Pain Assessment

Pain is prevalent and undertreated in the palliative care setting, contributing significantly to patient discomfort and suffering at the end of life. Pain assessment is the cornerstone to evidence-based pain management strategies. However, multiple barriers to pain assessment persist. Patients should be routinely screened for pain on admission to a hospital, clinic, long-term care facility, hospice, or home care setting. If new, persistent, or worsening pain exists, comprehensive pain assessment and reassessment is crucial and includes a detailed history (including substance abuse or misuse), a comprehensive physical examination, and patient self-report of pain, whenever possible. In the absence of patient self-report of pain, observing for nonverbal pain behaviors using reliable and valid assessment instruments is appropriate. Nurses and healthcare providers should follow the hierarchy of a pain assessment framework to guide pain assessment approaches.