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Caring for Health Susan Procter, Macmillan Press Ltd 2000 Basinastoke, 212 pages ISBN: 0-333-62248-0, Price £14.99 (paperback)
B O O K
R E V I E W S
Caring for Health Susan Procter, Macmillan Press Ltd 2000 Basinastoke, 212 pages ISBN: 0-333-62248-0, Price £14.99 (paperback)
Nurses and Nursing: Influencing Policy Gough P, Walsh N (eds), Radcliffe Medical Press, Oxon, 2000, 125 pages ISBN 1 85775 353 4, Price: £17.95 (paperback)
The concept of existentialism, and indeed holism, is undisputed in the ethos of nursing and within the curriculum of nurse education today, and may be considered a crucial aspect in the future development of nursing into and beyond the 21st century. Within the political arena, now more than ever, there is increasing emphasis upon a collaborative approach to health care by knowledgeable doers, and of providing best practice that is appropriate to meet the needs of the local population. Unfortunately, there still remain many ambiguities as far as health and health care is concerned, and although much good work has been developed in support of the ideology of nursing, the true strengths of nursing have to date been undervalued. This is a particularly important and useful book for several reasons. Firstly, it makes a very valuable contribution to nursing, enabling the reader to develop a conceptualised approach to the delivery of care. Secondly, its structured thematic visionary approach endorses the concept of caring, and encourages collaborative practice as the way forward to realise health care outcomes. The book is organized into an introduction followed by eight chapters, each of which focus upon nursing and nursing’s contribution to health care. In the introduction, Proctor’s focus is on the lack of apparent caring in many of our so-called health care institutions. She acknowledges the contribution that activities of daily living have on the physiological, psychological and sociological well being of the individual. The introduction concludes with a brief overview of each of the chapters that make up the book. The range of chapters all capture the underlying theme of care and useful vignettes contribute to further understanding of the issues. The variability of health and health care, and the way in which nursing may be subjectively and objectively measured, caters for a wide audience and the book will be a suitable text for both undergraduate and postgraduate study. Many of the issues within the book are not new to nursing. Indeed, many issues may have been studied in isolation in some depth. Proctor has incorporated the relevance of the concept of caring, and consequently makes a valuable contribution to both the future delivery of health care and, in particular, the development of an ideology for nursing.
The first in a series that sets out to explore the contribution of nursing and nurses to the development of health, social and public policies, this book specifically focuses on public health within the current NHS reforms and modernization agenda. The main aim of the book is to move away from looking at nursing as a victim and recipient of policy, to one of active participation in influencing policy development. This aim is reasonably achieved by the various contributors, although chapter four covers much of the same ground as chapters two and three and does not take the dabate much further. Opening the dabate, chapter two provides an interesting and detailed discussion of the changing role of the nurse in public health. The author however concentrates her arguments on a challege to medicine, based on the trait approach to professionalization, with power drawn from having a unique body of knowledge. This is an old argument that has obsessed nurses for too long. The power relationship is tripartite between the State, the Patient/Client and the professions, with the State taking central position. If nurses are to have any impact on policy development, efforts should be directed at influencing the public and the government (as demonstrated by the nurse-led health centre described in chapter five), rather than challenging the power base of another profession. The chapter spends too much space on historical changes and misses an opportunity to explain and argue the case for a major public health role for nurses based on health impact on the environment and a whole system care approach. The following two chapters are excellent in their detail and dicussions. The first, on the strategic role of nurses in commissioning healthcare services, provides a positive approach on how to operate between policy and practice. However, the suggestion that nurses can act both as commissioner and operational manager is not convincing. The second on the establishment of a nurse-led primary care act pilot (PCAP) is a salutary example of how to work with the power bases to influence policy and change practice. It should be recommended reading for all nurses. Chapter six describes the role of nurses in Health Action Zones (HAZ). While this is an excellent explanation of the issues, it focuses on the HAZ framework rather than the role and impact that nurses can make in working with or within a whole system model that draws on multi-agency
Kathryn M King doi:10.1054/cein.2001.0211, available online http://www.idealibrary.com on
C 2001 Harcourt Publishers Ltd Clinical Effectiveness in Nursing (2001) 5, 133–134 °
134
Clinical Effectiveness in Nursing
working to tackle inequality of provision in certain areas and conditions. HAZ, as a politically driven framework, is becoming dated already like other such initiatives, for example GP Fundholding. The role of nurses in leading a whole system approach to public health could have been discussed in more depth, using HAZ as an example of such systems. The final chapter summarizes the key arguments and brings together the different aspects of the initial aim. Part of that aim is to move a position of policy for nursing. This may not be the best way forward. In most policy contexts the concern should be about the public’s health and patient care. Nursing’s impact on policy should focus on that rather than the development of nursing or the profession. The latter is an outcome of the former. The benefit to the profession will follow. The book overall is very readable and accessible to all nurses but lacks references to the main literature on health/social care policy development. This is reflected in the limited references list at the end of each chapter. While I would recommend the book for undergraduate courses, perhaps with the aim of generating debate around the issues raised in this review, at £17.95 it is expensive for most students.
