CHAPTER 2: ASSESSMENT OF PAIN IN THE PATIENT WITH CANCER

Recommendations

7. Health professionals should ask about pain, and the patient's self-report should be the primary source of assessment (B). 8. Clinicians should assess pain with easily administered rating scales and should document the efficacy of pain relief at regular intervals after starting or changing treatment. Documentation forms should be readily accessible to all clinicians involved in the patient's care(Panel Consensus). 9. Clinicians should teach patients and their families to use assessment tools in their homes in order to promote continuity of effective pain management across all settings (Panel Consensus). 10. The initial evaluation of pain should include:

A detailed history, including an assessment of pain intensity and characteristics.

A physical examination.

A psychosocial assessment.

A diagnostic evaluation of signs and symptoms associated with the common cancer pain syndromes (Panel Consensus).

11. Clinicians should be aware of common pain syndromes: this prompt recognition may hasten therapy and minimize the morbidity of unrelieved pain (B). 12. Changes in pain patterns or the development of new pain should trigger a diagnostic evaluation and modification of the treatment plan (Panel Consensus).

Assessment of pain in the cancer patient is imperative for all health care professionals because failure to assess pain can lead to its undertreatment. The critical role of the assessment of cancer pain was highlighted in a 1993 study of 897 oncologists who, collectively in the previous 6 months, had managed more than 70,000 cancer patients. According to these physicians, poor pain assessment was the greatest barrier to effective cancer pain management in their own practices (Von Roenn, Cleeland, Gonin, et al., 1993). Because of the multiple possible causes of pain, careful evaluation of pain is required.

Related Chunks

Overview

Suffering, Loss of Control, and Quality of Life

Barriers to Effective Pain Management

Initial Pain Assessment

Initial Pain Assessment.

Ongoing Pain Assessment

Under development

MONITORING THE QUALITY OF PAIN MANAGEMENT

Index