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Multidimensional continuous pain assessment chart (MCPAC) for terminal cancer patients: A preliminary report

Palliative Care Team, Tel Hashomer Hospice, Tel Aviv, Israel

Alexander Waller, MD

Chaim Sheba Medical Center and Israel Cancer Association, Tel Aviv, Israel

Abraham Adunsky, MD

Division of Geriatric Medicine, Chaim Sheba Medical Center, Tel Hashomer Hospice, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

Current use of pain measures is limited in clinical practice. The common pain measures neither target nor monitor the changes that occur with time with regard to the effect of other parameters associated with pain control. Changes in parameters, such as pain type, various pharmacological and nonpharmacological interventions, dosage of medications, and use of rescue doses, usually complicate pain control in terminal cancer patients. The authors propose use of a multidimensional, continuous pain chart that permits better assessment and control of pain. The chart integrates visual analogue pain assessment, special treatment techniques, regular medications and rescue doses, co-analgesics, pain categories, parameters relating to quality of life, sleep, and mobility. A total of 1,178 assessments were performed in 100 consecutive patients with full compliance. The chart permitted a continuous monitoring of patients’ most important needs concerned with pain control and was easily integrated into the hospice daily routines. We conclude that the chart represents an effective and friendly graphic tool to monitor pain and associated parameters that relate to the quality of the broad spectrum of pain control. The hope is that this tool may improve pain control by hospice professionals and facilitate communication between patients and the interdisciplinary team members.

Key Words: assessment • cancer • continuous pain assessment • pain • hospice • hospice patients • pain • terminal care

American Journal of Hospice and Palliative Medicine®, Vol. 19, No. 6, 419-425 (2002)
DOI: 10.1177/104990910201900615


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