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Poor pain assessment is cited as one barrier to the adequate treatment of cancer pain. The identification of relevant psychosocial factors may improve the assessment of chronic cancer pain. This article presents: 1) a critical review of the evidence for an association between chronic cancer pain and psychological distress, social support, and coping; 2) clinical implications of the findings; and 3) recommendations for future research. Fourteen of the 19 reviewed studies on psychological distress found a significant association between increased pain and increased distress. Seven of the eight studies on social support found significant association between higher levels of pain and decreased levels of social activities and social support. Three of the four studies that examined coping strategies found that increased catastrophizing was significantly associated with more intense pain. Based on several criteria, the evidence is considered Strong for psychological distress, Moderate for social support, and Inconclusive for coping. This review suggests that comprehensive chronic pain assessment should include routine screening for psychological distress.

GAS has affected both care practices and patient outcomes. This study illustrates the clinical impacts an outcome measure can have, as well as the use of qualitative methods for this type of research.

Although the multidimensional nature of chronic pain has been recognized since the 1960s, pain management continues to reflect a biomedical model for many chronic pain patients. The application of a biopsychosocial approach would be aided by measurement tools that reflect the multidimensional nature of pain, facilitate interdisciplinary care planning, and focus treatment on the consequences of pain that are important to patients. Goal Attainment Scaling (GAS) is an individualized health outcome measure that is suitable for health problems that warrant a multidimensional and individualized approach to treatment planning and outcome measurement. This paper describes the use of GAS as a treatment and research tool in cancer pain, pediatric pain, work-related nonmalignant pain, and geriatric pain. Unlike the typical process where goals are not explicitly stated, GAS allows goals to be stated in a systematic measurable manner that is relevant and meaningful for each patient, and that can guide individual treatment planning. GAS is an appropriate technique for guiding and monitoring the treatment of individual chronic pain patients, and may provide a useful tool for evaluating chronic pain programs.