O: Onset
When did it begin? How long does it last? How often does it occur?
See Onset Guide P: Precipitating & Alleviating Factors
What brings it on? Makes it better? Worse?
Q: Quality
What does it (pain) feel like?
R: Region & Radiation
Where is it (the pain)? Does it (the pain) spread anywhere?
S: Severity
What is the intensity of this symptom? Is a pain/symptom rating scale being used (e.g. on a scale of 0 to 10 with 0 being none and 10
being worst possible)? Average, worst, best scores? How bothered are they by this symptom?
T: Timing/Treatment
Current treatments and efficacy? Timing of symptom?
U: "How is the pain affecting you?"
What does the person believe is causing this symptom? How is it affecting them?
V: Values - What is the acceptable level for this symptom?
What is the person’s comfort goal or acceptable level for this symptom?
Other Assessment Tool Used:
*Cognitively Impaired Only
Most recent scores from observational tool used (e.g. PainAD) and dates completed:
*Cognitively Impaired Only
Any other results/findings of assessment:
*Cognitively Impaired Only
