Student Theses, Dissertations and Capstones

Document Type


Degree Name

Doctor of Nursing Practice (DNP)

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.


College of Nursing

First Advisor

Kelly Henson-Evertz

Second Advisor

Marica Derby-Davis

Publication Date / Copyright Date



Nova Southeastern University


Background: Patients with dementia have difficulty articulating pain due to cognitive deficits incommunication, sensation, and overall physical decline due to the aging and disease process. Patients who have dementia are considered at-risk for uncontrolled pain due to under-assessment, under-treatment, or untreated pain. Current research notes gaps exist in pain assessment among nurses’ due to knowledgedeficits and attitudes on pain assessment for dementia patients. Barriers regarding the utilization of evidence-based behavioral pain assessment tools are related to nurses’ knowledge deficit and skills competency.

Purpose: The purpose of this evidence-based practice (EBP) project was to increase hospice nurses’ knowledge and improve attitudes on pain assessment in dementia patients by implementing an EBP training program on utilizing the Pain Assessment in Advanced Dementia Scale (PAINAD).

Theoretical Framework: Knowledge to Action Model

Methods: A before and after project design with pre-test/post-test measurements was used to determine whether providing an EBP training on utilizing the PAINAD Scale for pain assessment increased hospicenurses’ knowledge and improved attitudes on pain assessment in dementia patients.

Results: Comparison of pre-test/post-training measures demonstrated a small increase in hospice nurses’ knowledge and a significant increase in attitudes on assessing pain in dementia patients.

Conclusion: EBP training programs utilizing the PAINAD Scale improves hospice nurses’ attitudes onpain assessment in dementia patients. Positive changes in attitude should enhance hospice nurses’ ability and willingness to assess and manage pain in patients with dementia.




Dementia, End-of-life, Hospice, Hospice nurses, Pain assessment; Pain assessment in advance Dementia (PAINAD)



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