Brief pain inventory short form brief pain inventory short form brief pain inventory user guide description form to assess the severity of pain and the impact of pain on daily functions. Brief pain inventory short form first name date last name time 1.
The brief pain inventory bpi has become one of the most widely used measurement tools for assessing clinical pain.
Brief pain inventory. The brief pain inventory short form bpi sf is a 9 item self administered questionnaire used to evaluate the severity of a patient s pain and the impact of this pain on the patient s daily functioning. Brief pain inventory short form patient initials. Throughout our lives most of us have had pain from time to time such as minor headaches sprains and toothaches.
The brief pain inventory is adaptable to computer use although it has not been validated for all pain conditions 99 another valuable tool is a modification of the medical outcomes study short form 36 item sf 36 survey the low back sf 36pf 18. Have you had pain other than these everyday kinds of pain during the last week. 15 please rate your pain by circling the one number that tells how much pain you have right now.
17 what kinds of things make your pain worse for example walking standing lifting. Throughout our lives most of us have had pain from time to time such as minor headaches sprains and toothaches. Pain research group department of neuro oncology the university of texas md anderson cancer center.
The bpi has been translated into dozens of languages and it is widely used in both research and clinical settings. 012345678910 no pain as bad as pain you can imagine 16 what kinds of things make your pain feel better for example heat medicine rest. The bpi was originally developed from a measure known as the wisconsin brief pain questionnaire.
On the diagram shade in the areas where you feel pain. Brief pain inventory brief pain inventory short form. The brief pain inventory bpi rapidly assesses the severity of pain and its impact on functioning.
Put an x on the area that hurts. 100 this instrument is also amenable to computer use and includes aspects of the sf 36 and the oswestry and quebec back pain questionnaires. The brief pain inventory bpi is a self administered assessment tool used in pain management.
Visit date dd mm yyyy. The bpi allows patients to rate the severity of their pain and the degree to which their pain interferes with common dimensions of feeling and function.