Australian Occupational Therapy Journal

(2002)

49

, 53–56

Blackwell Science, Ltd

B o o k R e v i e w s

BEES SGML

LIVING WITH BRAIN INJURY: A GUIDE FOR FAMILIES AND CAREGIVERS

Sonia Acorn and Penny Offer, Eds (1998), 168 pp., US$18.95

University of Toronto Press, Toronto, Canada

As the title suggests, this book has been written specificallyfor families and caregivers of people with an acquired braininjury (ABI), with an emphasis on adults rather than children.It presents issues along the rehabilitation continuum, fromacute care to long-term adjustment issues.

Each chapter has been contributed by a differentauthor from a variety of backgrounds and experience,including two authors who are ‘survivors of brain injury’.For occupational therapists working in the field of ABI, thisbook offers a further resource in our work with familiesand adds to an understanding of psychosocial, family andadjustment issues.

The downside to this collection of chapters fromvarious authors, some of which have been previouslypublished, is that there tends to be some repetition betweenchapters, and writing style and format varies. However,information is generally clearly presented and is easilyunderstood, given the broad spectrum of likely outcomesfollowing ABI, which the book attempts to address.

Each chapter deals with a specific issue, beginning withthe basics of ‘What is a Brain Injury?’, acute care, rehabil-itation, case management, long-term adjustment, familyand relationships, leisure and recreation, and legal issues.Vocational issues are not dealt with in detail. Childrenand adolescents with ABI are covered under a separatechapter. Given that the book is a Canadian publication,some material is not relevant to the Australian situation(e.g. legal issues). An attempt has been made to extendthe relevance of the resource by including contact detailsof National Brain Injury Associations in Canada, UnitedStates, Great Britain, Australia and New Zealand, plussome website addresses.

Some topics have been dealt with more simply andidealistically than others. For example, the Case Manage-ment chapter advocates for life-long case management

following ABI, beginning in acute care. Depending onresources, philosophy and each individual situation, thismay not be possible or desirable. However, other topics arewell covered with a variety of perspectives and recogni-tion of the wide spectrum of outcomes and individualcircumstances of people and ABI.

For occupational therapists, this book is a usefulresource for work with families and caregivers, particu-larly if chapters are used selectively on an individualbasis. A loose-leaf format would better suit this use. Whilesimilar to one or two other resources, this one is unique inthe variety of its authors, particularly those who have anABI themselves.

Susan Gauld

Rehabilitation Coordinator — O.T.

Acquired Brain Injury Outreach Service

Buranda, Queensland, Australia

491278Book ReviewsBook Reviews10.1046/j.0045-0766.2002.00278.xBook ReviewsBEES SGML

USING QUALITATIVE RESEARCH: A PRACTICAL INTRODUCTION FOR OCCUPATIONAL AND PHYSICAL THERAPISTS

Karen Whalley Hammell, Christine Carpenter and Isabel Dyck, Eds (2000), 136 pp., £15.95

Churchill Livingstone

,

London, UK

The editors of this book have aimed to provide students,researchers and rehabilitation practitioners with ‘apractical introduction to qualitative research’ (p. ix). Theeight contributing authors are affiliated in some way withthe University of British Columbia, Canada. All but one(a physiotherapist) are occupational therapists.

The book’s 10 chapters explore fundamental issues ofqualitative research including: its characteristics and assump-tions (compared with those of ‘quantitative’ research);design features and ethical considerations; practical aspectsof collecting and analysing data; and guidelines for evalu-ating the quality of published research. Chapters are short,well organised and easy to read.

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A case study approach is used throughout, wherebyphilosophies, concepts and methods of qualitativeresearch are discussed in relation to studies undertaken bythe authors. This approach brings abstract elements ofresearch ‘to life’ in an interesting way as each authorexplains various steps of the research process and therationale behind them. The research studies used asexamples should appeal to a broad readership. These spana variety of practice arenas (from community mental healthto neurological rehabilitation) and a range of daily lifesettings (from the home to the workplace).

Although this book does not present anything newcontent-wise, it presents standard material in an appliedand accessible form for the research newcomer. In thissense, it is a welcome addition to the qualitative researchliterature. The book’s shortcomings are few and minor.For example, there is some unnecessary repetition ofcontent among several of the chapters. Also, further dis-cussion of major qualitative research methodologies, withaccompanying examples, would be a welcome addition.

In summary, the book succeeds as a concise, readableintroduction to qualitative research for beginners. Forthe more sophisticated research consumer, the bookcontains ample references to more comprehensive researchpublications.

