Key Points

• Pain assessment needs to be individualized, comprehensive, measurable, and documented sufficiently such that all providers involved in the patient's care have a clear understanding of the patient's pain experiences.

• On a basic level, the clinician needs to characterize the type and intensity of pain. In addition, comprehensive pain assessment requires evaluation of the cognitive, emotional, and social factors influencing the pain experience. Identification of such influences of the pain experience can identify additional areas warranting treatment.

• Psychological factors influencing the pain experience can include disturbances in mood and affect, cognitive appraisals, and coping strategies.

• Social factors influencing the pain experience can include adaptive functioning, the impact of pain on interpersonal relationships, access to medical care, financial and litigation issues, and substance abuse or dependence.

• Standardized instruments allow for quantifiable assessments that, in many cases, are reproducible and reliable. Several single-dimension pain assessment instruments are available that assist with the quantification of pain severity and intensity. Use of multidimensional assessments and psychological instruments can enhance the information gathered from the clinical interview, revealing emotional, cognitive, and subsyndromal psychological factors contributing to the pain experience.

• Together, physical, psychological, and social factors can predispose one to pain, precipitate pain, augment or mitigate pain, and influence one's reactions to pain.

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