Background: One helpful strategy adopted for pain management in non-verbal, intubated patients is the use of a\nproper pain assessment scale. The purpose of the present study is to achieve a better and deeper understanding of\nthe existing nursesââ?¬â?¢ challenges in using pain assessment scales among patients unable to communicate.\nMethods: This qualitative study was conducted using content analysis. Purposive sampling was used to select the\nparticipants and continued until data saturation. The participants included 20 nurses working in intensive care units.\nData was collected using semi-structured interviews and analysis was done using an inductive approach.\nResults: Four categories and ten sub-categories were extracted from the experiences of the nurses working in the\nintensive care units in terms of nursing challenges in using non-verbal pain assessment scales. The four categories\nincluded ââ?¬Å?forgotten priorityââ?¬Â, ââ?¬Å?organizational barriersââ?¬Â, ââ?¬Å?attitudinal barriersââ?¬Â, and ââ?¬Å?barriers to knowledgeââ?¬Â.\nConclusions: The findings of the present study have shown that various factors might influence on the use of nonverbal\npain assessment scales in patients unable to communicate. Identifying these challenges for nurses can help\ntake effective steps such as empowering nurses in the use of non-verbal pain assessment scales, relieving pain, and\nimproving the quality of care services
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