*3.2.1 Brief Pain Inventory (BPI)*

BPI was developed by Collaborating Centre for Symptom Evaluation in Cancer Care, a team of WHO [22]. This is a method incorporated to assess self-reported pain severity and any interference in daily functioning, used in both clinical and research settings and is widely utilized and recognized in cancer pain assessment it is being self-administered and easy to access [7, 20, 23, 24]. It was approved and translated into many languages including Hindi, Spanish, Brazilian, etc. [22]. The subject is asked to fill up nine questions like if they have been feeling pain recently, location of the pain (a pictorial representation of both dorsal and ventral side of the human body which the subject can use to highlight the area of distress), pain intensity/severity during different intervals and other questions may include the effect of the drugs like an opioid taken for medication for pain management and lastly how pain affects your mood and your daily routine [25]. The scoring is divided into two categories that are pain severity and pain interference with a score of 0–10 where zero being no pain and ten being severe [25]. Similar scaling is done for interference also the final scoring is 0–40 and 0–70 respectively [25]. Multiple studies suggest that this two-dimensional tool (BPI) is quite adequate and is a capable method in analyzing pain intensity and pain interference caused due to neuropathic and nociceptive pain. In cancer pain assessment such as in a study conducted with 199 patients who underwent radiotherapy and results showed that there is a good correlation with an increase in pain intensity and its interference in the daily routine after radiotherapy [22].

## *3.2.2 Neuropathic Pain Scale (NPS)*

As the name suggests it is a scale that is utilized for the differentiation in the neuropathic and non-neuropathic pain developed by Galer and Jensen [26, 27]. This scale contains 11 items for judging the qualitative and quantitative aspects of pain [20]. These items include pain intensity and its effect some items help in determining the features of the neuropathic pain such as sharpness, sensitivity, etc., and also how deep the pain is [28]. These items help in drawing a more accurate picture of the location and the quality of the pain widely utilized in the diagnosis of multiple sclerosis [20, 27, 28].

### *3.2.3 Pain Quality Assessment Scale (PQAS)*

It is also a multidimensional scaling tool with questions that are explained descriptively such as sensitivity etc. In case of severity of pain, a numerical rating from 1 to 10 with ten being severe pain. The patient is advised to fill up/mark answers to the questions based on 20 items. These queries were recently revised by Mark P. Jensen in a cognitive revision test of the items to make them more understandable by the patients [21].

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ailments [14].

*Assessment and Management of Pain in Palliative Care DOI: http://dx.doi.org/10.5772/intechopen.96676*

considered substantial) with 89.5% sensitivity [29, 31].

been mainly used in the initial screening of neuropathic pain [20].

*3.2.5 Neuropathic Pain Questionnaire (NPQ )*

*3.2.6 Douleur Neuropathique 4 Questions (DN4)*

*3.2.7 McGill Pain Questionnaire (MPQ )*

into many languages and has a sensitivity of 83% [20].

*3.2.4 Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)*

LANSS was developed to address the less reliability of the NPS in neuropathic

This is another method for judging and differentiating neuropathic pain from non-neuropathic pain [20]. A test regarding the validation on 528 chronic pain suffering patients of which 149 of them with neuropathic symptoms they were asked to fill up the NPQ with 12 items with the last 2 related effect of pain [32]. It was noted that it had a very low-reliability rate (66% sensitivity only) because of which it is not much popular as compared to the others [20, 30, 32]. Hence, it has

A ten-item scaling method utilized in the characterization of neuropathic pain has 4 questions that are simple to attempt with validated cognitive tests to prove its understandability to the patients it is administered to [21]. It has been translated

McGill pain questionnaire established by Dr. Melzack and Torgerson in 1971 at McGill University in Montreal, Canada is widely used in assessment tools for monitoring the intensity of pain [7]. Many studies have been conducted on the questionnaire such as by B Nicholson suggesting that it is a documentation method that utilizes the patient's experience like how he feels the pain, duration site, etc. [3, 7, 14]. A survey done by P. Kumar et al. showed that a total of 297 patients who underwent MPQ reported that it was qualitatively and quantitatively satisfying [7]. It gives multiple choices that help in identifying and in relating the pain suffered by the patient and these can be later compared with changes in a longer period of monitoring the patient [7, 14]. Not only that it also gives a human diagram to point out wherein the body the pain exists. With questions such as where your pain is? Is it internal or external? And the multiple-choice for how the pain changes with time, with this it seems to be quite regarded and efficient in diagnosing pain and related

