Recognising and responding to pain in adults with severe intellectual disability: the effectiveness of an intervention targeting support workers

Dr Stella Koritsas1, Dr Anna Devlin1, Dr Nick Hagiliassis1, Associate Professor Rachael McDonald2, Dr Michael Hogg3

1Scope (Aust) Ltd, Hawthorn, Australia, 2Swinburne University, Hawthorn, Australia, 3Melbourne Health, Parkville, Australia

Identifying and managing pain effectively in people with severe intellectual disability (ID) can be challenging. Often there are difficulties with assessment, and staff lack knowledge about pain and its treatment. The aim of the current research was to evaluate the effectiveness of a pain education session in changing knowledge, attitudes and confidence in support workers of adults with severe ID who live in group homes.

An education session was delivered to support workers. It was designed by the authors and delivered by a research clinician with expertise in pain management. The session was 2.5 hours and the content was informed by the research literature and through consultation with health professionals with expertise in ID. It included activities and quizzes, and time for discussion about experiences of working with the participants with ID. A written resource was also developed to accompany the education session.

Support workers completed a survey exploring knowledges, attitudes, confidence and practices on three occasions: baseline, post, and three months following the completion of the education session.

Forty-one support workers participated in the research and completed the baseline and post survey, 16 of these participants also completed the follow-up survey. At baseline, common reasons that the person experienced pain was constipation, dental issues and arthritis/ osteoarthritis, and pain was usually located in the abdomen/ stomach or legs. Overall, there was a significant improvement in support worker knowledge from baseline to immediately post-education, and these improvements were sustained over a three month period. There were also significant improvements in support worker attitudes and confidence in identifying pain from baseline to immediately post, however, not all of these changes were sustained long-term.

The results of this research indicate that an education session can be effective in changing knowledge, attitudes, confidence and practices of support workers who work with adults with severe ID. There is a need to explore additional strategies that might facilitate the maintenance of all the positive changes over time.


Dr Stella Koritsas is the Manager of Strategic Research at Scope Aust. Her background is in disability research with an emphasis on inclusion, health and wellbeing, and behaviour. Dr Koritsas holds an honorary appointment at the University of Melbourne and is a member of Human Research Ethics Committee at the Department of Health and Human Services Human.

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