PAIN / SYMPTOM ASSESSMENT
HISTORY FOR EACH PAIN / SYMPTOM 1.Location 2.Description Nociceptive, e.g., aching, throbbing Neuropathic, e.g., burning, shooting, stabbing, electrical Associated radiation, numbness, allodynia, hyperalgesia Mixed 3.Change over time (Temporal Profile)
BEHAVIORAL CHANGES Activities, eating, sleeping, thinking, mood
PSYCHOLOGICAL, SOCIAL, SPIRITUAL FACTORS Anxiety, depression Family or other social stresses, burdens Meaning and value, why me?
Constant
Breakthrough
Intermittent Acute
ON EXAMINATION At rest, on movement, on palpation
4. Severity (0‒10) 5.Effect of medications, other therapies Beneficial, adverse / side effects
6 NB: These Reference Cards do not replace careful clinical judgment specific to each patient / family situation. PCIC: Palliative Care Interdisciplinary Curriculum is a collaborative effort of OhioHealth, The Ohio State University Wexner Medical Center, and Nationwide Children’s Hospital in Columbus, Ohio, USA, and other contributors. Permission to reproduce any or all of these PCIC Reference Cards is granted for non-commercial educational purposes only, provided that the attribution statement and copyright are displayed. To reproduce for all other purposes, contact Frank D. Ferris at info@pallmed.us. Copyright © Frank D Ferris 2013-2024. All rights reserved. V14.1, 2024
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