Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage” (International Association for the Study of Pain (IASP), 1986). However twentieth century theories support the rationale that “Pain is a multidimensional phenomenon and includes the patient’s emotions, behaviours and functionality both physically and mentally in response to the pain” (Osborn et al, 2009 Pg.335). The World Health Organisation (WHO) confirmed its belief in the importance of pain control by making its 2004 motto ‘the relief of pain should be a human right’ (www.who.int, 2004)
A fundamental requirement of diagnosing and treating any patient’s condition is the assessment of pain. Failure to assess a patient’s pain may result in misdiagnosis and lack of adequate pain control. Without pain assessment it cannot be confirmed whether treatment is necessary, effective and should be continued. Life threatening complications can be the result of unrelieved pain especially in older people, for example, severe pain leads to an increase in the activity of the sympathetic nervous system which may result in tachycardia, hypertension and myocardial ischaemia (Cousins et al, 1999 cited in McGann, 2007, Pg. 26). Untreated pain can result in fear and anxiety and affect the relationship between patients and healthcare workers.
Failing to assess pain has been acknowledged as a barrier to pain management, assessment tools have evolved over the past 10 years and multiple tools are now available for use (Osborn et al, 2009).
In the1960s a non-verbal measure of pain was adapted by Bond et al. A new technology, which came to be known as VAS, generated continuous data of pain intensity which did not need verbal description. It was a 10cm long line with “no pain” and “the pain is as much as I can bear” at either end. Patients were asked to mark a point on the line that represented their pain