The Patient Pain Questionnaire (PPQ)


Cancer pain is recognised as a serious barrier to mental wellbeing in cancer patients. One of the main aims of palliative care is to buffer patients against pain, both mental and physical. By using the Patient Pain Questionnaire (PPQ) and also the related family pain questionnaire (FPQ) clinicians and researchers can gain a clearer understanding of the patient/caregiver perspective and how this might interact with or even predict wellbeing or adjustment to pain. The PPQ can be used by either clinicans or researchers.


The psychometric properties of the Patient Pain Questionnaire (PPQ) are discussed in the introduction to the instrument itself which is attached below.

Author of Tool:

The City of Hope Pain & Palliative Care Resource Center

Key references:

Ferrell, B. R., Ferrell, B., Rhiner, M., Grant, M. (1991). Family Factors Influencing Cancer Pain. Post Graduate Medical Journal, 67 (Suppl 2), 64-69.

Ferrell, B. R., Rhiner, M., Cohen, M., Grant, M. (1991). Pain as a Metaphor for Illness. Part I: Impact of Cancer Pain on Family Caregivers. Oncology Nursing Forum, 18(8), 1303-1309.

Ferrell, B. R., Cohen, M., Rhiner, M., Rozak, A. (1991). Pain as a Metaphor for Illness. Part II: Family Caregivers’ Management of Pain. Oncology Nursing Forum,18(8), 1315-1321.

Ferrell, B. R., Rhiner, M., Ferrell, B. (1993). Development and Implementation of a Pain Education Program. Cancer, 72(11), 3426-3432.

Primary use / Purpose:

The Patient Pain Questionnaire (PPQ) is a 16-item ordinal inventory. Its purpose is to measure the knowledge and experience of a cancer patient in managing chronic pain.

Patient Pain Questionnaire

Dear Colleague,

The Patient Pain Questionnaire (PPQ) is a sixteen item ordinal scale that measures the Knowledge and Experience of a patient in managing chronic cancer pain.   This tool can be useful in clinical practice as well as for research. This instrument can be administered by mail or in person.

Directions: The patient is asked to read each question thoroughly and decide if he/she agrees with the statement or disagrees. The patient is then asked to circle a number to indicate the degree to which he/she agrees or disagrees with the statement according to the word anchors on each end of the scale.

The PPQ includes 9 items that measure knowledge about pain and 7 items that measure the patient’s experience with pain. All of the items have been formatted such that 0 = the most positive outcome and 10 = the most negative outcome. We have found it most helpful to analyze the data by focusing on the subscales as well as the individual items as each item has important implications.

You are welcome to use this instrument in your research/clinical practice to gain information about patient knowledge and experience to formulate or evaluate pain management programs. You have permission to duplicate this tool.

This tool is used in conjunction with a version created for use by family caregivers, the Family Pain Questionnaire (FPQ). The PPQ tool has been tested with established reliability and validity. A series of psychometric analyses were performed on the PPQ instrument including content validity (CVI = .95), test-retest reliability (r = .65), internal consistency (alpha = .74), and factor analysis established with caregivers (N=219).

Good luck with your research!!

Betty R. Ferrell, RN, PhD, FAAN Research Scientist


  1. Ferrell BR, Ferrell B, Rhiner M, Grant M. “Family Factors Influencing Cancer Pain”. Post Graduate Medical Journal, 1991; 67 (Suppl 2):S64-S69.

  2. Ferrell BR, Rhiner M, Cohen M, Grant M. “Pain as a Metaphor for Illness. Part I: Impact of Cancer Pain on Family ” Oncology Nursing Forum, 1991; 18(8):1303-1309.

  3. Ferrell BR, Cohen M, Rhiner M, Rozak A. “Pain as a Metaphor for Illness. Part II: Family Caregivers’ Management of Oncology Nursing Forum, 1991; 18(8):1315-1321.

  4. Ferrell BR, Rhiner M, Ferrell B. “Development and Implementation of a Pain Education Program. Cancer, 1993; 72(11):3426-3432.

  5. Ferrell BR, Ferrell B, Ahn C, Tran K. “Pain Management for Elderly Patients with Cancer at Home.” Cancer, 1994; 74(7):2139-2146.

  6. Ferrell BR, Borneman T, Juarez G. “Integration of Pain Education in Home Care.” Journal of Palliative Care, 1998; 14(3):62-68.

  7. Ferrell BR, Rivera LM. “Cancer Pain Education for Patients.” Seminars in Oncology Nursing, 1997; 13(1):42-48.

  8. Ferrell BR, Juarez G, Borneman T, ter Veer A. “Pain management in home care.” Journal of Hospice and Palliative Care Nursing Association, 1999.

Patient Pain Questionnaire (P.P.Q.)

Below are a number of statements about cancer pain and pain relief. Please circle a number on the line to indicate your response.


  1. Cancer pain can be effectively
  2. Pain medicines should be given only when pain is severe.
  3. Most cancer patients on pain medicines will become addicted to the medicines over
  4. It is important to give the lowest amount of medicine possible to save larger doses for later when the pain is
  5. It is better to give pain medications around the clock (on a schedule) rather than only when needed.
  6. Treatments other than medications (such as massage, heat, relaxation) can be effective for relieving
  7. Pain medicines can be dangerous and can often interfere with breathing.
  8. Patients are often given too much pain medicine.
  9. If pain is worse, the cancer must be getting


  1. Over the past week, how much pain have you had?
  2. How much pain are you having now?
  3. How much pain relief are you currently receiving?
  4. How distressing is the pain to you?
  5. How distressing is your pain to your family members?
  6. To what extent do you feel you are able to control your pain?
  7. What do you expect will happen with your pain in the future?

Cuestionario Sobre el Dolor del Paciente (sigla en inglés: P.P.Q.)

A continuación se encuentran un número de afirmaciones sobre el dolor ocasionado por el cáncer y su alivio. Favor de marcar uno de los números en el renglón con un círculo para indicar su respuesta.


  1. El dolor del cáncer puede aliviarse
  2. Las medicinas para aliviar el dolor se deben de dar únicamente cuando el dolor sea
  3. La mayoría de los pacientes con cáncer que toman medicamentos para aliviar el dolor a la larga quedarán adictos a los medicamentos.
  4. Es importante dar la menor cantidad posible de la medicina con fines de guardar la las las dosis más altas para cuando empeore el dolor en un
  5. Es preferible dar los medicamentos para aliviar el dolor a base continua (según un horario) en vez de sólo cuando estos sean
  6. Otros tratamientos ademas de los medicamentos (tales como masajes, tratamientos de calor, relajación) pueden ser eficaces para aliviar el dolor.
  7. Los medicamentos contra el dolor pueden ser peligrosos y con frecuencia pueden interferir con la respiración.
  8. A los pacientes con frecuencia les dan demasiados medicamentos para aliviar el
  9. Si el dolor empeora, el cáncer deberá estar


  1. Durante esta última semana, ¿cuánto dolor ha tenido?
  2. ¿Cuánto dolor está sufriendo/padeciendo en la actualidad?
  3. ¿Cuánto alivio al dolor está recibiendo en la actualidad?
  4. ¿Cuánta aflicción/angustia le causa el dolor?
  5. ¿Cuánta aflicción/angustia le causa su dolor a los miembros de su familia?
  6. ¿Hasta qué punto estima usted que le es posible controlar su dolor?
  7. ¿Qué piensa usted pasara con su dolor en un futuro?