City of Hope Pain & Palliative Care Resource Center

IV.   Pain and Symptom Management
        A.   Pain Assessment Tools (Also see Research Instruments)

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.

Recommended Publications

1.      Pain Assessment and Pharmacologic Management
         -     Pasero, C. & McCaffery, M. (2010). MO: St Louis, Elsevier Mosby. ISBN# 978-0-323-05696-0.
         -     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.

2.     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.
DOI: 10.3928/00989134-20100108-04.

3.      Gloth, F. M. III, Scheve, A. A., Stober, C. V., Chow, S., Prosser, J.  (2001). The Functional Pain Scale: reliability, validity and responsiveness
in an elderly population.  Journal of the American Medical Directors Association, 2(3), 110-114.  
DOI: 10.1016/S1525-8610(04)70176-0. 
 

Pain Assessment Tools

1.      CARES: A Tool for the Care of the Dying – City of Hope, Duarte, CA
         CARES:  Comfort Airway Restlessness Emotional support Self Care
         CARES printable versions (use legal size paper)
         -     CARES is acronym for Comfort, Airway, Restlessness, Emotional support, and Self care to organize the most common needs and education requirements to support the dying patient and their family.  

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.      Fast Facts and Concepts – End of Life/Palliative Education Resource Center (EPERC), Milwaukee, WI
         Over 200 Fast Facts, a PDA version and a Discussion Blog. 
         -      Neuroexcitatory Effects of Opioids: Patient Assessment, 2nd ed., #57
         -      Pseudoaddiction, 2nd ed., #69
         -      Cultural Aspects of Pain Managements, 2nd ed., #78
         -      Pediatric Pain Assessment Scales, #117
         -      Pain Assessment in the Cognitively Impaired 
         -      Opioid Poorly Responsive Cancer Pain, #215          

4.      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.

5.     Pain Assessment Packet/Chart Forms 
         -       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  
               The three pain rating scales included are:  0-10 visual analog scale, Wong-Baker Faces rating scale and the verbal scale.

6.    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.         

7.      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.        

8.      Pain Care Fast Facts: 5-Minute Clinical Inservice  - UW Health, University of Wisconsin Hospital & Clinics, Madison, WI
         -     Establishing Pain Relief Goals
         -     Insomnia Assessment and Treatment 
       -     Pain, Suffering and Spiritual Assessment
        -     What is Neuropathic Pain?

9.      Pain Management – United States Department of Veterans Affairs
         -         Clinical Tools and Resources

10.      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).

11.    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   

12.    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 with AGS Persistent Pain Guidelines, Review References   
         -      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.)