Nurses' Experiences of Pain Management for Patients With Diagnosed Mental Health Conditions: A Systematic Review.
Aaron Lapuz Alejandro, Yvonne Middlewick, Seng Giap Marcus Ang et al.
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In 30 seconds
This mixed-methods systematic review synthesised evidence on nurses’ pain assessment and management for patients with diagnosed mental health conditions. Searches identified 1,318 eligible studies, of which 12 met inclusion criteria. Findings described inconsistent assessment, reliance on visible signs, uncertainty about trusting patients’ reports, diagnostic overshadowing, and the influence of organisational constraints and support. The review concludes that stigma can contribute to pain being under-assessed and inadequately treated, and identifies education, institutional support, and validated assessment tools as ways to strengthen nursing practice.
Key findings
- Twelve studies met inclusion criteria from 1,318 eligible studies identified.
- Six themes included inconsistent assessment, reliance on visible signs, trust in patient reports, diagnostic overshadowing, and organisational influences.
- Barriers included inconsistent use of assessment tools, limited nursing knowledge and confidence, power imbalances, and organisational constraints.
- Studies were predominantly conducted in high-income countries and frequently neglected nonresponse bias.
Why it matters
Pain may be under-assessed or inadequately treated when mental health diagnoses shape how clinicians interpret symptoms and patient reports. The review highlights that assessment practices are influenced not only by individual nursing knowledge and judgement but also by stigma, education, resources, and institutional policies. Recognising these influences can inform efforts to support more consistent, person-centred pain care.
What to keep in mind
The evidence base comprised 12 studies, was predominantly from high-income countries, and frequently neglected nonresponse bias, potentially limiting generalisability.