Definition
Pain assessment in adults is a multidimensional process that evaluates the intensity, quality, location, and impact of pain on function and well-being. Because pain is subjective and influenced by biological, psychological, and social factors, accurate assessment is essential for diagnosis, treatment planning, and monitoring response to therapy.
Types of Pain Scale
- Descriptive.
- Numerical.
- Visual analog scale.
Articles
Preparation of Equipment
- Pain scales-visual analog scale, descriptive, and numerical scale.
- Privacy screen as per need.
Key Dimensions of Pain Assessment
| Dimension | Description |
|---|---|
| Intensity | Severity of pain (e.g., mild, moderate, severe) |
| Location | Site(s) of pain and radiation |
| Quality | Descriptors like burning, stabbing, throbbing, aching |
| Duration | Onset, frequency, and temporal pattern (e.g., intermittent, constant) |
| Aggravating/Relieving Factors | What worsens or eases the pain |
| Impact | Effect on sleep, mood, mobility, and daily activities |
Common Pain Assessment Tools
| Tool | Description |
|---|---|
| Numeric Rating Scale (NRS) | Rate pain from 0 (no pain) to 10 (worst pain imaginable) |
| Visual Analog Scale (VAS) | Mark pain intensity on a 10 cm line |
| Verbal Descriptor Scale | Choose words like “no pain,” “mild,” “moderate,” “severe” |
| Defense and Veterans Pain Rating Scale (DVPRS) | Combines numbers, faces, and descriptors |
| McGill Pain Questionnaire | Uses 78 descriptive words to characterize pain |
| Brief Pain Inventory (BPI) | Assesses pain severity and interference with function |
Procedure
| Nursing Action | Rationale | |
| 1. | Explain the procedure to the patient. | Promotes compliance. |
| 2. | Wash hands and wear gloves if needed. | To prevent transmission of microorganisms. |
| 3. | Provide privacy if needed. | To promote a sense of well-being. |
| 4. | Ensure presence of adequate lighting. | For easy assessment. |
| 5. | Assess the level of pain using a pain scale in the following method: Assess characteristics of pain, using PQRSTU of pain assessment: Provocative/palliative factors-What makes your pain better or worse? Quality-Tell me what your pain feels like? Region and radiation-Show me where your pain is. Where is the pain spreading to? Severity-Using a pain intensity scale appropriate to the patient’s age, developmental level, and comprehension, ask the patient to rate pain; it has to be rated in descriptive and numerical scale for adults and visual analog for children. Timing-Ask the patient if pain is constant, intermittent, and continuous, or a combination. Ask the patient, “How is the pain affecting you (U)”? | For pain management. |
| 6. | Ask the remedial nonpharmacological and pharmacological measures taken at home and in the hospital. | To decide the care to be given and to avoid duplication of care. |
| 7. | Mark it in the pain assessment form. | Serves as an evidence for the care. |
| 8. | Perform hand hygiene and discard gloves, if used. | Reduces transmission of infection. |
Special Considerations
- Older Adults: May underreport pain due to stoicism or cognitive impairment. Use verbal descriptors or PAINAD scale when needed.
- Nonverbal Patients: Use behavioral tools like FLACC or CPOT to assess facial expression, movement, and vocalization.
- Cultural Sensitivity: Recognize that pain expression and tolerance vary across cultures—tailor communication accordingly.
- Chronic vs. Acute Pain: Chronic pain requires assessment of emotional and functional impact, not just intensity.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
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