|ONSET||When did it begin? How long does it last? How often does it occur?|
|PROVOKING/PALLIATING||What brings it on? What makes it better? What makes it worse?|
|QUALITY||What does it feel like? Can you describe it?|
|REGION/RADIATION||What does it feel like? Can you describe it?|
|SEVERITY||What is the intensity of the pain? (On a scale of 0 to 10 with 0 being none and 10 being the worse possible). Right now? At best? At worst? On average?|
Is the pain constant? Does it come and go? Is it worse at any particular time?
What medications and treatments are you currently using?
How effective are these?
Do you have any side effects from the medications and treatments?
|UNDERSTANDING/IMPACT ON YOU||
What do you believe is causing the pain?
Are there any other symptoms with this pain?
How is this pain impacting you and your family?
|VALUES||What is your goal for this pain? What is your comfort goal or acceptable level for this pain? (On a scale of 0 to 10 with 0 being none and 10 being worst possible)? Are there any other views or feelings about this pain that is important to you or your family? Is there anything else you would like to say about your pain that has not been discussed or asked?|