Factors Associated with Pain Assessment in Nursing Home Residents: A Systematic Review Protocol.

BACKGROUND: The burden of pain in nursing homes is substantial; however, pain assessment for both acute and chronic conditions remain inadequate resulting in inappropriate or inadequate treatment. Complexities in assessing resident pain have been attributed to factors (barriers and facilitators) arising at the resident, health care provider and health care system levels. OBJECTIVES: In this systematic review protocol, we identify our research approach that will be used to critically appraise and synthesize data in order to assess barriers and facilitators to pain assessment in nursing home residents aged ≥ 65 years. METHODS: This is a Cochrane style systematic review protocol adhering to the PRISMA-P reporting standards. This review will include primary (original) qualitative literature concerning either barriers or facilitators to pain assessment in older adult nursing home residents. A thematic analysis approach will be employed in collating and summarizing included data, and will be categorized into resident, health care provider, and system levels factors. Database searches will include Abstracts in Social Gerontology, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, and Web of Science. DISCUSSION: The identification of barriers and facilitators to pain assessment in older adult nursing home residents may assist health care providers across all platforms and levels of education to improve pain assessment among nursing home residents. Improving the assessment of pain has the potential to improve quality of care and ultimately quality of life for older adult nursing home residents.