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III. Pain and Symptom Management
A. Pain Assessment Tools
(Also see Research
Instruments)
This section includes various
tools to assess pain and its management. Specifically, pocket
reference cards, rating scales, assessment packets, chart forms,
database tools, home health flow sheets, chart documentation
packets, and tools for infant and pediatric pain assessment are
among the resources available.
1.
Advanced Practice
Nursing (APN) Toolkit
- The
APN toolkit contains a compendium of tools used in APN related research.
The measurement instruments listed on this website have been organized
according to the Participatory,
Evidence-based, Patient-focused
Process, for guiding the development,
implementation, and evaluation of Advanced
practice nursing (PEPPA) framework.
2.
Communication Cards for Patients and Their Care Team, City of Hope, Duarte,
CA
-
Pain assessment tools include phrases in
English, Spanish, Chinese, Armenian and Korean.
3.
Pain Care Fast Facts: 5-Minute
Clinical Inservice - UW Health, Madison, WI
-
Establishing Pain Relief Goals
-
Insomnia Assessment and Treatment
-
Pain, Suffering and Spiritual Assessment
4.
Fact Sheets – International Association for the Study of Pain (IASP)
- Assessment
of Cancer Pain
5.
Home Health Pain Management Flow Sheet - University of Wisconsin Hospitals &
Clinics, Madison, WI
- A one-page pain management flow sheet to
be used in the home care setting.
6.
Pain Scales in
Multiple Languages
- The British Pain Society
has produced a series of pain scales
in multiple languages (Albanian, Arabic, Bengali, Chinese (simplified), Chinese
(traditional), Greek, Gujurati, Hindi, Polish, Punjabi, Somali, Swahili,
Turkish, Urdu, Vietnamese, and Welsh).
7.
Veterans
Affairs Pain Management - United States Department of Veterans Affairs
-
Chronic Pain Primer
-
Pain
as 5th Vital Sign Toolkit
-
Pain Outcomes Toolkit
-
Pain
Outcomes Questionnaire
8.
Pain Assessment Packet/Chart
Forms
-
Initial Pain Assessment Tool
- Margo McCaffery, RN, MS, FAAN and Alexandra Beebe, RN, MS, OCN
- a charting form to be used on the patient's initial hospital admission to
document location, intensity, quality of pain, and relief.
-
Nursing
Assessment and Care Plan - City of Hope, Duarte, CA -
comprehensive pain assessment tool for use in initial evaluation of patients
referred to a pain service
- Pain Rating Scales
- InteliHealth - three pain rating scales
included are: 0-10 visual analog scale, Wong-Baker Faces rating scale and the
verbal scale.
9. Pain
Assessment Packet/Chart Forms - Dartmouth-Hitchcock Medical Center, Lebanon, NH
-
Initial Pain Rating Tool & Pain Flow Sheet
-
Post-Operative Pain Management Needs Assessment
10. Pain
Assessment Packet/Chart Forms - Via Christi Regional Medical Center - St.
Francis Campus, Wichita, Kansas
-
Initial Pain Assessment
for Pediatric Use
-
Initial Pain Assessment
for Adult Use
-
Pain
Flow Sheet for Adults and Pediatrics - one-page documentation
form to record pain assessment and management.
11. Pain
Assessment Tools - Pain Treatment Topics, Glenview, IL
-
Pain
scales and checklists offered are useful for clinically assessing how intensely
patients are feeling pain and for monitoring the effectiveness of treatments at
different points in time. These pain management
tools
are
designed for different age groups, as well as individuals who do not speak
English and/or cannot verbalize responses.
12. Pain Management Tools
-
Bedside Pain Manager
-
Pain Assessment Guide
-
Pain Management Pocket Tool
-
SCCPI
Equianalgesic Pocket Card
13.
Pain Rating Instrument - Johns Hopkins University, Baltimore,
MD
- American
Society of Clinical Oncology (ASCO) permits users to download and make
presentation slides of this instrument for personal and educational use.
