Learning Objectives

On completion of this module participants will gain knowledge in:

  • Definitions of Pain
  • Different Types of Pain
  • Pain Assessment Tools
  • Pain Assessment for People Living with Dementia
  • Pharmacological Management of Pain
  • Non-Pharmacological Pain Management
  • Common Misconceptions About Opiates
  • ‘The Doctrine of Double Effect’ at The End of Life

Select the Materials tab above for the references and further reading for Module 5.



Brennan et, F. et al (2019) Access to Pain Management as a Human Right.

American Public Health Association


Clark, D. (1999) ‘Total Pain’ disciplinary power and the body in the work of Cicely Saunders, 1958-1967

Social Science & Medicine vol 49 issue 6 pp. 727-736.


International Association for study of Pain (IASP) (2018)

McCaffery, M. and Pasero, C. (1999) Pain Clinical Manual. Mosby, St. Louis.


Reed, C.J. Ethical dilemmas, and end-of-life care: Have you ever had to make a practice decision with no clear answer? We give you the tools you need to confront moral distress. Nursing made Incredibly Easy, 13 (6), pp. 16.


Tuckey, L. and Slowther, A. The Doctrine of Double Effect and end-of-life decisions. Clinical Ethics, 4 (1), pp. 12.


World Health Organization (1986) The WHO Analgesic Ladder

World Health Organization (2015) updated version of the WHO (1986) pain ladder


Wholihan, D. and Olson, E. The Doctrine of Double Effect: A Review for the Bedside Nurse Providing End-of-Life Care. Journal of Hospice & Palliative Nursing, 19 (3), pp. 205-211.




Further Reading for interest


Krawczyk, M. and Richards, N. The relevance of 'total pain' in palliative care practice and policy. European Journal of Palliative Care, 25 (3), pp. 128-130.


Allsop, M.J., Taylor, S., Bennett, M.I. and Bewick, B.M. Understanding patient requirements for technology systems that support pain management in palliative care services: A qualitative study. Health Informatics Journal, 25 (3), pp. 1105-1115.


Jacobsen, R., Samsanaviciene, J., Liubarskiene, Z., Sjøgren, P., Møldrup, C., Christrup, L., Sciupokas, A. and Hansen, O.B. Barriers to cancer pain management in Danish and Lithuanian patients treated in pain and palliative care units. Pain Management Nursing, 15 (1), pp. 51-58.

Burns, M. and McIlfatrick, S. (a) Nurses' knowledge and attitudes towards pain assessment for people with dementia in a nursing home setting. International Journal of Palliative Nursing, 21 (10), pp. 479-487.


Kalyadina SA, Ionova TI, Ivanova MO, Uspenskaya OS, Kishtovich AV, Mendoza TR, Guo H, Novik A, Cleeland CS, Wang XS. (2008). Russian Brief Pain Inventory: validation and application in cancer pain. J Pain Symptom Manage 35(1): 95-102. ​​​​



Further reading for interest- pain in the person living with dementia


Reference for pain assessment in Dementia:

Warden, V, Hurley AC, Volicer, V. (2003). Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) Scale. J Am Med Dir Assoc, 4:9-15. Developed at the New England Geriatric Research Education & Clinical Center, Bedford VAMC, MA


Leong, I., Chong, M., & Gibson, S. (2006). The use of self-reported pain measure, a nurse-reported pain measure, and the PAINAD in nursing home residents with moderate and severe dementia: a validation study. Age and aging, 35, 252-25



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