• Valérie Vitou, Marie-Christine Gély-Nargeot, and Sophie Bayard.
• University Paul Valéry Montpellier 3, University Montpellier, Montpellier, France; Fondation Partage et Vie, Montrouge, France. Electronic address: vitou.valerie@orange.fr.
• Pain Manag Nurs. 2021 Jun 1; 22 (3): 377-385.

PurposePeople with dementia are at great risk of their pain being undetected. In long-term care facilities, certified nursing assistants are on the front-line to detect whether a resident with dementia is experiencing pain, but research on certified nursing assistants' abilities to accurately assess pain are scarce. This study aims to examine certified nursing assistants' pain assessment skills using a simulated standardized video context.DesignA cross-sectional study was conducted.MethodsFifty certified nursing assistants and 40 individuals with no professional experience in the field of care (controls) watched the same video of an older adult woman with dementia experiencing pain. Afterwards, they completed visual analog scales (pain intensity, affective distress), an observational pain assessment scale (Algoplus), and a set of questionnaires.ResultsIn both groups, pain intensity assessment and empathic reaction scores showed important interrater variability. Moreover, certified nursing assistants and controls did not differ in detecting the presence of pain or assessing its intensity. But certified nursing assistants displayed lower empathic reactions and dispositions. Certified nursing assistants pain assessment scores decreased with experience and expertise.ConclusionsThe practice of pain assessment is challenging for certified nursing assistants in long-term care facilities. Their professional status does not prevent inter-personal inconsistency and tends to lower their empathic dispositions. Personal determinants may interfere with their assessment behaviors and must be considered to enhance pain management for residents with dementia.Copyright © 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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