Paul Morrison

One of the most challenging aspects of any qualitative research study is building successful relationships between participants and researchers. This challenge is made more difficult when those participants and researchers belong to discrete cultural groups that do not necessarily share the same individual or worldviews. This is the case, for instance, when health authorities seek to promote their version of health and wellbeing amongst Indigenous Australians. Overcoming barriers associated with such a potential variance in cultural beliefs and values can be approached using ethnographic action research (EAR). This approach combines the methodologies of ethnography, participatory techniques and action research (Tacchi, Slater, & Hearn, 2003), where the EAR becomes an integral part of a project that is relevant to a particular community. EAR then acts as a means of understanding the community’s needs as the project is developed and evaluated within the context of that community’s beliefs, values, and aspirations.

A crisis in life often appears like a bolt out of the blue. The sudden onset of illness, the loss of a job or a death in the family can visit at any time. These events can throw stable lives into a chaotic state with no apparent positive solution. This chapter examines some of the crises that can erupt without warning. It considers the defining features of a crisis and the potential impact of a crisis on people’s lives. While two people can be exposed to the same stressful event, they are likely to construe the event differently; one may be able to adapt and cope well, while the other may feel anxious and ‘crushed’ by the experience. It is this personal appraisal process that is at the core of coping with a crisis. When a person is unable to cope, even for a short time, some form of professional intervention may be required. A number of crisis events are broached here, including suicide, attempted suicide, self-harm, being a victim of crime, and sudden death, with an emphasis on the important role that nurses can play in helping patients and clients to deal with these effectively. There is also a strong focus on dealing with the loss that usually trails a life crisis. The need for a heightened awareness of cultural considerations in the helping process is also stressed. The final section of the chapter deals with some of the helping attitudes and skills that are needed to assist people to deal with crisis and loss. These look straightforward enough on paper, but in the ‘disordered’ environment of a busy casualty department or an acute mental health admission unit they may be much more difficult to practise and sustain. These are nevertheless required competencies for high-quality nurse–patient relationships.

The HRCHPW is a multidisciplinary research centre, working to conduct health promotion and wellbeing research and evaluation in partnership with other organisations and communities in the Australian Capital Territory. The research undertaken by the Centre will be linked to the key issues which impact on the health and wellbeing of the ACT community as outlined in the Canberra Plan and the ACT Health Promotion Board’s Strategic Plan.