Pain Assessment continued

Pain is unique, personal and subjective.

Pain perceptions includes the patient’s self-report and the pain assessment itself – this accomplishes the healthcare provider’s assessment.

Perception is to become aware in one’s mind

pain perception is influenced by:

  •  cognitive and emotional processes
  • by what the individual feels and thinks of their present and future pain
  • meaning or reason for their pain
  • individual’s coping pattern or locus of control
  • the presence of additional symptoms
  • other concerns or emotional distress
Assessment is the act of evaluating, appraising or estimating.
The healthcare professional’s assessment of a patient’s pain is most useful when the assessor is:

  • completely patient focused
  • listens empathetically
  • maintains open communication
  • validates and legitimizes the concerns of the patient and significant others
In essence the clinician’s understanding of the patient’s pain and accompanying symptoms confirms that there is a genuine personal interest in facilitating a positive pain management outcome.
Total pain occurs when the patient is experiencing not only physical but psychologically, socially and spiritually.
Pain may be a triplet component experience:
  1. The sensory/discriminative – selection and modulation of pain sensation
  2. Motivational/affective – affective reactions to pain via the brain’s reticular formation and limbic system
  3. The cognitive – past or present pain experiences
Cultural theories –
different ethnic have different cultural experiences, attitudes, and meanings for pain. These may affect pain perception, assessment, tolerance and neurophysiological, psychological and behavioral responses.
Environmental theories –
Environmental components, referring to the setting, environmental conditions, or stimuli affect pain assessment and management. Excessive noise, lighting or adverse temperatures may be sources of stress for individuals in pain and may negatively affect the pain experience.
Pain assessment scales
Visual Analogue Scale – X marked by patient indicative of pain intensity experienced
Numeric Rating Scale – rated 0-10
Verbal descriptor scale – descriptors are given a number.
Faces/Wong-Baker Scale – cartoon faces descriptive of pain, typically used in pediatrics
Pain thermometer

Ferrel, B. R., & Coyle, N. (Eds.). (2010). Oxford textbook of palliative nursing (3rd ed.). New York: Oxford University Press.

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