Journal of Advanced Nursing, 1995, 21, 1024-1028

B O O K R E V I E W S

Resources for Nursing Research by C.G.L. Clamp. Library Association, London, 1994.480 pages, £45-00(pb), ISBN 1-85604-117-4.

In the foreword for this book, Dr Lisbeth Hockey refers to its function as a 'sign post ' to nursing literature. This is indeed exactly what this book is, but it does it in a very rich and considered manner. It is a source- book to assist wi th finding appropriate lit- erature on nursing research, and is in itself is a handy reference work packed with information.

All aspects of research are covered, from tools for literature searching to the role of government, from research design to data analysis, interpretation and presentation. The research universe in its entirety is to be found wi th in this book. All sections are clearly laid out and there is a comprehen- sive guide to using the book. A subject index and author index, together with five detailed contents pages, allow the reader to find the desired section quickly.

In particular, I liked the thoughtfulness with which definitions are given for some subject headings. I say thoughtfulness because this consideration of the needs of the reader extends to having an appendix dedicated to referencing all the definitions used in the book.

The many sections of the book follow the same format to a high standard. After a description of the subject heading, often wi th a referenced definition, an example of the sort of work being recommended is given, follqwed by an account of the major work in this field. The sources refer0nced each have a brief abstract, and are cross- referenced to other sections of the book which may be of related interest. The whole thing is then tidily finished off with, as often as not, a p lump suggested textbook reading list.

Most of the 2150 references are from North American and United Kingdom lit- erature; UK English spelling has been used throughout, except for some journal titles. This book, I think, will be essential to nurs- ing libraries and those individuals involved in the teaching or supervision of nursing research. Students undertaking major research projects, and indeed any

practising nurse wishing to have an up-to- date appreciation of the world of nursing research, should seek this book out.

Ramon Pediani RGN BSc(Hons}

Clinical Nurse Specialist for Acute Pain Control,

Blackpool Victoria Hospital NHS Trust, Blackpool

Nurse Education: Teaching About HIV Infections & AIDS by Helen Chalmers. AVERT, The AIDS Education & Research Trust, Horsham, West Sussex, 1994. 52 pages, £9.95, ISBN 1-898616-01-9.

The AIDS Education and Research Trust (AVERT) funded a major 'H/V, AIDS and Nursing Project' at two insti tutions in the University of London. As with an increas- ing number of studies in this area, the pro- ject was concerned with an exploration of nurses ' knowledge, attitudes and beliefs about HIV and AIDS. The author has pro- duced a book which reports the findings of the surveys carried out to ascertain a number of important education and train- ing issues, with particular reference to stu- dents undertaking Project 2000 courses,

The introduction summarizes the overall aim of the project and draws attention to aspects which inform curriculum develop- ment in Project 2000 pre-registration nurs- ing courses, particularly the Common Foundation Programme (CFP). Impli- cations for post-registration personal and professional development through the English National Board (ENB) Framework and Higher Award are reviewed.

There are nine short chapters which are all concerned with teaching and learning aspects of caring for people with H/V infec- tion. Chapters 1-4 consider issues about curriculum contents, the challenge of teaching about H/V and AIDS, the learning milieu and activities designed to aid the acquisition of knowledge.

Chapter 5 addresses the crucial aspect of skill development leading to a discussion of professional attitudes and the focus on nursing care in chapters 6 and 7. Information about using the AVERT Booklet produced as a result of the project

is covered in chapter 8. This provides information on essential reading materials which can be used by nursing staff and lay readers. The final chapter examines the important but often underestimated difficulty of closing a session. There are two appendices, references, and suggested and further reading.

The author has presented a short, read- able book on current and on-going chal- lenge of HIV and AIDS education to teachers of nursing. It offers nurse edu- cators and practitioners concise and rel- evant information on curriculum development, action planning and evalu- ation. It demonstrates how curriculum development for Project 2000 and Framework and Higher Award courses can benefit from the findings of the AVERT pro- ject generally and specifically in relation to the care of people with HIV infection. This is an important contribution to the literature in this area and a recommended text for students, teachers and practitioners.

