The recognition and assessment of pain in people with profound intellectual disabilities by nurses: An appreciative inquiry

Individuals with profound intellectual disabilities are non-verbal and reliant on carers for pain recognition, assessment and management. Pain is a multifaceted and interconnected experience. Assessment tools designed specifically for this population are needed. This study aimed to develop methods for improved pain care practices by nurses. This qualitative study followed the four phases of appreciative; Discovery, Dream, Design, Destiny. Eight nurses were recruited from one Irish intellectual disability organisation. Data were analysed from individual and focus group interviews, using thematic analysis and continuous reflexivity. A pain awareness campaign and RAPPID tool (recognition and assessment of pain in people with profound intellectual disabilities) were developed. Respect for personhood in individuals with profound intellectual disabilities is reflected through holistic approaches to pain assessment. The empowerment of nurses enables positive change. Implicit knowledge can be communicated more proficiently with a formal, collaborative tool.