Pain Assessment Tools: Is the Content Appropriate for Use in Palliative Care?

Jacob Chr Hølen, Marianne Jensen Hjermstad, Jon Håvard Loge, Peter M. Fayers, Augusto Caraceni, Franco De Conno, Karen Forbes, Carl Johan Fürst, Lukas Radbruch, Stein Kaasa

Research output: Contribution to journalArticle

Abstract

Inadequate pain assessment prevents optimal treatment in palliative care. The content of pain assessment tools might limit their usefulness for proper pain assessment, but data on the content validity of the tools are scarce. The objective of this study was to examine the content of the existing pain assessment tools, and to evaluate the appropriateness of different dimensions and items for pain assessment in palliative care. A systematic search was performed to find pain assessment tools for patients with advanced cancer who were receiving palliative care. An ad hoc search with broader search criteria supplemented the systematic search. The items of the identified tools were allocated to appropriate dimensions. This was reviewed by an international panel of experts, who also evaluated the relevance of the different dimensions for pain assessment in palliative care. The systematic literature search generated 16 assessment tools while the ad hoc search generated 64. Ten pain dimensions containing 1,011 pain items were identified by the experts. The experts ranked intensity, temporal pattern, treatment and exacerbating/relieving factors, location, and interference with health-related quality of life as the most important dimensions. None of the assessment tools covered these dimensions satisfactorily. Most items were related to interference (231) and intensity (138). Temporal pattern (which includes breakthrough pain), ranked as the second most important dimension, was covered by 29 items only. Many tools include dimensions and items of limited relevance for patients with advanced cancer. This might reduce compliance and threaten the validity of the assessment. New tools should reflect the clinical relevance of different dimensions and be user-friendly.

Original languageEnglish
Pages (from-to)567-580
Number of pages14
JournalJournal of Pain and Symptom Management
Volume32
Issue number6
DOIs
Publication statusPublished - Dec 2006

Fingerprint

Pain Measurement
Palliative Care
Breakthrough Pain
Pain
Compliance
Neoplasms
Quality of Life
Therapeutics

Keywords

  • cancer
  • clinical practice
  • Pain
  • pain measurement
  • palliative care
  • palliative medicine

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology
  • Neurology
  • Nursing(all)

Cite this

Pain Assessment Tools : Is the Content Appropriate for Use in Palliative Care? / Hølen, Jacob Chr; Hjermstad, Marianne Jensen; Loge, Jon Håvard; Fayers, Peter M.; Caraceni, Augusto; De Conno, Franco; Forbes, Karen; Fürst, Carl Johan; Radbruch, Lukas; Kaasa, Stein.

In: Journal of Pain and Symptom Management, Vol. 32, No. 6, 12.2006, p. 567-580.

Research output: Contribution to journalArticle

Hølen, JC, Hjermstad, MJ, Loge, JH, Fayers, PM, Caraceni, A, De Conno, F, Forbes, K, Fürst, CJ, Radbruch, L & Kaasa, S 2006, 'Pain Assessment Tools: Is the Content Appropriate for Use in Palliative Care?', Journal of Pain and Symptom Management, vol. 32, no. 6, pp. 567-580. https://doi.org/10.1016/j.jpainsymman.2006.05.025
Hølen, Jacob Chr ; Hjermstad, Marianne Jensen ; Loge, Jon Håvard ; Fayers, Peter M. ; Caraceni, Augusto ; De Conno, Franco ; Forbes, Karen ; Fürst, Carl Johan ; Radbruch, Lukas ; Kaasa, Stein. / Pain Assessment Tools : Is the Content Appropriate for Use in Palliative Care?. In: Journal of Pain and Symptom Management. 2006 ; Vol. 32, No. 6. pp. 567-580.
@article{5f6eef91121e4bfb90328c68d2720660,
title = "Pain Assessment Tools: Is the Content Appropriate for Use in Palliative Care?",
abstract = "Inadequate pain assessment prevents optimal treatment in palliative care. The content of pain assessment tools might limit their usefulness for proper pain assessment, but data on the content validity of the tools are scarce. The objective of this study was to examine the content of the existing pain assessment tools, and to evaluate the appropriateness of different dimensions and items for pain assessment in palliative care. A systematic search was performed to find pain assessment tools for patients with advanced cancer who were receiving palliative care. An ad hoc search with broader search criteria supplemented the systematic search. The items of the identified tools were allocated to appropriate dimensions. This was reviewed by an international panel of experts, who also evaluated the relevance of the different dimensions for pain assessment in palliative care. The systematic literature search generated 16 assessment tools while the ad hoc search generated 64. Ten pain dimensions containing 1,011 pain items were identified by the experts. The experts ranked intensity, temporal pattern, treatment and exacerbating/relieving factors, location, and interference with health-related quality of life as the most important dimensions. None of the assessment tools covered these dimensions satisfactorily. Most items were related to interference (231) and intensity (138). Temporal pattern (which includes breakthrough pain), ranked as the second most important dimension, was covered by 29 items only. Many tools include dimensions and items of limited relevance for patients with advanced cancer. This might reduce compliance and threaten the validity of the assessment. New tools should reflect the clinical relevance of different dimensions and be user-friendly.",
keywords = "cancer, clinical practice, Pain, pain measurement, palliative care, palliative medicine",
author = "H{\o}len, {Jacob Chr} and Hjermstad, {Marianne Jensen} and Loge, {Jon H{\aa}vard} and Fayers, {Peter M.} and Augusto Caraceni and {De Conno}, Franco and Karen Forbes and F{\"u}rst, {Carl Johan} and Lukas Radbruch and Stein Kaasa",
year = "2006",
month = "12",
doi = "10.1016/j.jpainsymman.2006.05.025",
language = "English",
volume = "32",
pages = "567--580",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Pain Assessment Tools