Cynthia Y. Akinsanya RGN RM RFN DN Cert DipEd(P)

Cert Psychol PGCEA PWT DNT RNT Senior Lecturer in Nursing,

Anglia Polytechnic University

Bolden and Takle' s Practice Nurse Handbook 3rd edn by Gillian D. Hampson. Blackwell Scientific Publications, Oxford, 1994. 320 pages, £14.99(pb), ISBN 0-632-03692-3.

The United Kingdom's National Health Service (NHS) has undergone changes of fairly seismic proportions over the last few years. As a relatively recent development in primary care, practice nurses have been well placed to evolve rapidly to meet changing circumstances. Thus, in the 5 years since the last edition of this book appeared not only have the rules by which practice nurses live changed, but there has also been a metamorphosis in their role.

That this extensively revised edition should appear at this time is wholly appro- priate. While there will inevitably be further change ahead, practice nursing does appear to have entered a period of consolidation after major transformation.

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Book reviews

This new edit ion has been extensively rewrit ten by its new author and bears marked superiority to its predecessor in many ways. The text has also been exten- sively reorganized and expanded to reflect the new realities. In so doing, it has gained an extra 74 pages.

Among influences which have left their mark on the book are the new general prac- tit ioner contract of 1990 and subsequent amendments , and UK government policy documents, which have increased the sig- nificance on heal th promotion in primary care. Thus 'Contraception' becomes the broader 'Sexual Health'. Similarly, the sec- t ion 'Special Clinics' has been replaced wi th one entit led 'Health Promotion' which reflects the new heal th promotion emphasis.

More recent concerns of the practice nurse are acknowledged in sections on mental heal th and on women 's heal th issues. Some of the latter reappear in 'Diagnostic and Screening Tests' in which such techniques as cervical screening and breast examination are ably covered. In dealing wi th the latter, it is unfortunate that the author has placed insufficient emphasis on the more accepted concept of breast awareness. Most welcome is the superior weight given to the management of chronic diseases, particularly asthma and diabetes mellitus, since these twin concerns provide a large part of the m o d e m practice nurse 's work.

Inevitably, a book such as this, crammed wi th information as it is, can only skim the surface of many issues. However, it is well referenced and also gives further sources. The style is approachable and the text is well laid out, wi th good use being made of bullet points. There are some areas which should have been given better emphasis. These include the evolutionary changes still under way in the NHS, GP fundhold- ing, practice financial management, audit, quality and standards, practice profiles and men 's health, this last a major poten- tial growth area for heal th promotion in general practice. Although Gillian Hampson acknowledges the degree of pro- fessional isolation in which many practice nurses practice, she fails to take account of the important issue of clinical supervision.

Overall, though, this is a book of which the author should be justifiably proud. Being in standard book format, unlike a rival handbook, it will commend itself particularly to practice nurses studying for qualifications in practice nursing. However, it also makes an essential refer- ence and source book for practice nurses at any stage in their careers. It should also

be compulsory reading for other members of the primary heal th care team wishing to gain insight into the work of this growing branch of the profession.

John C. Hooker BSc RGN RMN DN Cert

Senior Nurse (Commissioning), South of Tyne Health Commission,

Gateshead

Divided Sisterhood: Race, Class and Gender in the South Afn'can Nursing Profession by Shula Marks. The Macmillan Press, Basingstoke, Hampshire, 1994. 324 pages, £40.00(hb), ISBN 0-333-54619-9.

Shula Marks is a highly respected historian of South Africa. Reading her history of the South African nursing profession, it is easy to unders tand why. Her exposition com- bines an accessible style with rigorous scholarship. She deftly i l luminates the combined, and sometimes contradictory, effects of 'race', gender and class relations upon the occupation of nursing.

