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This study is designed to identify factors which influence quality of life for elderly people suffering from painful conditions. It is based upon a theoretical model of control in which mood state is used as the indicator of coping. One hundred and ninety elderly patients took part in semi-structured interviews about their pain and coping experiences, and data were also collected from their nurses in the community. Multivariate statistical analysis revealed that the key determinants of mood were having regrets about the past, being occupied, perceived level of pain control, additional personal problems (notably bereavement) and feeling informed about the painful condition. Active personal coping strategies were identified as more therapeutic than passive strategies. Nurses' data revealed that pain complaints were associated with perceived exaggeration. Few nurses used formal pain assessment. Recommendations for the management of persistent pain in the community are given.

This paper describes qualitative findings from a study which was designed to explore the nursing needs of elderly people in the community who experience persistent pain. Participants were 190 elderly people who were receiving visits from a district nurse and who reported pain of more than 6 weeks' duration. The most common reported cause of pain was arthritis. Respondents participated in structured interviews which included open questions about their experiences and expectations. The district nurses completed questionnaires that included a combination of open and closed questions concerning pain and coping factors, for each individual respondent known to them. They were also asked questions about their general attitudes and beliefs about pain management. Data from all open questions were subjected to content analysis. The results indicate that most elderly respondents valued having someone who was prepared to listen to them, understand how they felt and provide information and encouragement. Most did not expect the nurse to relieve their pain. On the other hand, the nurses appeared to feel relatively helpless when medical treatments failed and although the importance of good social support visits was well recognized by most, the concept of 'support' tended to be vaguely defined. These findings highlight the importance of psychosocial care for the elderly in the community and the need for a strong focus upon psychosocial assessment and management during training for health professionals.

In recognition of the important ethical issues posed by qualitative research in health care, the authors present key questions to aid ethical review. The purpose is to assist lay and professional members of research ethics committees in their assessment of applications involving qualitative research methods and to inform researchers intending to submit such applications for ethical approval. For the benefit of those less familiar with this type of research, the authors include an overview of different types of qualitative research, together with an explanation of terms commonly used by qualitative researchers.