Experiencing improved assessment and control of pain in end-of-life care when using the Abbey Pain Scale systematically

Aim: To describe staff's reflections on aspects influencing pain assessment at end-of-life (EoL) care in nursing homes before and after the implementation of the Abbey Pain Scale (APS). Background: People with cognitive impairment in the EoL care often suffer from underdiagnosed and undertreated pain due to the lack of knowledge and guidelines for systematic pain assessment. Methods: Semi-structured focus group interviews were conducted and analysed using qualitative content analysis. Results: The staff described their experiences before the implementation of APS asstriving to achieve control of pain by trusting in themselves and the team,while the experiences after the implementation of APS were described asimproving symptom control with remaining weak confidence in the team. Conclusions: Implementation of APS was experienced as improving systematic pain assessment. Efforts to establish clear routines and improve confidence in the care team would be prioritized to optimize pain assessment and pain relief in EoL care.