IV. Pain and Symptom Management
A. Pain Assessment Tools
This section includes various
tools to assess pain. 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.
Pain Assessment and Pharmacologic Management
C. & McCaffery, M. (2010). MO: St Louis, Elsevier Mosby. ISBN#
Section II: Assessment, particularly
Chapter 3: Assessment Tools. Forms, checklists, tips, and strategies for
assessing acute and chronic pain, nociceptive and neuropathic pain, pain in
adults, children, infants, cognitively impaired persons, and persons who cannot
self-report. Many tools for a variety of populations in English and several
other languages. Fifteen pages of references at the end of the section.
Herr, K., Bursch, H., Ersek, M.,
Miller, L. L., Swafford, K. (2010).
Use of pain-behavioral
assessment tools in the
nursing home: Expert consensus
recommendations for practice. Journal of Gerontological
Nursing, 36(3), 18-29.
F. M. III, Scheve, A. A., Stober, C. V., Chow, S., Prosser, J.
The Functional Pain Scale: reliability,
in an elderly population. Journal of the
American Medical Directors Association, 2(3), 110-114.
Pain Assessment Tools
Communication Cards for Patients and Their Care Team - City of Hope, Duarte,
Pain assessment tools include phrases in
English, Spanish, Chinese, Armenian and Korean.
and Concepts – End of Life/Palliative Education Resource Center (EPERC),
Over 200 Fast Facts, a PDA version and a Discussion Blog.
Aspects of Pain Managements, 2nd ed., #78
- Establishing Pain Relief Goals
Insomnia Assessment and Treatment
in the Cognitively Impaired #126
- Pain, Suffering and Spiritual Assessment
Pain Assessment Scales, #117
2nd ed., #69
is Neuropathic Pain?
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.
Pain Assessment Packet/Chart Forms
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
The three pain rating scales included are: 0-10 visual
analog scale, Wong-Baker Faces rating scale and the verbal scale.
5. Pain Assessment Packet/Chart
Forms - Dartmouth-Hitchcock Medical Center, Lebanon, NH
Initial Pain Rating Tool & Pain Flow Sheet
Post-Operative Pain Management Needs Assessment
A tool to assess the nurse’s
knowledge and attitude regarding pain management.
Pain Management –
United States Department of Veterans Affairs
- Clinical Tools and Resources
Pain Scales in
- 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).
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
Psychosocial Pain Assessment Forms in Spanish (for adults and
Formulario de Análisis Psicosocial del
Dolor Para Adultos
Formulario de Analisis
Psicosocial del Dolor Para Nińos y
State of the
Art Review of Tools for Assessment of Pain in Nonverbal Older Adults (New Tools Added)
Criteria for Evaluation, Comparison
Grid, Comparison of Tool Items with AGS Persistent Pain Guidelines,
Criteria for Evaluation
Comparison of Tool Items
Abbey Pain Scale
(Abbey, J., et al.)
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.)
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
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.)
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.)
Website last modified:
December 15, 2014