The association of nurses' assessment and certainty to pain management and outcomes for nursing home residents in Jordan

Despite advances in dementia care, pain in people with dementia is still undertreated due to poor assessment, poor treatment, and factors relating to nurses' critical thinking and decision-making skills. The purpose of the study is to examine temporally based relationships between change in behavior, the nurses' level of certainty regarding pain, assessment scope, and outcomes of pain. The findings of the study were consistent with the Response to Certainty of Pain model. This study found high percentage of variances accounted for by nurses' level of certainty due to potential unexpected confounding variables. This study may provide a new understanding of the relationship between nurses' certainty, assessment scope, and patient outcomes for people with dementia. Improved understanding of this relationship and how it relates to the problem of unrelieved pain in people with dementia is crucial. (C) 2017 Elsevier Inc. All rights reserved.