The story of nursing in Southern Africa begins with the arrival of missionary nurses from Britain. Marks shows that beneath the 'official' history which con- centrates on the achievements of mission- ary nurses, there lies a more sinister tale. Missionary nursing was part and parcel of the imperialist project; its practitioners conceived of themselves as being involved in a civilizing mission. This meant both that previous heal th care practices were denegrated, and that African and Afrikaner women were marginalized. When upper- class African women were eventually accepted into the occupation, their train- ing was designed to inculcate in them a western identity, and thus set an example to others.

With the end of British role, and the emergence of the apartheid regime, the position of African nurses did not improve. In 1957 it was decreed that mem- bership of the South African Nursing Council and the Board of the South African Nursing Association were to be restricted to white nurses. Bizarre rules were insti- tuted. For example, African nurses, no matter how senior, were unable to issue instructions to white nurses, no matter how junior. It is depressing to note the col- laboration of many white nurses in this racist madness. Marks cites the doyen of South African nursing, Charlotte Searle:

The non-European nurse in South Africa is being drawn from a social milieu and has a psychologi- cal attitude which is completely different to the generally accepted concept in the Western world... ! am not prepared to describe her as a

reel nurse.., the non-European nurse is at the moment unable to discharge.., these functions of the nurse, viz., the psychological and sociologi- cal care of the patient.

Marks gives us some harrowing accounts of the abysmal working conditions of African nurses. Ironically, despite the indignities and deprivations of apartheid, for a considerable period of t ime they remained politically quiescent. It was larg- ely unregistered nurses who actively con- fronted the racist heal th care system. Marks argues that nurses ' quiescence and detachment from the community was a result of their self-image as professionals; an image that had its roots in the 'civiliz- ing' ideology of the missionaries, and which was subsequently exploited by the apartheid regime.

The strength of this book lies not only in its skilful treatment of the substantive issue. More generally, no one who reads it can fail to be struck by how closely the development of nursing is tied to social developments. Marks clearly demonstrates that conceptualizations of nursing as insu- lated from the wider world are inadequate. Nurses, of whatever society, are affected by and affect the dynamics of the society around them. This relationship creates responsibilities which cannot be shirked by professional detachment.

Sam Porter RGN DipN BSSc Phi]

Lecturer in Sociology, The Queen's University of Belfast

Practitioner Research in Health Care: The Inside Story edited by Jan Reed & Sue Procter. Chapman & Hall, London, 1994. 224 pages, £13.99, ISBN 0-412-49810-3.

As the title infers, the editors are revealing the mysteries of a research enterprise which purports to have h idden depths. They present an argument to support heal th care professionals undertaking research in a way which exploits their own knowledge-base. Added value is inferred and an al temaiive phi losophy is advo- cated, as previous 'objective' 'scientific' work is said to deny the intuitive, undocu- mented and in-depth information which is all-important to practice.

Approximately half the text is devoted to explaining the rationale and merits of practitioner research. Akin to new para- digm research, but wi th the essential d imension of the insider or participant practitioner, these protagonists claim that new insights can be revealed if researchers reflect on issues that are important to their

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Book reviews

clients and themselves. By using their own experience and through their closeness with practice and confidence in their ability to uncover situations, they are seen to have unique opportunities as researchers.

Central characteristics are considered essential to this type of practitioner research, as follows (from p. 195):

• integral with the practice of health care; • a social process undertaken with colleagues; • educative for all participants in the projects; • imbued with an integral development

dimension; • focused upon aspects of practice in which the

researcher has some control and can initiate change;

• able to identify and explore sociopolitical and historical factors affecting practice;

• able to open up value issues for critical enquiry and discussion;

• designed so as to give a say to all participants; • able to exercise the professional imagination

and enhance the capacity of participants to interpret everyday action in the work setting;

• table to integrate personal and professional learning;

• likely to yield insights which can be conveyed in a form which make them worthy of interest to a wider audience.

Thus the editors see that the practitioners' perspective and access to data can provide rich, formerly largely untapped ways of doing research. Essentially, the insider has wisdom which needs to be exploited through constant reflection in practice and through his or her daily contacts. Reflection is essential to this research approac.h which is dynamic and allowed to unfold in ways which are determined by findings as they emerge. Combined with all the data collection procedures advo- cated by the new research approaches, this is thought to hold the key to ah established problem; that is, the lack of meaningful research directed by t h e nature of prob- lems arising in practice.

