ABSTRACT
Pain is a common symptom in patients at the end of life. This chapter provides an overview of the assessment and management of pain at the end of life. It addresses definitions of pain and barriers to adequate pain management. The chapter discusses the pain guidelines, developed internationally as a basis for evidence-based practice. Nurses have a primary responsibility to recognise pain, to provide a comprehensive pain assessment, and to participate in the overall pain-management plan. Nurses should also act as advocates for patients and families, and reassure them that most pain can be adequately relieved. Nurses and other health-care professionals often misinterpret the meanings of the terms 'addiction', 'tolerance', and 'dependence'. In addition to a physiological assessment, nurses should assess behavioural factors that affect the pain. An important element in assessing pain is to use a convenient assessment tool, and to use it consistently. The tool should include characteristics of the pain—including location, intensity, quality, and temporal factors.