Professor Vince Ramprogus doi:10.1054/cein.2001.0218, available online http://www.idealibrary.com on
Research in Palliative Care, Field D, Clark D, Corner J and Davis C (eds) Open University Press, 2001 ISBN 0335204 368, Price £22.50 (paperback) ISBN 0335204 376, Price £65.00 (hardback) With an ever increasing emphasis on the need for evidence based care, this book comes at an oppurtune time. Palliative Care is a small, young speciality which is striving to increase its evidence base in the face of particular, often unique, difficulties. This book is aimed at practitioners in specialist Palliative Care with little or no formal research training and students. The introduction begins by outlining some of the difficulties and challenges of research in this area, highlighting the problems of a small speciality in small clinical settings leading to small samples. It then raises the issue of working with profoundly ill people with a lack of developed
measurement tools or outcome measures. It goes on to discuss the history of Palliative Care research and the selection of a appropriate methodologies for research in this area. There is a useful set of questions to use as a guide when implementing or evaluating research. The rest of the book is set out in three parts. The first examines specific methodologies in more detail with links to clinical examples in part 2 of the book. A helpful distinction between quantitative and qualitative research is made and their relative merits in Palliative Care research discussed. This section closes with a chapter on ethical considerations such as informed consent, confidentiality, weighing benifits and risks of research and the specific issues these pose in Palliative Care. Part 2 is a series of real research projects which are presented to emphasize particular topics such as the merits of prospective studies versus retrospective studies, the complexities of multi-centre studies and the emotional and practical difficulties for the researchers themselves. Part 3 looks at the emerging science of needs assessment research and the struggle to develop methodologies in the face of increasing demands from policy makers. Both organizational and clinical audit in Palliative Care are discussed as well as the use of evaluation studies. The book’s overall message is that research methodology must be matched to the research question. Developments in methodologies are necessary to approach the particular difficulties and challenges in specialist Palliative Care research and the authors suggest that more multi disciplinary, multi-method, collaborative studies are needed. This is a readable and very useful text book which is logically laid out with clear aims and introductions to the sections. it can be read as a whole or ‘dipped into’. Each chapter addresses particular Palliative Care challenges and puts general research topics into the specific context of Palliative Care. It offers something to readers at many levels – those who are about to embark on research themselves, those who wish to be able to better evaluate others’ research and to students studying research as a topic in its own right. Specific research texts in Palliative Care are rare so this is a ‘must have’ for any library with a Palliative Care section. It would also be useful to have around in specialist Palliative Care clinical settings.
Alison Conner doi:10.1054/cein.2001.0230, available online http://www.idealibrary.com on
R E V I E W S
Caring for Health Susan Procter, Macmillan Press Ltd 2000 Basinastoke, 212 pages ISBN: 0-333-62248-0, Price £14.99 (paperback)
Nurses and Nursing: Influencing Policy Gough P, Walsh N (eds), Radcliffe Medical Press, Oxon, 2000, 125 pages ISBN 1 85775 353 4, Price: £17.95 (paperback)
The concept of existentialism, and indeed holism, is undisputed in the ethos of nursing and within the curriculum of nurse education today, and may be considered a crucial aspect in the future development of nursing into and beyond the 21st century. Within the political arena, now more than ever, there is increasing emphasis upon a collaborative approach to health care by knowledgeable doers, and of providing best practice that is appropriate to meet the needs of the local population. Unfortunately, there still remain many ambiguities as far as health and health care is concerned, and although much good work has been developed in support of the ideology of nursing, the true strengths of nursing have to date been undervalued. This is a particularly important and useful book for several reasons. Firstly, it makes a very valuable contribution to nursing, enabling the reader to develop a conceptualised approach to the delivery of care. Secondly, its structured thematic visionary approach endorses the concept of caring, and encourages collaborative practice as the way forward to realise health care outcomes. The book is organized into an introduction followed by eight chapters, each of which focus upon nursing and nursing’s contribution to health care. In the introduction, Proctor’s focus is on the lack of apparent caring in many of our so-called health care institutions. She acknowledges the contribution that activities of daily living have on the physiological, psychological and sociological well being of the individual. The introduction concludes with a brief overview of each of the chapters that make up the book. The range of chapters all capture the underlying theme of care and useful vignettes contribute to further understanding of the issues. The variability of health and health care, and the way in which nursing may be subjectively and objectively measured, caters for a wide audience and the book will be a suitable text for both undergraduate and postgraduate study. Many of the issues within the book are not new to nursing. Indeed, many issues may have been studied in isolation in some depth. Proctor has incorporated the relevance of the concept of caring, and consequently makes a valuable contribution to both the future delivery of health care and, in particular, the development of an ideology for nursing.
