Aim: The overall aim of the research project was to develop an intervention to support healthcare personnel in systematic pain management for people with dementia residing in nursing homes, and to establish the foundation for integrating this intervention into practice. The intervention was to be grounded in palliative and person-centred care, built on a holistic understanding of pain, and focused on supporting and utilising the resources of people with dementia.

Method: The project follows the MRC Framework for developing and implementing complex interventions and is structured as a sequential design comprising four studies (I-IV), each building on the findings of the previous one. The first three studies; (I) Scoping Review; (II) Focused ethnography; (III) Nominal Group Technique formed the basis for developing a prototype intervention. Dyadic interviews in study IV explored stakeholders’ perspectives on the intervention’s content, relevance, and implementation strategy.

Results: Pain management is a continuous, multi-phase process in which people with dementia, with appropriate support, can utilise their resources and be active participants. The findings highlight the need for comprehensive models grounded in professional competence and structured approaches. This led to the development of a prototype intervention consisting of educational modules and a flowchart to structure clinical practice. The prototype was deemed relevant, and the results provide insight into participants’ perspectives on activities, potential moderators and outcomes of the intervention.

Conclusion: This thesis provides knowledge to systematise pain management processes in nursing homes, enhance healthcare personnel competence, and improve pain management for residents. It presents an actionable approach to stakeholder collaboration in intervention development and highlights the need for nursing homes organised to prioritise care and high-quality nursing at their core.

Pain management for people with dementia is widely recognised as both challenging and complex for healthcare personnel. People with dementia experience a high prevalence of pain and are at substantial risk of mismanagement. Given the subjective nature of pain, it is essential for healthcare personnel to integrate the remaining resources of people with dementia into pain management practice.

This thesis explores pain management processes and presents the content of an intervention aimed at supporting healthcare personnel in the systematic management of pain for people with dementia residing in nursing homes. The intervention is grounded in palliative and person-centred care, built upon a holistic understanding of pain, and focuses on supporting and utilizing the resources of people with dementia in pain management. The intervention is developed through a sequential design consisting of four studies, where each builds on the findings of the previous one.