Core values and principles
The following core values and principles are integral to and embedded within all domains and competencies. To deliver the highest quality of care, health professionals must be able to determine and address the needs of patients from a variety of cultures and socio-economic backgrounds; advocate for patients on individual, system and policy levels; and communicate effectively with patients, families and professionals. These principles transcend any single domain and reflect the need for evidence-based comprehensive pain care that is patient centered and is delivered in a collaborative, team-based environment.
Health Disparities Reduction
The following core competencies were developed by an interprofessional expert group comprised of leaders from multiple health professions, including: dentistry, medicine, nursing, pharmacy, physical therapy, psychology, social work, acupuncture and veterinary medicine. The domains are aligned with the outline categories of the International Association for the Study of Pain curricula.
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Multidimensional Nature of Pain:
What is Pain?
This domain focuses on the fundamental concepts of pain including the science, nomenclature, experience of pain and pain’s impact on the individual and society.
- Explain the complex, multidimensional and individual-specific nature of pain.
- Present theories and science for understanding pain.
- Define terminology for describing pain and associated conditions.
- Describe the impact of pain on society.
- Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain.
Pain Assessment and Measurement:
How is Pain Recognized?
This domain relates to how pain is assessed, quantified and communicated, in addition to how the individual, the health system and society affect these activities.
- Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess related outcomes as appropriate for the clinical context and population.
- Describe patient, provider and system factors that can facilitate or interfere with effective pain assessment and management.
- Assess patient preferences and values to determine pain-related goals and priorities.
- Demonstrate empathic and compassionate communication during pain assessment.
Management of Pain:
How is Pain Relieved?
This domain focuses on collaborative approaches to decision making, diversity of treatment options, the importance of patient agency, risk management, flexibility in care and treatment based on appropriate understanding of the clinical condition.
- Demonstrate the inclusion of patient and others, as appropriate, in the education and shared decision-making process for pain care.
- Identify pain treatment options that can be accessed in a comprehensive pain management plan.
- Explain how health promotion and self-management strategies are important to the management of pain.
- Develop a pain treatment plan based on benefits and risks of available treatments.
- Monitor effects of pain management approaches to adjust the plan of care as needed.
- Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction and non-adherence.
- Develop a treatment plan that takes into account the differences between acute pain, acute-on-chronic pain, chronic/persistent pain and pain at the end of life.
How Does Context Influence Pain Management?
This domain focuses on the role of the clinician in the application of the competencies developed in Domains 1-3 and in the context of varied patient populations, settings and care teams.
- Describe the unique pain assessment and management needs of special populations.
- Explain how to assess and manage pain across settings and transitions of care.
- Describe the role, scope of practice and contribution of the different professions within a pain management care team.
- Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems and health care providers in the context of available resources.
- Describe the role of the clinician as an advocate in assisting patients to meet treatment goals.