Underlying this tenet is the philosophi- cal work of SchStl. In an early chapter expounding on these different epistem- elegies and attempting to clarify such writings, Meerabeau has excelled. All who have tried to master these ideas for education, practice or research should now relax and benefit from this clear and interesting section.

By way of illustrating the merits of prac- titioner research, the editors have invited six researchers (or research teams) to dis- cuss their studies. These were designed to share the process of research rather than the outcomes. In these accounts the con- tributors use an informal style of presen- tation to explain their motivations,

difficulties, surprises and reflections. Observation or interviews were employed and researchers provided an open and often rather humble account of their suc- cesses and problems.

Research about practice is essential to developing nursing and other professions. This book is therefore of central impor- tance to both academics and practitioners alike. Undoubtedly one of the most erudite and accessible to be recently published, it deserves serious attention. It encapsulates so much that may have perplexed those who genuinely want to improve the quality of research. At times the editors are so determined in their arguments that they are at risk of alienating researchers from other schools. It is quite difficult at times to decide whether these writers agree that all suitable approaches to research are acceptable or whether practitioner research is the only true way for the future. However, the final chapter provides a wise and measured account of how far this may be successful.

Questions or concerns which may occupy the reader are perhaps not resolved when reading the researchers' contri- butions. It may have been more convincing if they had focused on the value of their approach and findings rather than what they learned. Some of their rather naive observations would not convince a hard- ened experimentalist that this approach was important. After all, their data collec- tion and modes of analysis were not that alternative.

Finally, one must congratulate the edi- tors for a timely reflection! This could be invaluable for postgraduates and senior practitioners. Others may also be inspired by this work but possibly rather sanguine about their abilities to step into this demanding world.

Jenifer Wilson-Barnett BA MSc PhD RGN DipN RNT FRCN

Professor of Nursing Studies, K3"ng" s College, London

Cancer Care: Prevention, Treatment and Palliation edited by J. David. Chapman & Hall, London, 1994.444 pages,£17.99(pb), ISBN 0-412-55430-5.

This book is very much a product of Marie Curie Cancer Care. The contributors are mainly tutors working at Marie Curie Cancer Care Centres or clinical nurse specialists at various hospitals in the United Kingdom. There are many well known and respected names and some new ones making an equally important contribution.

The aim of the book is to act as a support text for the many courses run by Marie Curie Cancer Care and to provide an intro- duction for other nurses caring for cancer patients and their families. It is also intended that the text should be useful as a resource for those in other fields of care.

All aspects of cancer care are included in the book, from prevention and screen- ing, treatment, palliation and bereavement. The 17 chapters also cover a wide range of topics including: health promotion, com- munication, community care, rehabili- tation, education and there is a good section on where to get help. The main principles are covered well in each of the chapters, with useful suggestions for further reading, resources and useful addresses included in addition to refer- ences. The layout of the book is consistent, with frequent headings and sub-headings, and some clear diagrams.

Cancer Care more than adequately achieves its aims. It is an excellent text to have in any hospital or community setting where nurses are likely to care for patients with cancer. It provides a basic level of information on which to build further knowledge, covering everyday issues from clinical settings. It is not, and was not intended to be, an 'advanced level' text but it provides much stimulation for the reader to go on and learn more. In addition, I would anticipate it being of great value to Project 2000 nursing students in achieving an understanding of the principles of cancer care. Many of the issues covered will be of interest to other disciplines.

Denise Bircumshaw MN BA(Hons) RGN Oncology Cert

Dip Palliative Nursing Macmillan Nurse Specialist,

University Hospital, Nottingham

Principles and Practice of Adult Health Nursing 2nd edn edited by P. G. Beare & J. L. Myers. Mosby, St Louis, 1994. 2288 pages, £52.00, ISBN 0-8016-6856-5.

