre Harkin and 1 others

PMID 41947293

WHAT IT FOUND

Valid pain assessment tools exist for dementia, but using them alone does not reduce pain.

Nurses often miss pain-related agitation despite high knowledge scores. Effective care requires embedding assessment in person-centred protocols with training and managerial support.

Key findings

01Pain assessment tools like PAINAD are valid, but their use alone does not guarantee timely or effective pain relief.

02In a simulation, 98% of nurses had adequate pain knowledge, yet most failed to identify pain-related agitation, with 88% choosing antipsychotics first.

03Implementing comprehensive approaches like the Dementia Toolkit or PROACTIVE improved pain management and reduced hospital stays, but evidence for standardized protocols remains lacking.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

The review included only English-language publications, excluding 11 non-English studies. The included studies were predominantly small, with sample sizes ranging from 20 to 274, limiting generalizability. Most studies focused on pain assessment rather than pain management interventions, leaving a gap in evidence for effective treatment strategies. The review did not perform a quality appraisal of the included studies, which is typical for scoping reviews but limits the certainty of the findings.

Declared interests

The study was funded by a PhD studentship from the Ulster University Vice-Chancellor Research Scholarship. No other conflicts of interest were declared.

The easy way to misread this

Do not assume that using a validated pain assessment tool like PAINAD will automatically improve patient outcomes. The review shows that assessment alone does not reduce pain and that nurses often miss pain-related agitation despite knowing the tools. Effective management requires a structured, person-centred approach that links assessment to timely intervention.

Read it on PubMed →