T2 - Is the Content Appropriate for Use in Palliative Care?

AU - Hølen, Jacob Chr

AU - Hjermstad, Marianne Jensen

AU - Loge, Jon Håvard

AU - Fayers, Peter M.

AU - Caraceni, Augusto

AU - De Conno, Franco

AU - Forbes, Karen

AU - Fürst, Carl Johan

AU - Radbruch, Lukas

AU - Kaasa, Stein

PY - 2006/12

Y1 - 2006/12

N2 - Inadequate pain assessment prevents optimal treatment in palliative care. The content of pain assessment tools might limit their usefulness for proper pain assessment, but data on the content validity of the tools are scarce. The objective of this study was to examine the content of the existing pain assessment tools, and to evaluate the appropriateness of different dimensions and items for pain assessment in palliative care. A systematic search was performed to find pain assessment tools for patients with advanced cancer who were receiving palliative care. An ad hoc search with broader search criteria supplemented the systematic search. The items of the identified tools were allocated to appropriate dimensions. This was reviewed by an international panel of experts, who also evaluated the relevance of the different dimensions for pain assessment in palliative care. The systematic literature search generated 16 assessment tools while the ad hoc search generated 64. Ten pain dimensions containing 1,011 pain items were identified by the experts. The experts ranked intensity, temporal pattern, treatment and exacerbating/relieving factors, location, and interference with health-related quality of life as the most important dimensions. None of the assessment tools covered these dimensions satisfactorily. Most items were related to interference (231) and intensity (138). Temporal pattern (which includes breakthrough pain), ranked as the second most important dimension, was covered by 29 items only. Many tools include dimensions and items of limited relevance for patients with advanced cancer. This might reduce compliance and threaten the validity of the assessment. New tools should reflect the clinical relevance of different dimensions and be user-friendly.

AB - Inadequate pain assessment prevents optimal treatment in palliative care. The content of pain assessment tools might limit their usefulness for proper pain assessment, but data on the content validity of the tools are scarce. The objective of this study was to examine the content of the existing pain assessment tools, and to evaluate the appropriateness of different dimensions and items for pain assessment in palliative care. A systematic search was performed to find pain assessment tools for patients with advanced cancer who were receiving palliative care. An ad hoc search with broader search criteria supplemented the systematic search. The items of the identified tools were allocated to appropriate dimensions. This was reviewed by an international panel of experts, who also evaluated the relevance of the different dimensions for pain assessment in palliative care. The systematic literature search generated 16 assessment tools while the ad hoc search generated 64. Ten pain dimensions containing 1,011 pain items were identified by the experts. The experts ranked intensity, temporal pattern, treatment and exacerbating/relieving factors, location, and interference with health-related quality of life as the most important dimensions. None of the assessment tools covered these dimensions satisfactorily. Most items were related to interference (231) and intensity (138). Temporal pattern (which includes breakthrough pain), ranked as the second most important dimension, was covered by 29 items only. Many tools include dimensions and items of limited relevance for patients with advanced cancer. This might reduce compliance and threaten the validity of the assessment. New tools should reflect the clinical relevance of different dimensions and be user-friendly.

KW - cancer

KW - clinical practice

KW - Pain

KW - pain measurement

KW - palliative care

KW - palliative medicine

UR - http://www.scopus.com/inward/record.url?scp=33845344038&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845344038&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2006.05.025

DO - 10.1016/j.jpainsymman.2006.05.025

M3 - Article

C2 - 17157759

AN - SCOPUS:33845344038

VL - 32

SP - 567

EP - 580

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

IS - 6

ER -