Exploring nursing assistants' roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study
Article first published online: 16 SEP 2013
© 2013 John Wiley & Sons Ltd
Journal of Advanced Nursing
Volume 70, Issue 5, pages 1065–1077, May 2014
How to Cite
2014) Exploring nursing assistants' roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study. Journal of Advanced Nursing 70(5), 1065–1077. doi: 10.1111/jan.12259(
- Issue published online: 2 APR 2014
- Article first published online: 16 SEP 2013
- Manuscript Accepted: 17 AUG 2013
- behavioural observation;
- cognitive impairment;
- nursing assistants;
- nursing homes;
- pain assessment;
- pain management
To explore nursing assistants' roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain.
Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents' pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants' functions in pain management.
This is a descriptive, exploratory qualitative study.
Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis.
Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions.
This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants' scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation.