Pain Assessment in the Patient Unable to Self-Report: Clinical Practice Recommendations in Support of the ASPMN 2019 Position Statement

Pain Manag Nurs. 2019 Oct;20(5):404-417. doi: 10.1016/j.pmn.2019.07.005. Epub 2019 Oct 12.


Pain is a subjective experience, unfortunately, some patients cannot provide a self-report of pain verbally, in writing, or by other means. In patients who are unable to self-report pain, other strategies must be used to infer pain and evaluate interventions. In support of the ASPMN position statement "Pain Assessment in the Patient Unable to Self-Report", this paper provides clinical practice recommendations for five populations in which difficulty communicating pain often exists: neonates, toddlers and young children, persons with intellectual disabilities, critically ill/unconscious patients, older adults with advanced dementia, and patients at the end of life. Nurses are integral to ensuring assessment and treatment of these vulnerable populations.

MeSH terms

  • Consciousness Disorders / complications
  • Consciousness Disorders / physiopathology
  • Critical Illness
  • Humans
  • Pain Measurement / methods*
  • Pain Measurement / trends
  • Professional-Patient Relations*
  • Societies, Nursing / organization & administration
  • Societies, Nursing / trends*