Pain Control (1605) Domain-Health Knowledge & Behavior (IV) Class-Health Behavior (Q) Scale-Never demonstrated to Consistently demonstrated

(m) Definition: Personal action to control pain

Pain control Never demonstrated Rarely demonstrated Sometimes demonstrated Often demonstrated Consistently demonstrated

Indicators 160501 160502 160503

160504

160505 160506

160507

160508 160509

160510 160511 160512

Recognizes causal factors Recognizes pain onset Uses preventive measures Uses nonanalgesic relief measures Uses analgesics approprietely Uses warning signs to seek care Reports symptoms to health care professional Uses available resources Recognizes symptoms of pain Uses pain diary Reports pain controlled other (Specify)

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

1 1

2 2

3 3

4 4

5 5

1 1

2 2

3 3

4 4

5 5

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

Pain Level (2102) Domain-Perceived Health (V) Class-Symtom Status (V) Scale-Severe to None (n) Definition: Severity of reported on demonstrated pain
Pain Level Indicators 210201 Severe 1 1 Substansial 2 2 Moderate 3 3 Slight 4 4 None 5 5

Reported pain 210202 Percent of body affected 210203 Frequency of pain 210204 Lenght of pain episodes 210205 Oral expressions of pain 210206 Facial expressions of pain 210207 Protective body postions 210208 Restlessness 210209 Muscle tension 210210 Change in respiratory rate 210211 Change in heart rate 210212 Change in BP 210213 Change in pupil size 210214 Perspiration 210215 Appetile loss 210216 Other Specify BP = Blood pressure.

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

1 1 1 1 1 1

2 2 2 2 2 2

3 3 3 3 3 3

4 4 4 4 4 4

5 5 5 5 5 5

Comfort Level (2100) Domain-Perceived Health (V) Class-Symptom Status (V) Scale-None to Extensive (i) Definition: Extent of Physical, and Psychological ease
Comfort Level None 1 Limited 2 Moderate 3 Substansial 4 Extensive 5

Indicators 210001

210002

210003

210004

210005

210006

210007

210008

Reported physical wellbeing Reported satisfaction with symptom control Reported psychological well-being Expressed contentment with sociaal relationship Expressed spiritual contentment Reported satisfaction with level of independence Expressed satisfaction with pain control other (Specify)

Pain : Disruptive Effects (2101) Domain-Perceived Health (V) Class-Symtom Status (V) Scale-Severe to None (n) Definition: Observed, or reported disruptive effects of pain on emotions and behavior
Pain Disruptive Effects Indicators 210101 Severe 1 1 Substansial 2 2 Moderate 3 3 Slight 4 4 None 5 5

Impaired interpersonal relationships 210102 Impaired role Performance 210103 Compromised play 210104 Compromised leisure activities 210105 Compromised work 210106 Compromised life enjoyment 210107 Compromised sense of control 210108 Impaired concentration 210109 Compromised sense of hope 210110 Impaired mood 210111 Lack of patiance 210112 Distrupted sleep 210113 Impaired physical mobility 210114 Impaired selfcare 210115 Lack of appetite 210116 Dificulty eating 210117 Impaired elimination 210118 Other Specify BP = Blood pressure.

1 1 1 1 1 1 1 1 1 1 1 1

2 2 2 2 2 2 2 2 2 2 2 2

3 3 3 3 3 3 3 3 3 3 3 3

4 4 4 4 4 4 4 4 4 4 4 4

5 5 5 5 5 5 5 5 5 5 5 5

1 1 1 1 1

2 2 2 2 2

3 3 3 3 3

4 4 4 4 4

5 5 5 5 5