Michael Lyons

Discipline of Occupational Therapy,

University of Newcastle, Newcastle,

New South Wales, Australia

491March 2002283Book ReviewsBook Reviews10.1046/j.0045-0766.2002.00283.xBook ReviewsBEES SGML

CONTINUING PROFESSIONAL DEVELOPMENT IN HEALTHCARE

Auldeen Alsop (2000), 224 pp., £19.99

Blackwell Science, Oxford, UK

The publication of Auldeen Alsop’s guide to professionaldevelopment for therapists is most timely given the recentlaunch of the Accredited Occupational Therapist programmein Australia. Accredited occupational therapists are expectedto maintain their knowledge and skill by participating in arange of professional development activities. If you haveany doubt at all about whether you can achieve or maintainaccredited status, this book will provide a great deal ofreassurance and inspiration.

The author does a very good job of describing profes-sional development strategies and their benefits. Shetakes a broad-brush approach to the definition of profes-sional development and identifies a range of learningopportunities that are often taken for granted by thera-pists as simply ‘part of work’. I particularly like the inclu-sion of quality improvement activities such as clinicalaudit and critical pathways as professional developmentopportunities.

Two chapters focus on learning portfolios. Portfoliosare broadly comparable with an accreditation log, andprovide a record of learning experiences and outcomes ofthese experiences. A particularly nice definition of port

-

folios, ‘a record of what the portfolio owner has to offerclients’, emphasises that ultimately professional develop-ment activities are designed to impact on those who utilisetherapy services. The use of portfolios for career develop-ment is also highlighted.

There is some discussion of learning theory andlearning styles. This is written in a way that will assist thereader to obtain an understanding of their own learning,rather than as an academic exploration of the topic.Additionally, there is some discussion of the mutualobligation of therapists and employers for professionaldevelopment; however, this does not extend into consider-ation of any potentially controversial issues, such as whoshould pay.

The book expands on views previously presented bythe author in

British Journal of Occupational Therapy

publications. Some aspects of the book specifically addressa UK audience. Hence, some references to legislation,professional association, government policy on lifelonglearning and software are not directly relevant to theAustralian reader.

This book is essentially a practical and useableresource. The content is primarily directed toward indi

-

vidual practitioners mapping out a learning plan, althoughthere is a discussion of strategies that can create a learningorganisation that will be of interest to service managers. Itwill also appeal to those providing professional supervisionand mentoring to support others in their learning andcareer progression.

Rebecca Allen

Education Development Officer,

Department of Psychiatry,

The University of Melbourne,

Parkville, Victoria, Australia

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Book Reviews

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491March 2002282Book ReviewsBook Reviews10.1046/j.0045-0766.2002.00282.xBook Reviews000000BEES SGML

OCCUPATIONAL THERAPY AND STROKE

Judi Edmans, Annette Champion, Louise Hill, Mike Ridley, Fiona Skelly, Therese Jackson and Moya Neale (2000), 174 pp., £19.50

Whurr, London, UK

Occupational Therapy and Stroke

, written by the strokeclinical forum members of the National Association ofNeurological Occupational Therapists, UK, is intendedfor occupational therapists novice in the field of strokemanagement. The primary purpose of the book is to providepractical clinical guidelines for managing the many andcomplex problems experienced post-stroke. This is achievedin the context of current standards of practice in the UK.

Stroke management is presented as encompassingdirect patient contact duties as well as broader profes-sional issues. The authors provide an overview of the med-ical condition of stroke and identify major areas of deficit,followed by assessment and treatment guidelines. The textis structured to follow the medical model.

In presenting practice guidelines, the authors provide abrief overview of different frames of reference and treat-ment approaches, based on the literature. This is followedby specific, clinically based suggestions of how an occupa-tional therapist may address limitations to performance ofdaily activities associated with the major areas of deficit.Practice guidelines are often presented in checklist format.However, the novice therapist needs to be cautioned notto adopt a recipe-based approach and to incorporate thesesuggestions within a frame of reference, such as the occu-pational performance model. Therapists would also needto read more widely on current, evidence-basedapproaches before being able to incorporate these intopractice. There is scope for more recent, evidence-basedprinciples of training to be referenced in this section.

Standards of practice and many of the resourcesreferred to are specific to current practice in the UK. Assuch, the book provides a particularly useful guide fortherapists in the UK. There are, however, differences inpractice across countries, potentially limiting applicationof this text. Nevertheless, while emphasis is given toapproaches commonly adopted in the UK (e.g. Bobathapproach), other approaches are also reviewed. Further-more, many issues are common across countries. Thereare only a few current publications, such as that by the

American Occupational Therapy Association, that spec-ify clinical practice guidelines for stroke.

