Palliative Care Assessment: Psychosocial Pain Assessment Form

This tool was designed to standardize a comprehensive psychosocial pain assessment for an interdisciplinary pain service. Through the use of a guided interview process, the clinician explores the impact of unrelieved pain on the patient/family experience in the following domains: Economic, Social, Support, Activities of Daily Living, Emotional Impact, and Coping Style.

Contact Shirley Otis-Green with any questions regarding usage.