Pain gives the body warning and often is accompanied by anxiety and the need to relieve the pain. Pain is both sensation and emotion. As noted earlier, it can be acute or chronic. Health-care professionals may find the following mnemonic tool useful for assessing a client in pain:
- P = place (client points with one finger to the location of the pain)
- A = amount (client rates pain on a scale from 0 [no pain] to 10 [worst pain possible])
- I = interactions (client describes what worsens the pain)
- N = neutralizers (client describes what lessens the pain)
The scale of 0 to 10, as described in the mnemonic, is a useful method of assessing pain. Further pain assessment skills include observing the client’s appearance and activity. Monitoring the client’s vital signs may be of value in assessing acute pain but not necessarily chronic pain.
To assess the pain of children or those with some cognitive dysfunction or dementia, a “smiley face” model often proves beneficial. The first smiley face shows a happy face with no pain or hurt, whereas the last face shows pain that “hurts worst.” Individuals are asked to point to the face that describes his or her smile. Note the faces are on a numeric scale.
FIGURE. Pain assessment scales for adults and children.