A PainChek Assessment looks at 42 descriptors (attributes) across these 6 domains:
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The Face
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The Voice
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The Movement
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The Behaviour
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The Activity
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The Body
You may be wondering what those descriptors mean and so the table below provides an explanation of each of them.
Also noted for each descriptor is the time frame to consider when assessing a person. That is, do you consider what is happening right now, or do you consider what's been occurring over a period of time (e.g. last week).
Descriptor |
Explanation |
Time frame to consider upon recording items |
Brow lowering |
Anatomical changes in upper face (lower central forehead) · Lowering down of both eyebrows · Movement of eyebrows towards each other · Appearance of vertical or oblique wrinkles between eyebrows in the lower central part of the forehead |
At the time of assessment |
Cheek raising |
Anatomical changes in central face (infraorbital region) · Pulling of skin towards the eye · Pulling the cheeks upward by lifting of the infraorbital triangle · Narrowing the eye aperture and wrinkling the skin below the eye · Appearance of Crow’s feet lines or wrinkles · Deepening of the lower eyelid furrow |
At the time of assessment |
Tightening of eyelids |
Anatomical changes in upper face · Tightening of the eyelids · Narrowing of the eye aperture · Raising of lower lid |
At the time of assessment |
Wrinkling of nose |
Anatomical changes in central face · Pulling of skin upward along the side of the nose towards the root of the nose · Appearance of wrinkles along the side and root of nose · Wrinkling of infraorbital furrow · Lowering the medial portion of the eyebrows · Pulling the centre of the upper lip upwards |
At the time of assessment |
Raising of upper lip |
Anatomical changes in central-lower face · Prominent deepening or wrinkling of infraorbital furrow · Deepening of nasolabial furrow · Pouching at upper lip and nasal passages · Widening and raising of the nostril wings |
At the time of assessment |
Pulling at corner lip |
Anatomical changes in lower face · Drooping or oblique movement of lateral corners of the lips |
At the time of assessment |
Horizontal mouth stretch |
Anatomical changes in lower face · Bilateral stretch of lips. |
At the time of assessment |
Parting lips |
Anatomical changes in lower face · Relaxed opening of the mouth i.e. jaw drop. |
At the time of assessment |
Closing eyes |
Shutting both eyes for at least half a second |
At the time of assessment |
Descriptor |
Explanation |
Time frame to consider upon recording items |
Noisy pain sounds |
Sounds or utters related to pain e.g. ouch, ah, mm |
At the time of assessment |
Requesting help repeatedly |
Include one or more of the followings: · Expressing numerous verbal requests of help within short periods of time e.g. “help me, help me” · Constant talking · Repetitive use of words or phrases (i.e. echophrasia) · Verbal nonsense · Vocalizations with/without discernible meaning Exclude verbal requests for ADL purposes |
At the time of assessment |
Groaning |
Using a deep, creaking or incoherent sound |
At the time of assessment |
Moaning |
Producing a long, low pitched and inarticulate sound |
At the time of assessment |
Crying |
Weeping, sobbing or whimpering |
At the time of assessment |
Screaming |
Using excessively loud voice when communicating (as in shouting or yelling) |
At the time of assessment |
Loudtalk |
Making louder than normal pitched voice |
At the time of assessment |
Howling |
Producing a long wailing cry sound |
At the time of assessment |
Sighing |
Breathing in followed by long audible sound upon breathing out |
At the time of assessment |
Descriptor |
Explanation |
Time frame to consider upon recording items |
Altered or random leg/arm movement |
Changed or random movement of any of the limbs |
At the time of assessment |
Restlessness |
Unable to relax i.e. fidgeting |
At the time of assessment |
Freezing |
Sudden stiffening, avoiding movement, holding breath |
At the time of assessment |
Guarding/touching body part |
An abnormally stiff, rigid or interrupted movement while changing position. Protecting affected area by holding body part |
At the time of assessment |
Moving away |
Avoiding being touched or staying away from the interaction |
At the time of assessment |
Abnormal sitting/standing/walking |
Distorted, asymmetrical or changed sitting, standing (e.g. posture), and/or imbalanced gait (e.g. Limping) |
At the time of assessment |
Pacing/wandering |
Roaming restlessly back and forth |
At the time of assessment |
Descriptor |
Explanation |
Time frame to consider upon recording items |
Introvert |
Being unsocial or socially isolated i.e. reluctant to be involved in social activities |
Over the last 7 days |
Verbally offensive |
Verbally abusive or aggressive, cursing, swearing or using foul/insulting language |
At the time of assessment |
Aggressive |
Involved in combative or violent behaviour |
At the time of assessment |
Fear or extreme dislike of touch, people |
Phobias of being touched or interaction with people including family members, other residents, and/or aged care staff |
At the time of assessment |
Inappropriate behaviour |
Aberrant or socially unacceptable behaviour e.g. fiddling |
Over the last 7 days |
Confused |
Unclear in thinking or understanding e.g. unable to follow instructions or repetitive questioning |
At the time of assessment |
Distressed |
Anxious, worried and agitated |
At the time of assessment |
Descriptor |
Explanation |
Time frame to consider upon recording items |
Resisting care |
Unable to cooperate or become compliant, or refuse to receive care e.g. food, medicine |
Over the last 7 days |
Prolonged resting |
Long resting periods |
Over the last 7 days |
Altered sleep cycle |
Changed sleep-wake cycle e.g. long sleeps during the day |
Over the last 7 days |
Altered routines |
Changed the order or timing of activities from the norm |
Over the last 7 days |
Descriptor |
Explanation |
Time frame to consider upon recording items |
Profuse sweating |
Excessive sweating in various parts of the body excluding circumstances due to environmental factors such as no air conditioning or lack of proper ventilation |
At the time of assessment |
Pale/flushed (red-faced) |
Colour faded or red-colored face |
At the time of assessment |
Feverish/cold |
Changes in body temperature either too hot or too cold |
At the time of assessment |
Rapid breathing |
Fast rate of breathing |
At the time of assessment |
Painful injuries |
Injuries are known to induce pain e.g. falls, bed sores, active wounds |
Over the last 7-14 days |
Painful medical conditions |
Conditions known to cause pain including currently presented e.g. dental infections, urinary tract infections, or previously documented chronic conditions in medical history e.g. arthritis |
Consult medical history |