-
Feasibility
of Quantitative Pain Assessment in Outpatient Oncology Practice - Journal of
Clinical Oncology
14.
Psychosocial Pain Assessment Form
- City of Hope, Duarte, CA
- Developed by
Shirley Otis-Green, MSW, LCSW. This 8-page assessment and guided interview form measures the impact of pain
on five domains; economics, social support, activities of daily living, emotional
problems, and coping behaviors as perceived by the interviewer, patient and
significant other.
Psychosocial Pain Assessment Forms in Spanish (for adults and
children/adolescents):
-
Formulario de Análisis Psicosocial del
Dolor Para Adultos
-
Formulario de Analisis
Psicosocial del Dolor Para Nińos y
Adolescentes
15. State of the Art Review of Tools for
Assessment of Pain in Nonverbal Older Adults (New Tools Added)
-
Overview
-
Criteria for Evaluation
-
Comparison Grid
-
Comparison of Tool Items
-
Review References
-
Detailed
Information or Brief Summaries
Tools:
-
Abbey Pain Scale
(Abbey, J., et al.)
-
Assessment
of Discomfort in Dementia
(ADD) Protocol, (Kovach, C.R., et al.)
-
Certified Nurse Assistant Pain
Assessment Tool (CPAT) (Cervo, F., et al.)
-
Checklist of Nonverbal Pain
Indicators (CNPI), (Feldt, K.)
-
Disability Distress
Assessment Tool (Dis DAT) (Regnard, D., et al.)
-
Discomfort Behavior Scale
(DBS) (Stevenson, K.)
-
Discomfort Scale-Dementia of the Alzheimer’s Type (DS-DAT), (Hurley, A., et al.)
-
Doloplus 2, (Wary, B.)
-
Elderly Pain Caring Assessment 2
(EPCA-2) (Morello, R., et al.)
-
Face, Legs, Activity, Cry
and Consolability Pain Assessment Tool (the FLACC), (Merkel, S.I., et al.)
-
Mobilization-Observation-Behavior-Intensity-Dementia Pain Scale (MOBID) (Husebo,
B.S., et al.)
-
Nursing Assistant-Administered Instrument to Assess Pain in Demented Individuals
(NOPPAIN), (Snow, A.L., et al.)
-
Pain Assessment in Advanced Dementia
(PAINAD)
Scale, (Warden, V., et al.)
-
Pain Assessment for the Dementing Elderly (PADE), (Villaneuva, M.R., et al.)
-
Pain Assessment in
Noncommunicative Elderly Persons (PAINE) (Cohen-Mansfield, J., et al.)
-
Pain
Assessment Scale for Seniors with Severe Dementia (PACSLAC),
(Fuchs-Lacelle, S.K., et al.)
-
Pain Behavior for Osteoarthritis
Instrument for Cognitively Impaired Elders (PBOICIE) (Tsai, P., et al.)
17.
Survivorship Needs Assessment Tools
Survivorship Care Summary/Plan
-
American Society of Clinical Oncology (ASCO) Cancer Treatment
Plan & Summary
-
Journey Forward Survivorship Care Plan Builder
-
Livestrong Care Plan - Penn Medicines Oncolink
-
NCI Community Cancer Centers Program (NCCCP) Breast Cancer
Survivorship Care Plan
Survivorship Needs Assessments
-
Cancer Survivors Survey of Needs - Mayo Clinic Cancer Center
- Transition
Plan for Cancer Survivors: Survey of Needs - Pearlman Cancer
Center, Adapted from Mayo Clinic Cancer Center
-
Survivor Needs Assessment (English) - St. Luke's Hospital
and Health Network
-
Survivor
Needs Assessment (Spanish) - St. Luke's Hospital and Health
Network
- Survivor
Assessment Tool (Patient) - University of Tennessee Medical
Center Cancer Institute
-
Survivor
Assessment Tool (Physician) - University of Tennessee
Medical Center Cancer Institute
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| Website last modified: June 22, 2009 |
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