Abstract
Background: Pain assessment in individuals with intellectual disabilities who are unable to communicate verbally poses a major challenge for nursing staff. In Pakistan, particularly in Punjab, there is limited awareness and structured training on recognizing and managing pain among non-communicating patients.
Aim: This study aimed to explore nursing staff perspectives on pain assessment among non-communicating individuals with intellectual disabilities in major mental health care institutions of Lahore, Pakistan.
Methods: A descriptive cross-sectional design was employed. The study was conducted at three major mental health institutions in Lahore — Punjab Institute of Mental Health, Fountain House, and Lahore Psychiatric Hospital. Data were collected from a sample of 160 nursing staff members using a semi-structured questionnaire based on the Non-Communicating Children’s Pain Checklist – Revised (NCCPC-R), adapted for adult and institutional contexts. Data were analyzed using descriptive and inferential statistics, including frequency distribution, mean scores, and non-parametric tests such as the Mann-Whitney U and Kruskal-Wallis tests.
Results: The study found that 85% of nurses identified pain primarily through behavioural cues such as moaning, guarding, and irritability, while only around 70% recognized physiological indicators like sweating or changes in skin colour as signs of pain. Additionally, 89% of respondents reported no formal training in pain management, underscoring a critical gap between clinical experience and evidence-based assessment practices in caring for non-communicating intellectually disabled individuals.
Conclusion: The study concludes that while nurses effectively recognize behavioural signs of pain in non-communicating individuals with intellectual disabilities, a significant lack of formal training and reliance on subjective observation highlight the urgent need for standardized pain assessment protocols in institutional care settings of Punjab.