Physiotherapy December 2003/vol 89/no 12

Book reviews 767

Mac Keith Press, distributed by Cambridge UniversityPress2003 (ISBN 1 898683 33 6). Illus. 274 pages

edited by John V Banta and David Scrutton £50This book, which is part of the Clinics in DevelopmentalMedicine series (no 160), has contributions from variousdistinguished authors from Britain and the USA.

It provides a complete manual, focused on hip disordersfound in childhood – not only those of children withdisabilities but also of non-disabled children. Readers of avariety of professional backgrounds will find this a usefultheoretical adjunct to their clinical practice.

The book begins with a chapter which outlines thedevelopment of the hip joint from an embryonic age offour weeks and charts this in the growing and developingchild. It provides a useful background and explains thebasis for many of the problems that can occur in laterchildhood.

It goes on to describe in detail how to examine the hipjoint in clinical practice with clear photographs anddiagrams supporting the text. A brief chapter onradiological examination of the hip completes the firstsection of the book.

The book then has a series of chapters (4 to 14) coveringcommon hip conditions found in childhood, such asdysplasias, painful hip, Perthes, juvenile idiopathic arthritis,cerebral palsy, myelo-meningocele and muscle weaknessdisorders.

Among these chapters is one (chapter 11) on gait analysisand although its content is excellent I would question itsinclusion within this section of the book as it might havebeen better placed at the end of the section, prior to thechapter covering orthotic management of hip pathologies.

The book concludes with a section on more unusualdisorders and covers such conditions as arthrogryposis,haemophilia, Down syndrome, sickle cell disease, proximalfocal femoral deficiency and chondrolysis of the hip. Ineach area there is a brief explanation of the condition andhow it affects the joint, followed by management strategies.

Throughout the book the text is well supported with references but in a few cases these are almost 30 years old. There are several photographs and diagramsthroughout the book as well as tables and figures. These arein the most part well labelled and clear – relating to andsupporting the text.

The book is very relevant to physiotherapists working inthe varied field of paediatrics and provides a usefulresource and collates information that previously may haveonly been found in several different texts. The format ofthe book is one with which many will be familiar. It isunwieldy and for some may not be an easy read, but it is aresource that can be picked up and put down as needed forreference. It may well be too expensive for individuals to buy but would be a valuable reference book for anypaediatric department.

Julia Graham MCSP

Radcliffe Medical Press, Abingdon2003, 2nd edn (ISBN 1 85775 981 8). 378 pages

by Moira Stewart, Judith Belle Brown, W Wayne Weston, IanR McWhinney, Carol L McWilliam and Thomas Freeman £25This substantial book explores in detail an approach tomedicine which is ‘patient-centred’ rather than ‘disease-centred’. Although it is written primarily for doctors, theissues are equally relevant to other healthcare workersincluding physiotherapists. Without denigratingbiomedicine, the authors urge us to expand our thinking toembrace psychosocial issues, including wide social andcultural factors, when attempting to assist people who seekour help. The authors are all Canadian but the issuesexplored are just as relevant to healthcare practitioners inBritain.

The book is presented in four parts. Part 1 provides anoverview of the patient-centred approach. Part 2 presentsthe six components of the patient-centred clinical methodwhich include ‘Understanding the whole person’ and‘Exploring both the disease and the illness experience’.Part 3 focuses on learning and teaching the patient-centredmethod. This is relevant to all educators but, as theemphasis is on one-to-one teaching, it may be particularlyuseful for those who teach in the clinical setting. There isalso a useful chapter on developing a patient-centredcurriculum which may be of interest to university lecturers.Part 4 focuses on research. It includes a discussion ofqualitative methodology, which may help to illuminatepatient-centred care, and presents various measures of‘patient centeredness’.

Despite these strengths, a major shortcoming for me isthe total absence of the voice of disabled people. Althoughthe concepts of ‘disease’ and ‘illness’ are carefully definedand differentiated, ‘disability’ and ‘impairment’ areequated with illness and disease and the whole academic

Hip Disorders in Childhood

Patient-centred Medicine Transforming the clinical method

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