Healthcare Personnel's Knowledge, Attitudes, and Practices of Pain Management for People With Dementia: An Integrative Review.

Background: Pain management in people with dementia is challenging, and there is a knowledge-practice gap in this area.

Objective: The purpose of this study was to comprehensively analyze and synthesize the current evidence on healthcare personnel's knowledge, attitudes, and practices regarding pain management for people with dementia.

Methods: An integrative review was conducted. Six electronic databases, including PubMed, CINAHL, Web of Science, PsycINFO, Cochrane Library, and EMBASE, were searched to identify qualified articles. After removing the duplicates, the search results underwent title screening, abstract screening, and full-text review. The 2018 Mixed-Methods Appraisal Tool was used to evaluate the quality of the included articles. Data analysis incorporated data reduction, display, comparison, conclusion drawing, and verification.

Results: A total of 32 full-text articles were included, and five themes were summarized based on the knowledge-attitude-practice (KAP) model as (1) inadequate knowledge; (2) mixed negative and positive attitudes towards pain management; (3) challenges in pain identification; (4) challenges and barriers to comprehensive pain assessment; and (5) undertreated and poorly documented pain.

Conclusion: Initiatives that prioritize improving healthcare personnel's knowledge, fostering positive attitudes, and promoting the adoption of effective assessment and management methods in pain management for individuals with dementia are essential.

Clinical implications: Nurses should participate in comprehensive training and education on dementia-specific pain assessment, proactively collaborate with interdisciplinary healthcare personnel, and ensure timely communication with family caregivers. Additionally, integrating structured pain assessment tools into electronic health records and standardizing documentation protocols could enhance care coordination and quality.