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Nurses' Experiences in Pain Management of Cognitively Impaired Older People With a Fractured Hip in the Acute Setting-An Integrative Review
Journal article   Peer reviewed

Nurses' Experiences in Pain Management of Cognitively Impaired Older People With a Fractured Hip in the Acute Setting-An Integrative Review

Belinda Evelyn Lincoln, Christina Aggar and Samuel Lapkin
International journal of older people nursing, Vol.20(5), pp.1-19
09/2025
DOI: https://doi.org/10.1111/opn.70045
PMID: 40936161
Appears in  Recent Faculty of Health Publications

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Abstract

cognitive impairment delirium dementia femoral neck fracture fractured hip nurse pain management
Background: Managing pain in older people with hip fractures and cognitive impairment, such as dementia or delirium, presents unique challenges in acute care settings. Cognitive impairment can complicate pain assessment and management, making nurses' roles in identifying and addressing pain particularly critical in this population. Aim: To review the existing research on nurses' experiences in pain management of cognitively impaired older people with a fractured hip in the acute setting. Design: An integrative review. Methods: Four databases were searched using the PRISMA framework to guide the search and screening. Eligible studies were identified and the quality of each was evaluated using the Mixed Method Appraisal Tool. Thematic analysis was conducted to identify and analyse key themes across all articles. Results: Nine studies examined nurses' experiences in managing pain for cognitively impaired older people with a fractured hip in the acute setting. Three key themes were identified: communication challenges, the importance of person-specific knowledge and complexities in analgesia administration. Conclusion: Nurses recognise the importance of pain management in cognitively impaired older people with a fractured hip. There is a reliance on opioid analgesia balanced with the potential for side effects. Effective pain management is challenged by communication barriers and the need for person-specific knowledge, underscoring the complexity of delivering optimal care in this setting. Relevance to Clinical Practice: Managing pain in cognitively impaired older people following a hip fracture can be challenging. Nurses are well placed to contribute to and support quality pain assessment and management in cognitively impaired older people with a fractured hip in the acute setting. Patient or Public Contribution: No direct patient or public contribution to the review.

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