This American text provides an interesting, extensive and comprehensive insight into the principles and practices of adult nurs- ing. The contributors to the book are numer- ous but necessary to support such detailed content to each of the chapters. However, it is important to highlight that many terms and aspects within the book are contextual to the American care settings and readers must be alert to the relevance within prac- tice settings in other countries.

The editors and contributors have struc- tured and designed the book in a direct and

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Book reviews

interesting format. The book is divided into two parts: the principles of adult health nursing (part 1) and the practice of adult health nursing (part 2).

Part 1 provides a foundation to part 2 and explores the foundations of adult health nursing, dimensions of the nurse's role, physiological and pathophysiological dimensions, psychosocial dimensions of adult health nursing and principles of per- ioperative nursing. Part 2 utilizes the body's systems (i.e. respiratory, etc) as a framework for focusing on specific client disorders. Each chapter in part 2 gives a detailed explanation on nursing manage- ment of the patient supported with refer- ence to normal anatomy and physiology, pathophysiology, diagnostic and labora- tory tests, etc.

l~.ach chapter/unit is we l l presented, commencing with learning objectives and key terms, making the text easy to read and follow. Text boxes are utilized within the book so as to attract the reader's attention to specific key points that are of particular relevance (e.g. standards of care, legal issues and illustrated skills). In addition, some of the chapters focus and enlarge upon particular pertinent areas of research, patient education guides, discharge plan- ning, etc. At the end of each chapter criti- cal thinking questions are posed. Unfortunately this term is misleading and is no more than review questions for the chapter. It would have been exciting and iimovative if the authors had attempted to introduce areas for critical thinking. As this is an American text the bibliographies are also exclusively American.

This comprehensive text of medical/sur- gical nursing has a lot to offer the reader. The layout is consistent in each chapter: diagrams, tables and figures are informa- tive, intelligible and support the text. The care plans that have been used are well laid out and incorporate the rationale for the intervention being used. Do read the preface as it is both informative and help- ful in guiding you through the book. Also contained within the preface is infor- mation on the ancillary pack which is designed to support instruction and pro- mote learning. This might well be of inter- est to educationalists but more information would be required. However, on balance, I would recommend that the book could be used as a reference text.

Ian Taylor Leslie IVIEd RGN RNT RMHN

Lecturer in Nursing, The Robert Gordon University,

Aberdeen

Safer Childbirth? A Critical History of Maternity Care 2nd edn by Marjorie Tew. Chapman & Hall, London, 1994. 432 pages, £16.00(pb), ISBN 0-412-56100X.

Truth according to the Chamber's Shorter English Dictionary is the practice of saying or telling what is in accordance with the facts, or in contemporary jargon 'telling it like it is'. Given that 'it ' stands for child- birth, is it safer now than in years past? Marjorie Tew, in this the 2nd edition of her book Safer Childbirth?, seeks to find not just an answer but the truth.

Faithful to the androgogical principle of self-directed study, the author embarks on a voyage of discovery. The opening dis- cussion provides a fiavour of each of the themes to be developed in later chapters. Essentially the book examines the history of childbirth. The focal points are: the practitioners, the practices, the politics and the quality of the product.

Behavioural sciences, midwifery theory, health studies, organizational structures and processes, mortality, morbidity stat- istics: teachers and students of midwifery alike will find information of value on these topics. More particularly, however, Tew seeks to expose the hidden agendas that lay beneath changes surrounding childbirth occurring in the past, or that still lie beneath those currently being pro- posed. Is the welfare of the mother and child the prime focus of health care pro- vision? Has it ever been?

In the preface Tew, a statistician, claims for herself the status of impartiality and of having an ability to be dispassionate. The reader does not progress far, however, without being acutely aware of a rising tide of emotion behind the sentiments being expressed. This depth of feeling lends fluency to her writing. The language is incisive, and the arguments presented are undeniably cogent and persuasive. Some of her most caustic comments are reserved for obstetricians. Only the masochistic or the most phlegmatic amongst them should read this volume.