The first in a series that sets out to explore the contribution of nursing and nurses to the development of health, social and public policies, this book specifically focuses on public health within the current NHS reforms and modernization agenda. The main aim of the book is to move away from looking at nursing as a victim and recipient of policy, to one of active participation in influencing policy development. This aim is reasonably achieved by the various contributors, although chapter four covers much of the same ground as chapters two and three and does not take the dabate much further. Opening the dabate, chapter two provides an interesting and detailed discussion of the changing role of the nurse in public health. The author however concentrates her arguments on a challege to medicine, based on the trait approach to professionalization, with power drawn from having a unique body of knowledge. This is an old argument that has obsessed nurses for too long. The power relationship is tripartite between the State, the Patient/Client and the professions, with the State taking central position. If nurses are to have any impact on policy development, efforts should be directed at influencing the public and the government (as demonstrated by the nurse-led health centre described in chapter five), rather than challenging the power base of another profession. The chapter spends too much space on historical changes and misses an opportunity to explain and argue the case for a major public health role for nurses based on health impact on the environment and a whole system care approach. The following two chapters are excellent in their detail and dicussions. The first, on the strategic role of nurses in commissioning healthcare services, provides a positive approach on how to operate between policy and practice. However, the suggestion that nurses can act both as commissioner and operational manager is not convincing. The second on the establishment of a nurse-led primary care act pilot (PCAP) is a salutary example of how to work with the power bases to influence policy and change practice. It should be recommended reading for all nurses. Chapter six describes the role of nurses in Health Action Zones (HAZ). While this is an excellent explanation of the issues, it focuses on the HAZ framework rather than the role and impact that nurses can make in working with or within a whole system model that draws on multi-agency
Kathryn M King doi:10.1054/cein.2001.0211, available online http://www.idealibrary.com on
C 2001 Harcourt Publishers Ltd Clinical Effectiveness in Nursing (2001) 5, 133–134 °
134
Clinical Effectiveness in Nursing
working to tackle inequality of provision in certain areas and conditions. HAZ, as a politically driven framework, is becoming dated already like other such initiatives, for example GP Fundholding. The role of nurses in leading a whole system approach to public health could have been discussed in more depth, using HAZ as an example of such systems. The final chapter summarizes the key arguments and brings together the different aspects of the initial aim. Part of that aim is to move a position of policy for nursing. This may not be the best way forward. In most policy contexts the concern should be about the public’s health and patient care. Nursing’s impact on policy should focus on that rather than the development of nursing or the profession. The latter is an outcome of the former. The benefit to the profession will follow. The book overall is very readable and accessible to all nurses but lacks references to the main literature on health/social care policy development. This is reflected in the limited references list at the end of each chapter. While I would recommend the book for undergraduate courses, perhaps with the aim of generating debate around the issues raised in this review, at £17.95 it is expensive for most students.
Professor Vince Ramprogus doi:10.1054/cein.2001.0218, available online http://www.idealibrary.com on
Research in Palliative Care, Field D, Clark D, Corner J and Davis C (eds) Open University Press, 2001 ISBN 0335204 368, Price £22.50 (paperback) ISBN 0335204 376, Price £65.00 (hardback) With an ever increasing emphasis on the need for evidence based care, this book comes at an oppurtune time. Palliative Care is a small, young speciality which is striving to increase its evidence base in the face of particular, often unique, difficulties. This book is aimed at practitioners in specialist Palliative Care with little or no formal research training and students. The introduction begins by outlining some of the difficulties and challenges of research in this area, highlighting the problems of a small speciality in small clinical settings leading to small samples. It then raises the issue of working with profoundly ill people with a lack of developed
measurement tools or outcome measures. It goes on to discuss the history of Palliative Care research and the selection of a appropriate methodologies for research in this area. There is a useful set of questions to use as a guide when implementing or evaluating research. The rest of the book is set out in three parts. The first examines specific methodologies in more detail with links to clinical examples in part 2 of the book. A helpful distinction between quantitative and qualitative research is made and their relative merits in Palliative Care research discussed. This section closes with a chapter on ethical considerations such as informed consent, confidentiality, weighing benifits and risks of research and the specific issues these pose in Palliative Care. Part 2 is a series of real research projects which are presented to emphasize particular topics such as the merits of prospective studies versus retrospective studies, the complexities of multi-centre studies and the emotional and practical difficulties for the researchers themselves. Part 3 looks at the emerging science of needs assessment research and the struggle to develop methodologies in the face of increasing demands from policy makers. Both organizational and clinical audit in Palliative Care are discussed as well as the use of evaluation studies. The book’s overall message is that research methodology must be matched to the research question. Developments in methodologies are necessary to approach the particular difficulties and challenges in specialist Palliative Care research and the authors suggest that more multi disciplinary, multi-method, collaborative studies are needed. This is a readable and very useful text book which is logically laid out with clear aims and introductions to the sections. it can be read as a whole or ‘dipped into’. Each chapter addresses particular Palliative Care challenges and puts general research topics into the specific context of Palliative Care. It offers something to readers at many levels – those who are about to embark on research themselves, those who wish to be able to better evaluate others’ research and to students studying research as a topic in its own right. Specific research texts in Palliative Care are rare so this is a ‘must have’ for any library with a Palliative Care section. It would also be useful to have around in specialist Palliative Care clinical settings.
Alison Conner doi:10.1054/cein.2001.0230, available online http://www.idealibrary.com on