Performing PQRST Pain Assessment: Explained

Why is the PQRST Pain Assessment Important?

Pain is subjective, meaning it’s experienced and described differently by each individual. The PQRST pain assessment ensures that healthcare professionals gather complete, standardized information. This method also helps patients feel heard and understood, improving communication between them and their caregivers.

PQRST Pain Assessment:

A systematic approach to assess pain, utilizing the PQRST mnemonic:

P – Provocation/Palliation

This step focuses on finding out what makes the pain better or worse.

1. What were you doing when the pain started?
2. Does anything make the pain feel better (resting, medications)?
3. Does anything make the pain worse (movement, stress, certain activities)?
4. Have you taken any medication or treatment for the pain? Did it help?

Q – Quality/Character

In this step, you ask the patient to describe what their pain feels like. This helps healthcare professionals understand the type of pain and its characteristics.

1. Describe the pain (e.g., sharp, dull, burning, aching).
2. Is it constant or intermittent?
3. Are there any triggers or exacerbating factors?

R – Radiate/Region

This element focuses on the location of the pain and whether it radiates to other areas of the body.

1. Does the pain radiate to other areas?
2. Are there any referred pain patterns (e.g., arm pain from cardiac origin)?
3. Identify any associated symptoms (e.g., numbness, tingling).

S – Severity

Here, you assess the intensity of the pain. One of the most common ways to measure this is by asking the patient to rate their pain on a scale of 0 to 10, with 0 meaning no pain and 10 meaning the worst possible pain.

1. Measure pain intensity using a scale (e.g., 0-10, Faces Pain Scale).
2. Assess pain impact on daily activities.
3. Evaluate pain changes over time.

T – Timing/Treatment

This step focuses on the duration of the pain—how long it has been present and how it changes over time.

1. When did the pain start?
2. How long does it last?
3. What triggers or relieves the pain?
4. Current pain management strategies.

Advantages of Using the PQRST Pain Assessment

1. Standardized Approach: The PQRST method gives healthcare providers a consistent way to evaluate pain across different patients and conditions.
2. Better Communication: The structured approach ensures patients are asked important questions, improving communication between healthcare providers and patients.
3. Improved Treatment: By thoroughly understanding a patient’s pain, doctors and nurses can make more informed decisions about medications, therapies, or further diagnostic tests.
4. Monitoring Progress: The PQRST method allows healthcare providers to monitor changes in pain over time, assessing whether treatments are effective.

Pain Assessment Scales:

How to Document the PQRST Pain Assessment

Once you’ve gathered this insightful information, it’s essential to document it correctly and thoroughly in your patient’s medical chart.

Remember, pain is subjective and can vary greatly from one person to another:

• Jot down the specific answers to each of the PQRST questions, making sure to note your patient’s own words whenever possible.
• Did the patient understand how to rate their pain using the 0-10 pain scale?
• Is the treatment modality working? Has the pain score decreased after treatment? By how much per patient report?
• When did you reassess your patient’s pain after treatment? Was it timely?
• Did you communicate your patient’s response or non-response accurately to the physician? In a timely fashion?
• Did you educate your patient about what to expect and how to communicate to you about their response to treatment?

REFERENCES

1. Editorial Team A. PQRST Pain Assessment. Melbourne (VIC): Ausmed [Internet]; 2019 June 22 [cited 2025 January 2]. Available from: [https://www.ausmed.com.au/learn/explainers/pqrst-pain-assessment].
2. IASP Announces Revised Definition of Pain. https://www.iasp-pain.org/publications/iasp-news/iasp-announces-revised-definition-of-pain/.
3. Practice and reflection on the management mode of pain quality control in emergency pre-check and triage. https://apm.amegroups.org/article/view/45380/html.
4. The PQRST Pain Scale Guide – SimpleNursing. https://simplenursing.com/pqrst-pain/.
5. Pain Assessment – StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK556098/.

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