Nurses' certainty and pain outcomes of nursing home residents with dementia: the mediating effect of pain assessment.

Aim: This study aims to examine the associations of pain assessment scope, nurses' certainty, patient outcomes, and cognitive and verbal characteristics of nursing home (NH) residents. Methods: This study used a descriptive correlational design and a convenience sample of 78 NH residents with dementia. Results: There are significant associations between the severity of dementia and the ability to self report symptoms in NH residents and nurses' certainty of pain. Also, pain assessment scope does not mediate the relationship between nurses' certainty and patient outcomes. Conclusion: Pain assessment in NH residents with dementia is very challenging for nurses due to multiple complex factors. Improved understanding of pain assessment in those residents and how it relates to certainty of pain and patient outcomes are crucial.