Approaches to Pain Assessment

NON-SELF-REPORT MEASUREMENT Respiratory and cardiovascular changes as well as changes in patient expression and movement can all occur due to pain. However, factors other than pain can cause or inhibit the same changes, making interpretation difficult. Physiologic parameters may be more useful to confirm a clinical impression than as a primary assessment tool. The more developed non-self-report tools are used in the pediatric setting. (See Chap 130.)

SELF-REPORT MEASUREMENT Self-report measurement scales include numerical or adjective ratings and visual analogue scales. These tools may also be used simply by asking the patient for a verbal response. Small changes in pain severity may not have clinical importance. For example, with a 100-mm visual analogue scale, a change in severity of less than 13 mm has statistical but minimal clinical significance.

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