Pain Interview Forms [1]

Child Form Parent Form
Tell me about the hurt you're having now.Tell me about the pain your child is having now.
Elicit descriptors, location, and cause.Elicit descriptors, location, and cause.
What would you like me to do for you?What would you like me to do for your child?

[1] Adapted with permission from Hester, N.O. and Barcus, C.S. (1986). Assessment and management of pain in children. Pediatrics: Nursing Update, 1, 2-8.

From: 1b, Acute Pain Management in Infants, Children, and Adolescents: Operative Procedures

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