pain. This tool has a self-reportable version similar to BPI called S-LANASS with seven elements each weighted differently and is readily used in cancer pain assessment [20, 26, 27, 29]. Five questions mostly deal with yes or no questions for the severity, location, sensitivity, duration, etc. The last two questions are activitybased and require certain diagnostic actions such as gentle touching/rubbing the painful area [26, 29, 30]. These help in deducing if there is any nerve dysfunction, the final scoring is given by 24 [26, 29]. If the person receives a general score of less than 12 the pain is designated in the nociceptive section if the scoring is greater than 12 then the person falls in the category of neuropathic or Pain of Predominantly Neuropathic Origin (POPNO) [29, 30]. Originally designed by Michael Bennett has now been translated to many languages such as German Turkish, Chinese and even in Malayalam. It confirms the validation of this tool 101 chronic pain suffering patients were brought of which fifty patient were nociceptive and fifty-one were neuropathic the test concluded with a Cohen's Kappa 0.743(is a statistical analysis to test the reliability of a test with a range of −1 to +; generally >0.70 values are

*Assessment and Management of Pain in Palliative Care DOI: http://dx.doi.org/10.5772/intechopen.96676*

*Suggestions for Addressing Clinical and Non-Clinical Issues in Palliative Care*

Leeds Assessment of Neuropathic Symptoms and Signs (LANSS).

BPI was developed by Collaborating Centre for Symptom Evaluation in Cancer Care, a team of WHO [22]. This is a method incorporated to assess self-reported pain severity and any interference in daily functioning, used in both clinical and research settings and is widely utilized and recognized in cancer pain assessment it is being self-administered and easy to access [7, 20, 23, 24]. It was approved and translated into many languages including Hindi, Spanish, Brazilian, etc. [22]. The subject is asked to fill up nine questions like if they have been feeling pain recently, location of the pain (a pictorial representation of both dorsal and ventral side of the human body which the subject can use to highlight the area of distress), pain intensity/severity during different intervals and other questions may include the effect of the drugs like an opioid taken for medication for pain management and lastly how pain affects your mood and your daily routine [25]. The scoring is divided into two categories that are pain severity and pain interference with a score of 0–10 where zero being no pain and ten being severe [25]. Similar scaling is done for interference also the final scoring is 0–40 and 0–70 respectively [25]. Multiple studies suggest that this two-dimensional tool (BPI) is quite adequate and is a capable method in analyzing pain intensity and pain interference caused due to neuropathic and nociceptive pain. In cancer pain assessment such as in a study conducted with 199 patients who underwent radiotherapy and results showed that there is a good correlation with an increase in pain intensity and its interference in

As the name suggests it is a scale that is utilized for the differentiation in the neuropathic and non-neuropathic pain developed by Galer and Jensen [26, 27]. This scale contains 11 items for judging the qualitative and quantitative aspects of pain [20]. These items include pain intensity and its effect some items help in determining the features of the neuropathic pain such as sharpness, sensitivity, etc., and also how deep the pain is [28]. These items help in drawing a more accurate picture of the location and the quality of the pain widely utilized in the diagnosis of

It is also a multidimensional scaling tool with questions that are explained descriptively such as sensitivity etc. In case of severity of pain, a numerical rating from 1 to 10 with ten being severe pain. The patient is advised to fill up/mark answers to the questions based on 20 items. These queries were recently revised by Mark P. Jensen in a cognitive revision test of the items to make them more

Douleur Neuropathique en 4 Questions (DN4) [20, 21].

These include:

Brief Pain Inventory (BPI).

*3.2.1 Brief Pain Inventory (BPI)*

the daily routine after radiotherapy [22].

*3.2.2 Neuropathic Pain Scale (NPS)*

multiple sclerosis [20, 27, 28].

*3.2.3 Pain Quality Assessment Scale (PQAS)*

understandable by the patients [21].

McGill Pain Questionnaire (MPQ ). Neuropathic Pain Scale (NPS).

Pain Quality Assessment Scale (PQAS).

Neuropathic Pain Questionnaire (NPQ ).

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