<P> The Multidimensional Pain Inventory (MPI) is a questionnaire designed to assess the psychosocial state of a person with chronic pain . Analysis of MPI results by Turk and Rudy (1988) found three classes of chronic pain patient: "(a) dysfunctional, people who perceived the severity of their pain to be high, reported that pain interfered with much of their lives, reported a higher degree of psychological distress caused by pain, and reported low levels of activity; (b) interpersonally distressed, people with a common perception that significant others were not very supportive of their pain problems; and (c) adaptive copers, patients who reported high levels of social support, relatively low levels of pain and perceived interference, and relatively high levels of activity ." Combining the MPI characterization of the person with their IASP five - category pain profile is recommended for deriving the most useful case description . </P> <P> When a person is non-verbal and cannot self - report pain, observation becomes critical, and specific behaviors can be monitored as pain indicators . Behaviors such as facial grimacing and guarding indicate pain, as well as an increase or decrease in vocalizations, changes in routine behavior patterns and mental status changes . Patients experiencing pain may exhibit withdrawn social behavior and possibly experience a decreased appetite and decreased nutritional intake . A change in condition that deviates from baseline such as moaning with movement or when manipulating a body part, and limited range of motion are also potential pain indicators . In patients who possess language but are incapable of expressing themselves effectively, such as those with dementia, an increase in confusion or display of aggressive behaviors or agitation may signal that discomfort exists, and further assessment is necessary . </P> <P> Infants do feel pain, but lack the language needed to report it, and so communicate distress by crying . A non-verbal pain assessment should be conducted involving the parents, who will notice changes in the infant which may not be obvious to the health care provider . Pre-term babies are more sensitive to painful stimuli than those carried to full term . </P> <P> The way in which one experiences and responds to pain is related to sociocultural characteristics, such as gender, ethnicity, and age . An aging adult may not respond to pain in the same way that a younger person might . Their ability to recognize pain may be blunted by illness or the use of medication . Depression may also keep older adult from reporting they are in pain . Decline in self - care may also indicate the older adult is experiencing pain . They be reluctant to report pain because they not want to be perceived as weak, or may feel it is impolite or shameful to complain, or they may feel the pain is a form of deserved punishment . </P>

Where do you have the most pain receptors