Pain is a subjective and complex experience, and it is important for all healthcare professionals to evaluate the pain accurately. Accurately evaluating the pain will ensure proper and effective treatment of the patient. One of the most effective methods that is used to evaluate pain is PQRST pain assessment.
What is PQRST pain assessment and medical abbreviation?
First, we will discuss the PQRST medical abbreviation.
P = Provocation/ Palliation
Q= Quality
R= Region
S= Severity
T= Timing
Understanding all these areas of inquiry helps medical healthcare professionals to make comprehensive treatment plans for patients. The pain assessment acronym PQRST helps healthcare providers to collect information on the patient’s pain.
What does PQRST stand for?
The PQRST scale is used to get detailed information about the pain of the patient. Now, let’s discuss what each letter stands for in detail.
Provocation or Palliation
Provocation:
It refers to what triggers the pain or what makes it worse.
Questions asked:
- What activities make your pain worse?
- What things increase your pain, such as certain movements or positions?
- Do you experience pain all the time or during certain times after an activity?
Example of Provocation:
Patients with chronic back pain might answer this question by saying that the pain increases after prolonged sitting or during heavy lifting.
Palliation:
Palliation refers to what makes the pain better or what relieves the pain.
Questions asked:
- What makes your pain more bearable?
- Any activities, medications, or exercise that ease your pain?
- What positions make you feel more comfortable or ease your pain?
Example of palliation:
Patients with back pain might answer these questions by saying that lying down and applying heat eases the pain. This might indicate that pain is muscle-related and not spine-related.
Quality
In the acronym PQRST of pain assessment, the letter Q stands for Quality. Understanding the quality of pain is also an important part of pain assessment. This indicates the description of the pain.
Questions asked:
What does the pain feel like? This quality of pain can be described by the following:
- Sharp or stabbing pain.
- Dull, aching, or throbbing pain.
- Burning pain.
- Tingling pain or pin or needles type pain.
- Cramp-like pain.
Sharp or stabbing pain:
This indicated that the pain is intense and localized and it feels like someone stabbed or cut you. For example, sciatica nerve pain or acute injury like muscle tear.
Throbbing pain:
Less intense than sharp pain and feels like a constant throbbing sensation. For example, a patient with dull, aching pain in the knee after walking may indicate osteoarthritis.
Burning pain:
The next type or quality of pain is burning pain or sensation. This means that the area is hot. For example, nerve damage, burns, or infections may give a burning sensation.
Tingling pain:
This pain means feeling like pins or needles or a tingling sensation. This can be caused due to nerve compression or poor circulation.
Cramp like pain:
This type of pain comes in waves. One time, you are in pain and the other time, you are feeling fine. An example is pain during periods, also known as period cramps.
Region
In the PQRST pain assessment, the letter R stands for the region. This means to indicate where the pain is located. It is also a crucial step in pain assessment. The region of pain can be localized, which means at one place or it can be generalized which means spread over a larger area.
Questions asked:
- Where is the pain located?
- Is the pain in a specific area or the pain spread?
Localized pain: localized pain indicates that the pain is located in one area such as a specific tissue or organ. An example of localized pain can be the pain in the abdomen might indicate an appendix issue.
Generalized pain: If the pain is spreading then this might indicate that the issue is more serious such as generalized inflammation or Fibromyalgia.
Severity
In the PQRST medical abbreviation, the letter S stands for the severity of the pain. Understanding the severity of pain and how it affects a patient’s daily routine is an important aspect of pain assessment.
Questions asked:
- How intense or severe is your pain?
- Can you describe the intensity of your pain? From the following.
There are several types of methods to describe the pain severity to the nurses or healthcare providers, such as:
- Numerical rating scale from 1-10: Patients describe the pain by choosing a number in which zero means no pain and 10 means worst pain.
- Visual analog scale (VAS): This is a 10 cm line where one end means no pain and the other end means worst pain.
- Faces Pain Scale-Revised (FPS-R): A series of faces are shown from a happy face indicating no pain to a crying face indicating intense pain.
- Brief Pain Inventory (BPI): This indicates the severity of pain and its effects on their life and daily activities.
- McGill Pain Questionnaire: This is a questionnaire method to assess the intensity of pain.
Timing
The last letter in the PQRST pain assessment is T, which stands for timing. The timing of the pain indicates when and how long the pain lasts. The importance of timing in pain easement is very crucial for effective treatment.
Questions asked:
- When does the pain occur?
- How long does the pain last?
Onset of pain: In nursing pain assessment it indicates when the pain started and how it started. Does the pain start suddenly or gradually?
Duration of pain: In nursing pain assessment duration of pain indicates how long the pain lasted and whether it was constant or not.
The pattern of pain: In this nursing pain assessment the pattern of pain indicates whether the pain occurs at a specific time or after a certain activity or is in a specific sequence.
Response to treatment over time: Finally, to assess the pain it is important to understand how pain reacts to the medications. Is it getting better or is there no change at all?
What does the quality of pain mean?
Quality of pain means the feeling of pain which might be throbbing, sharp, cramp-like, tingling, or burning sensation.
What is PQRST pain assessment?
PQRST nursing assessment is the method that healthcare providers use to assess pain. P stands for provocation or palliation, Q stands for the quality of pain, R stands for region of pain, S stands for the severity of pain and T stands for timing of pain.
What are PQRST pain assessment questions?
- Where is the pain located?
- How long did the pain last? or is continuous?
- Can you describe the pain?
- Can you describe the severity of pain from 1 to 10?
Example of pain documentation:
In nursing pain assessment pain documentation is important. Example of documentation is below:
Chronic back pain
Patient name: Brad
Date: September 16, 2024
Time: 12: 30 PM
Location of pain: Lower back pain
Description of pain: Dull
Severity of pain: 6/10
Duration of pain: Started 4 months ago but increasing with time.
What increases the pain: prolonged sitting or lifting heavy weights?
What relieves the pain: lying down.
Conclusion
In this blog, we have discussed what PQRST stands for and how nurses and healthcare workers use it to assess pain. Assessing the pain accurately is an important part of nursing assessment because this can help in effective treatment. PQRST method is commonly used by healthcare providers to understand the pain of the patients so they can provide them with effective treatment.
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