Table 4.

Patterns, advances and gaps in the included studies.

Patterns	Advances	Gaps
Healthcare personnel’s clinical practice in pain assessment
Pain awareness  Suspected pain  Pain mapping	How uncertainty around pain experience affects pain management processes Observational strategies to detect signs of pain, and the importance of knowledge regarding baseline behaviour HCP perspective on how people with dementia express/self-report pain The importance of continuity in information between shifts and healthcare personnel	Knowledge on • the promotion of systematic individualized pain assessment and how to place the results of assessment tools into a larger context • The application of pain assessment tools in clinical practice (outside the context of participation in studies testing given tools) • how to support people with dementia in communicating their subjective experience of pain • how to assess the residual ability of people with dementia to self-report • how to integrate different pain assessment strategies at different degrees of residual capacity to self-report • how people with dementia experience pain assessment processes in nursing homes • prerequisites for relational continuity in relation to pain assessment • systematic approaches to ensure informational continuity throughout the pain assessment processes • strategies of systematic trial-error where this is unavoidable
(. . .in response to) Pain expressions in people with dementia	Signs of pain (observable, nonverbal) Descriptions of self-reporting focus on the presence and severity of pain Importance of individualized pain assessment	Knowledge on • self-reports of aspects other than presence and severity of pain • cultural differences in pain expressions in people with dementia • the role of relatives in pain assessment