Chapter 4 – Pain Assessment
Brief Pain Inventory
The Brief Pain Inventory (BPI) (is a commonly used multidimensional tool for assessing pain in clinical environments (Cleeland, 2009). It was originally developed to assess cancer-related pain, but it is also a valid and reliable measure with other conditions (Cleeland, 2009). For example, a systematic review found a moderate quality of evidence for its clinical use related to postoperative pain assessment (Lapkin et al, 2021).
In comparison to the PQRSTU mnemonic, the BPI provides a more comprehensive evaluation of pain and has been more widely tested (Cleeland, 2009):
- It focuses on assessing pain intensity over the past week and interference with a client’s daily life.
- It takes 5–10 minutes to complete.
- It can be self-administered by clients who are literate or administered by healthcare professionals when the client has reduced literacy.
- It can be translated into other languages for clients who do not speak English, and has already been validated in many languages including French, Japanese, Chinese, Korean, Italian, Russian, German, and Spanish, among others.
Because of its focus on assessing pain over time and interference with daily lives, it is commonly used in primary care and for assessing chronic pain. A long version and short version are available; the shorter version has become the standard in clinical practice (Cleeland, 2009) – thus we encourage you to review the short version and understand it. Here is a link to a user guide with information about the tool’s development, scoring, , and relevant literature.
Clinical Tip
Provide clients with enough time to complete the BPI. The tool is often used at in-patient units and for clients with chronic pain, who may require additional time because pain can affect cognitive functioning. Many in-patient oncology units have clients complete the BPI on admission, and then weekly, to evaluate their pain over periods of time.
References
Cleeland, C. (2009). The Brief Pain Inventory: User guide. https://www.mdanderson.org/content/dam/mdanderson/documents/Departments-and-Divisions/Symptom-Research/BPI_UserGuide.pdf
Lapkin, S., Ellwood, L., Diwan, A., & Fernandez, R. (2021). Reliability, validity, and responsiveness of multidimensional pain assessment tools used in postoperative adult patients: A systematic review of measurement properties. JBI Evidence Synthesis, 19(2), 284-307.
refers to evaluating whether a tool is measuring what it is designed to measure (validity), whether the tool results in consistent responses under similar conditions or with the same level of pain (reliability), and whether the tool is sensitive to detect changes in pain (responsiveness).
