Table 1.

Outline of ethnographic study

Non-participant observation nursing practice (62 hours), patient interviews (n = 8), NWI-R questionnaire (Aiken and Patrician 2000):
Revealed pain management practices with older people were deficient due to:		Ely's thematic analysis (1991) revealed three potential action cycles:
Limited/absent pain assessment.	}	Action cycle one: pain assessment and practice.
Inflexible analgesic prescriptions.
Limited use of non-pharmacological strategies.	}	Action cycle two: Organisation of care.
Family and Physician opinion on use of analgesics.
Fear of addiction.	}	Action cycle three: Knowledge and insight to deal with problematic pain.
Patients not being believed.
Patients having decisions made 'for' rather than 'with' them.