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-

      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 thenursing home: Expert consensus recommendations for practice. Journal of Gerontological Nursing, 36(3), 18-29. DOI: 10.3928/00989134-20100108-04.
Pain Assessment Tools
  1. Communication Cards for Patients and Their Care Team - City of Hope, Duarte, CA
     -  Pain assessment tools include phrases in
        English, Spanish, Chinese, Armenian and

  2. Fast Facts and Concepts – Palliative Care Newtwork of Wisconsin (PCNOW)  Over 200 Fast Facts, a PDA version and a Discussion Blog.  
    Cultural Aspects of Pain Managements, 
          2nd ed., #78

    Establishing Pain Relief Goals
       - Insomnia Assessment and Treatment  

    Pain Assessment in the Cognitively
    Pain, Suffering and Spiritual Assessment
       - Pediatric Pain Assessment Scales, #117
    Pseudoaddiction, 2nd ed., #69       
    What is Neuropathic Pain

    Get the Fast Facts App
    iPhone (iTunes)
    -   Android (Google Play)
  3. 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.
  4. 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
  5. Pain Assessment Packet/Chart Forms - Dartmouth-Hitchcock Medical Center, Lebanon, NH
    Initial Pain Rating Tool & Pain Flow
    Post-Operative Pain Management Needs
    A tool to assess the nurse’s
          knowledge and attitude regarding pain
  6. Pain Management – United States Department of Veterans Affairs
         -  Clinical Tools and Resources
  7. 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).
  8. Psychosocial Pain Assessment Form - City of Hope, Duarte, CA
    - Developed by Shirley Otis-Green, MSW,
       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
    Formulario de Análisis Psicosocial del
             Dolor Para Adultos
           - Formulario de Analisis Psicosocial del
             Dolor Para Niños y Adolescentes    
  9. 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,Review References
         -   Criteria for Evaluation 
    Comparison Grid 
    Comparison of Tool Items
         -   Review References
         -   Detailed Information or Brief


         -  Abbey Pain Scale (Abbey, J., et al.)
    -   Assessment of Discomfort in
             Protocol, (Kovach, C.R., et al.)
    Certified Nurse Assistant Pain
            Assessment Tool (CPAT) (Cervo, F., et

       Checklist of Nonverbal Pain Indicators 
    , (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.)

               Intensity- Dementia Pain Scale 
               (MOBID) (Husebo, B. S., et al.)

       Nursing Assistant-Administered
               Instrument to Assess Pain in    
               Demented Individuals
    (Snow, A. L., et al.)

    -   Pain Assessment in Advanced
     (PAINAD) Scale, (Warden,
              V., et al.)

    -  Pain Assessment for the Dementing
     (PADE), (Villaneuva, M.R., et

    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.)

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