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The Value of Patient Use of PQRST in Describing Pain

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PQRST is a mnemonic used by doctors and nurses for evaluating pain. It can also be used by patients to improve communication in healthcare. The potential benefits of the improved communication include making PQRST doctor visits and other physician encounters more productive and improving healthcare outcomes. As a consequence, it might also reduce medical expenses.

P in the mnemonic stands for provocation and palliation. Which stated more simply means, what brings the pain on and what eases it.

Q stands for quality. It calls for a description of the pain with an adjective or adjectives such as cramping, dull, sharp, electrical-like, or burning.

R refers to the region of the body where the pain begins and where it radiates to if it moves from that position to another.

S stands for severity which generally should be rated on a scale of 1+ – 10+.  A grade of 1+ means the pain is barely noticeable or just above 0. A grade of 10+ means that it is almost unbearable.

T represents the relationship of the pain to time. This description should include when the pain first began, how long it lasts, how often it occurs, how long it takes to be relieved by whatever relieves it, and when the severity changed if it changed.

Research studies have shown that in most cases information provided by patients is more important than diagnostic tests or physical findings for accurate diagnoses. Therefore, a complete and accurate description of pain is a necessity. During many doctor/patient encounters however, patients are not prepared to give that all-important information in an accurate, succinct and organized manner. As a result, the doctor visit is not as productive as it should be.

Deficient productivity during doctor visits increases the cost of medical care. First of all, the inability to obtain important subjective information from patients oftentimes results in increased reliance on test ordering. In addition to the extra expense associated with the cost of the test(s), there is the added expense of additional office visits.

In order for patients to make the best use of PQRST communication in healthcare, it is necessary to track and document the various PQRST elements of pain and to have the documentation available at the time of a doctor visit. It is helpful to record the PQRST information about pain immediately as the information becomes available. That way, it is more likely to be accurate and can be well organized prior to seeing the doctor. Accurate and organize information in turn increases its usefulness for making an accurate and timely diagnosis and providing appropriate treatment.

The improved communication in healthcare resulting from patients’ use of the PQRST system in describing pain can be of benefit to patients. The benefits include timely diagnoses, better healthcare outcomes, and decreased cost of medical care.  Its value should become more obvious as we continue on the path of healthcare reform.

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