Background: A group of practitioners identified difficulties in identifying and assessing pain for people with communication problems. They felt there was a need for a behavioural pain assessment tool.

Aims and objectives: To identify a pain assessment tool for people with communication problems (including people with dementia) in acute care settings.

Method: This was a practice development project and was based on a participatory action research (PAR) methodology using cycles of planning, acting, evaluating, reflecting and re-planning. It included many stakeholders – this was to raise their awareness and to promote ownership and commitment to the project, leading to changes in practice.

Conclusions: A large number of behavioural pain assessment tools are available and three were used by staff in acute care but they did not always identify pain. There is a need to include members of the family or close carers in recognising and assessing pain in people with communication problems.

Implications for practice:

• There is a need to ensure that pain is recognised in acute care settings for people with communication problems and/or cognitive impairment
• Behavioural pain assessment tools can be used in acute care settings
• A holistic assessment of behaviour associated with pain includes the involvement of family members to identify and assess pain
• Actively involving members of the clinical team in all aspects of a project can result in changes to practice development

This article by Julie Gregory is licensed under a Creative Commons Attribution Non-Commercial 3.0 License.