The dictionary definition of truth quoted at the beginning of the review goes on to say: ' in the fine arts, a faithful adherence to nature'. Perhaps it is a misrepresentation to assign midwifery to one of the fine arts but certainly Tow makes a strong plea for a return to natural childbirth. As part of her target audience she has in her sights the general public. To this end she includes a glossary of obstetric terms to facilitate understanding by the lay reader.

Whilst concentrating mainly on England and Wales, information from the remain-

der of the United Kingdom, Europe, USA and other areas of the world is included where this lends weight to her argument. Coincidentally, therefore, this extends the appeal of the book.

The chapter headings and sub-headings allow for easy identification of topics. Extensive references at the end of each chapter and cross-referencing within the text are also helpful features.

Finally, the reader must decide whether the facts presented are indeed 'chiels that winna ding and downa be disputed' or that the author, a woman and a statistician, is playing the role of a feminist agent provo- cateur and/or confirming the comment made by Disraeli that 'there are three kinds of lies: lies, damned lies and statistics'. Whichever is true, this book is essential reading for anyone involved in anyway with childbirth. Any lurking complacency will be dispelled.

Anne C. Halliday RGN RM RCT RMT

Midwifery Tutor, Glasgow College of Nursing & Midwifery,

Glasgow

Disability is Not Measles: New Research Paradigms in Disability edited by M.H. Rioux & M. Bach. L'Institut Roehar Institute, Ontario, 1994. 288 pages, $28.00(pb), ISBN 1-895070-34-1.

Owing to the unashamedly post-modern stance which this text takes I have no doubt that it will be very popular, even amongst those who never read it. In many ways, I expect that it is precisely what many disabled people are waiting to hear: that their disabilities should not exclude them from helping to set the research agenda into disability and that, while there is no cure for disability, new research paradigms should be sought.

However, in addition to being post- modern, the book is thoroughly anti- modernist, anti-positivist and anti any of the 'ists' which have guided research into disability for the greater part of this century. in common with texts from this stable (i.e. post-modern) there are more assumptions per square inch about the wrongs which have been created by the modernist stance in disability research than are tolerable in a supposedly scholarly piece of writing.

The book, in fact, does post-moderuism no favours at all as a credible research paradigm for disability. How much more convincing it would have been if the authors had been able to reflect on several decades, or even a few years, of construc- tive research into disability on which to

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Book reviews

base their collective case. Of course, there is no such research and it is much easier to snipe at traditional positivist research.

However misguided some disability research has been in the past it is, pre- sently, not uncommon for research pro- grammes to involve disabled people. Unfortunately, there is now a concerted effort to undermine the traditional research agendas which are aimed at giving dis- abled people a better quality of life. The surrogate aims are to demand, and indeed to expect, that the whole of society should adapt to disabled people not only with changed attitudes, which is wholly land- able, but that this should be expressed by bui lding programmes which ensure that every nook and cranny of every inst i tut ion is accessible to every disabled person. All of this is regardless of cost and, being tot- ally unrealistic, is subverting the aims and objectives of organizations which rep- resent the disabled and which conduct research into disability.

The book rightly, and not unexpectedly, exposes the excesses of the eugenesist movement which, essentially, at tempted to eradicate mental disability and even low intelligence by selective breeding of the h u m a n race. Nevertheless, even in this respect, there is a major omission in that there is no ment ion of the current eugenics which operates by means of prenatal diag- nosis and abortion for a variety of potential physical and mental disabilities. Turning an obvious 'bl ind eye' to such a moral issue s imply demonstrates the nature of post- modernism: it is sufficiently politically correct that certain issues which may be upsetting to vested interests (qua femin- ism) are simply ignored.

It is very difficult for this reviewer to find anything positive to say about what may appear to be an offensive book. I would hasten to add that it is highly readable, absolutely consistent in its approach to the subject and, in its own terms, well refer- enced. Nevertheless, as ment ioned at the start of this review, I am sure the book will be hugely popular.

