Whole Patient Pain Assessment
What is the likely cause of this pain in this patient
at this time?
What structural or functional abnormality would cause this pain pattern?
How is the patient coping with the pain?
How much anxiety or depression is present?
What are the patient's ideas, concerns or expectations about pain and its management in this situation?
What information do they need?
How is the pain affecting the family?
How much family anxiety is present?
What are the family's ideas, concerns and expectations? (These may differ from the patient's)
How have family dynamics been affected by this illness?
How is the pain limiting the usual role(s)?
How much distress or suffering is this patient experiencing?
What does the pain mean to them?
What does the illness mean to them?
What sustains them in difficult times?
- Ask the patient 'Where is your pain?' 'Show me where you feel the pain.' 'How long have you had the pain?'
- Record the site, duration and intensity of each pain.
- What has already been tried by patient and clinician with what effect?
Site of pain:
Using a simple body chart to document location and intensity of pain(s) at first assessment can form a useful aide memoir and be valuable in monitoring the effectiveness of interventions, particularly when dealing with mulitple pains.
Duration of pain:
Should be recorded. Is it episodic or continuous? Was there a clear trigger e.g. a fall or a certain movement?
Intensity of pain:
A simple measure of pain intensity is to ask the patient 'What does the pain stop you doing?' and 'Does the pain disturb your sleep?' Various pain intensity scales are available and can be useful where staff and patients are well trained. These grade pain intensity on numerical or verbal visual analogue scales.
© Dr. Eileen Palmer, Dr John Howarth Palliative Care for the
Primary Health Care Team (2005) Quay Books ISBN 1856422291
Palliative Care Pain Pack 1. Dr Eileen Palmer 2008