Question

Respond to the challenge What elements are included in a pain assessment (i.e., what would you assess)? Watch the video and record your response to the question using one of the following recording options. RECORD WITH DESKTOP APP · or record using Mobile Recorder | Web Rechder File Uploader

Answer 1

Ans) A pain history should include location, quality, intensity, temporal characteristics, aggravating and alleviating factors, impact of pain on function and quality of life, past treatment and response, patient expectations and goals.

- Pain is often referred to as the “fifth vital sign,” and should be assessed regularly and frequently. Pain is individualized and subjective; therefore, the patient’s self-report of pain is the most reliable gauge of the experience. If a patient is unable to communicate, the family or caregiver can provide input. Use of interpreter services may be necessary.

- Components of pain assessment include:

a) history and physical assessment;

b) functional assessment;

c) psychosocial assessment

d) multidimensional
assessment.

History and Physical Assessment
The assessment should include physical examination and the systems in relation to pain evaluation.
Areas of focus should include site of the pain, musculoskeletal system, and neurological system.

Other components of history and physical assessment include:
• Patient’s self-report of pain
• Patient’s behaviors and gestures that indicate pain (e.g. crying, guarding, etc.)
• Specific aspects of pain: onset and duration, location, quality of pain (as described by patient), intensity, aggravating and alleviating factors
• Medication history
• Disease or injury history
• History of pain relief measures, including medications, supplements, exercise, massage,
complementary and alternative therapies.

- Functional and Psychosocial Assessment
Components of the functional and psychosocial assessment include:
• Reports of patient’s prior level of function
• Observation of patient’s behaviors while performing functional tasks
• Patient or family’s report of impact of pain on activities of daily living, including work, self-care,
exercise, and leisure
• Patient’s goal for pain management and level of function
• Patient or family’s report of impact of pain on quality of life
• Cultural and developmental considerations
• History of pain in relation to depression, abuse, psychopathology, chemical or alcohol use
• Impact of pain on patient’s cognitive abilities.

Multidimensional Assessment
Many tools are available for an in-depth, multidimensional pain assessment. This is particularly important with patients that have chronic pain, mixed pain (both acute and chronic), or complex situations (such as multiple disease processes). Common examples of these tools include:
• Brief Pain Inventory: Provides patient input in describing pain and effects, including
psychosocial components.
• McGill Pain Questionnaire: Patients can use descriptors for their pain, which provides
information about the experience and intensity.
Common Pain Scales
There are a variety of pain scales used for pain assessment, for patients from neonates through advanced ages. The three most common scales recommended for use with pain assessment are:
• The numeric scale
• The Wong-Baker scale (also known as the FACES scale)
• The FLACC scale