Roger Watson BSc PhD RGN CBiol MIBiol Lecturer in Nursing Studies,

University of Edinburgh

The Nurse as Group Leader 3rd edn edited by V. Tschudin. Scutari Press, Harrow, Middlesex, 1994. 168 pages, £12.99, ISBN 1-873853-10-6.

This is the third edit ion of a book, first pub- l ished in 1978, that is in tended as a resource to all nurses whose work involves

the membership and leadership of groups. The book contains 12 chapters which vari- ously examine such issues as the diversity of groups in nursing, group management, and specific groups for elderly people, rape survivors, parents, etc. Each chapter con- sists of a number of sub-headed sections. For instance, chapter 3, 'Working to Achieve Group Goals', has sections on phases of group movement, decision making and problem solving, leadership skills, team building and p lanned change. Each chapter ends with a number of simu- lated exercises and suggestions for further reading.

The strengths and weaknesses of this book both lie in the range of its subject matter. The author argues quite reasonably that many aspects of the nurse 's role involves group leadership or membership: case conferences, committees and meet- ings, therapeutic groups and formal classes all provide examples. There is no doubt that the book offers many useful insights into the ways these groups work and can be managed. These insights are supported by the exercises listed at the end of each chapter. However, in attempting to do jus- tice to topics as diverse as those that are covered here the author spreads herself too thin. Many of the sections on clinical topics are too brief to be useful to the novice, and would be better left in the hands of experts who would probably find little that is new. The author also fails to present much research-based evidence to support her obvious belief in the power of the group to solve problems.

This is a book that offers the interested non-expert a comprehensive overview of the field and provides a useful source of training exercises and further references, but that lacks the research-based evidence and critical rigonr that is required of a serious modem text.

Peter Draper PhD BSc RGN RNT Cert Ed

Lecturer, Institute of Nursing Studies, University of Hull

Information: A Prescription Against Pain. Vol. 1: Prescription for Recovery by Jack Hayward & Jennifer R.P. Boore. Scutari Press, Harrow, Middlesex, 1994. 114 pages, £15.99(pb), ISBN 1-873853-03-3.

This book has been re-released by the Royal College of Nursing (RCN) as part of their series of 'research classics', with the inten- tion of encouraging nursing research and awareness through the availability of exist- ing high-quality clinical studies. While cer- tain aspects of this book are a little out of

date, the relevance of these research studies cannot be understated. In many respects the authors were extremely forward thinking and there is a wealth of valuable infor- mation to be found, particularly from the literature reviews and the implications for practice because they were aware that clini- cal judgement and nursing outcomes could only be implemented and measured effec- tively when based on a standard of care which is research-based.

The book contains two pieces of research. The first, 'Information: A Prescription Against Pain', is a study of surgical patients and its aim is to measure the effect of pre-operative information- giving in relation to post-operative pain and its influence on the patient 's recovery. The second, 'Prescription for Recovery', examines the effect of pre-operative prep- oration and education on post-operative morbidity secondary to stress as a result of pain and anxiety.

Both studies are preceded by extensive literature reviews, and clear theoretical frameworks on which the studies are based. In the first book there is an explo- ration of the concepts of pain and anxiety and their relation to stress, while the second framework is constructed from Neuman's model of nursing, and was chosen because it allows for the practice of holistic care and considers the inter- action of the individual to the environment in relation to stress.

The methodology in both pieces of research is precise and clear, and the reader is in no doubt as to what the aims, hypotheses and operational definitions are. The methodology is further strength- ened because the authors undertook pilot studies in order to define dependant vari- ables and to test and refine the proposed measurement tools.

In recent years nursing has been striving to achieve recognition as an academic discipline by constructing a sound theor- etical framework on which to base its clini- cal practice. In order for nursing to move forward and continue to develop, it is essential that clinical research with rigor- ous methodology be encouraged and it would appear that the RCN feels that the availability and influence of literature such as this would be of benefit.

Debore R. Goran RGN RM Diploma Onc Nursing

Senior Staff Nurse, Royal Free Hospital NHS Trust, London

Individuals wishing to order books reviewed should contact the publisher of

the book direct.

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