Evaluation and evidence-based standards of practiceare important themes addressed in the later chapters. Theneed for evidence to guide clinical practice and the currentpaucity of occupational therapy research in stroke man-agement are highlighted. An interesting and valuablecontribution is the overview of new approaches to therapy,recent studies of occupational therapy effectiveness andcurrent research projects in the UK. This provides a plat-form to introduce the idea that research findings may leadtherapists away from more traditional treatment activitiesto new roles.

In conclusion, the authors provide a valuable practicalresource for therapists novice in stroke management.They present current clinical guidelines for the UK, whilehighlighting the importance and need for further evidence.

Leeanne Carey

Senior Lecturer, School of Occupational Therapy,

La Trobe University, Bundoora, and

Senior Research Fellow, National Stroke Research Institute,

Austin & Repatriation Medical Centre, Heidelberg,

Victoria, Australia

491March 2002290Book reviewsBook reviews10.1046/j.0045-0766.2002.00290.xBook ReviewsBEES SGML

NEUROPSYCHOLOGY FOR OCCUPATIONAL THERAPISTS

June Grieve (1999), 2nd Edition, 176 pp., £17.99

Blackwell Science, Oxford, UK

Neuropsychology for Occupational Therapists

providesstudents and clinicians with an introduction to the under-standing and assessment of cognition and perception. Thesecond edition, retaining the format of the previous edition,presents the topic in three parts. The first part provides abackground to cognitive neuropsychology, emphasisingthe importance of viewing cognition and perception inthe context of a complex, integrated neural network. Thesecond part introduces the reader to the theory behindtopics such as visual perception, spatial abilities, attention,memory, task performance and executive functions. Thethird part addresses the issue of assessing cognition and per-ception utilising functional and standardised methodology.

The book is written in a simple, easy to read manner.Activities are utilised to assist the reader in understanding

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relevant components of cognition and perception. Someadditional information has been incorporated into thesecond edition (although poorly referenced); however, thisdoes not reflect the recent increase in available evidenceregarding cognition and perception. Unfortunately thesimplicity of the information given, particularly in thesecond part, lends itself to misrepresentation of someimportant key components of cognition and perception.

The third part addresses the issue of the assessment ofcognition and perception in occupational therapy. Theauthor acknowledges two approaches to assessment: func-tional (ADL) assessment and impairment-based assess-ment. She includes the use of standardised assessments inimpairment-based assessment, claiming functional-basedassessments tend to be weighted towards physical, morethan cognitive, dysfunction. She argues cognitive impairmentis identified by standardised assessment, and the subsequenteffect of such impairment on daily activities is inferred fromthe assessment outcome. While the author does refer to acombination of both functional and impairment-basedassessment, the remainder of the text appears weightedtowards endorsement of standardised (non-functional)assessment. There is no reference to the existence ofstandardised functional assessments such as theÁrnadóttir Occupational Therapy Neurobehavioural Eval-uation (A-ONE; Árnadóttir, 1990); the Structured Obser-vational Test of Function (SOTOF; Laver & Powell, 1995)or the Assessment of Motor and Process Skills (AMPS;Fisher, 1997).

This reviewer considers this approach towards assess-ment disturbing. Our credibility as clinicians should not comefrom standing behind the results of standardised, non-functional assessments. The occupational therapist has aunique role in identifying what is the functional significance

of a cognitive and perceptual impairment. This informationis not available by standardised non-functional assessmentalone (hence the move by our neuropsychological colleagues tothe design of more functionally orientated assessment tools).Functional cognitive and perceptual assessment by skilledclinicians utilising clinical reasoning cannot be overempha-sised. While the author does make a token reference tothe importance of clinical reasoning, this is not emphasisedsufficiently in both the selection of assessment tools and theevaluation of such assessment and subsequent intervention.

This book, while providing some basic information incognition and perception, should be viewed in context. Itprovides a reasonable introduction to the area of cogni-tion and perception; however, the interested clinicianshould be encouraged to pursue evidence-based literaturethat incorporates a clinical-reasoning approach to cogni-tion and perception.

Louise Corben

Senior Clinician (Neurosciences),

Occupational Therapy,

Monash Medical Centre, Clayton,

Melbourne, Australia

REFERENCES

Árnadóttir, G. (1990).

The brain and behaviour: Assessing

cortical dysfunction through activities of daily living

. StLouis, MO: C.V. Mosby.

Fisher, A. G. (1997).

Assessment of motor and process

skills

(2nd edn). Fort Collins, CO: Three Star Press.Laver, A. J. & Powell, G. E. (1995).

The structured

observational test of function (SOTOF)

. Windsor:NFER-NELSON.

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