Non-Communicating Adult Pain Checklist

The NCAPC is for finding out whether an adult who cannot tell you they are in pain is in pain. It replaces asking with watching: an observer notes which specific behaviours appear, over a defined observation period.

Eighteen items sit in six categories. Vocal reaction covers crying out, moaning, and making sounds. Emotional reaction covers distress and agitation. Facial expression covers grimacing, furrowed brow, and screwed-up eyes. Body language covers stiffening and restlessness. Protective reaction covers guarding or pulling away from the painful area. Physiological signs cover shivering, colour change, and sweating. Each is rated by how often it occurred, and higher totals mean more pain behavior.

• Measurement properties in a Clinical Setting

Licensing Notes: The checklist circulates freely in academic and clinical settings — the CSV links to a University of Arkansas copy. I could not locate posted reproduction terms from the authors or Elsevier. Confirm before reprinting or embedding.

Learn More: Reliability is strong (ICC 0.87 across simultaneous observations), and the scale distinguishes intensity of experience — one validation found mean scores of 16.3 during dental hygiene versus 11.5 for an influenza injection. Note that validation was conducted around procedural pain; the authors state its use in other painful situations needs further investigation.