Management of pain for people with dementia living in nursing homes: stakeholders' perspectives on a prototype of a complex intervention.

Background: Healthcare personnel often report uncertainty about how to identify and alleviate pain in people with dementia. Up to 80% of nursing home residents with dementia are estimated to experience chronic pain. There is a lack of structured pain management interventions that focus on integrating and building upon the individual resources of people with dementia in the nursing home context. Although a prototype of such an intervention has been developed, further knowledge is needed regarding its functioning in clinical practice, relevance, and capacity to meet clinical needs. Stakeholders possess substantial field-specific knowledge. In this study, the prototype of the intervention is presented to stakeholders to increase the likelihood of a clinically relevant intervention and successful implementation. Objectives: To describe stakeholders' perspectives of the prototype regarding intervention content and relevance, and implementation strategy. Methods: Seven dyadic interviews were conducted with practice development nurses and first-line managers in nursing homes between May to June 2025 to describe their perspectives on the prototype. The transcripts were analyzed with a deductive framework analysis. Results: The intervention was regarded as relevant and as having the potential to enhance healthcare personnel competence, structure pain management, and integrate residents' resources. However, successful implementation requires integration into existing practice models, and potential moderators were identified at both the organizational and individual levels. Conclusions: This study presents an applied approach to collaborating with stakeholders in intervention development. The participants' perspectives on activities, moderators and potential outcomes of the intervention provides essential knowledge for further refinement of the intervention and future evaluation.