Australian Occupational Therapy Journal (2003) 50, 50–52

Blackwell Science, Ltd

L e t t e r t o t h e E d i t o r

Letter to the EditorLetter to the EditorLetter to the EditorDear Editor,As an occupational therapist who recently worked in thenursing home and hostel industry, I read with interestFrench’s (2001) Viewpoint article. The Journal is to be con-gratulated for facilitating discussion on such an importantissue as aged care.

The article illustrated the not-so-private personal careroutines of a Melbourne nursing home and hypothesiseda relationship between the organisational environmentand the occupational performance of the organisationalmembers. The author suggested that occupational therapyinterventions in these settings could be more effectivethrough changes in occupational therapy curricula.

I began working as an occupational therapist inresidential care soon after I graduated. My interventionsfocused on occupations outside the nursing care role andincluded not solely the immediate physical environmentbut on wider social, cultural, temporal and spiritual issuesrelevant to each resident. I observed in my organisationthe public toileting and showering acts French (2001)described. Although I knew from my undergraduate stud-ies of Kielhofner (1995) the importance of modifying theenvironment, I felt powerless to make changes outsidethe environment I believed I could change. I lacked the

experience and confidence needed to change the organisa-tion’s system and culture.

I welcome an education programme with greater emphasison the organisational, political, economic and social systems.This would equip young graduate occupational therapists withan understanding of the systems they move into and enablethem to be more politically, economically and socially awaretherapists. However, I believe that the experience and con-fidence needed to make organisational and cultural changeswithin a system need to be gained through doing and working,and cannot be learned solely in an educational programme.

Tamara TseOccupational Therapist,

Inner East Community Health Service,

Melbourne, Victoria, Australia

REFERENCES

French, G. (2001). Challenging the role of occupational therapistsin clinical practice: An environmental perspective. AustralianOccupational Therapy Journal, 48, 176–180.

Kielhofner, G. (Ed.) (1995). A model of human occupation: Theoryand application (2nd edn). Baltimore: Williams & Wilkins.

B o o k R e v i e w s

Book ReviewBook ReviewBook ReviewHANDBOOK FOR RESEARCH METHODS IN HEALTH SCIENCESVictor Minichiello, Gerard Sullivan, Ken Greenwood andRita Axford (Eds) (1999), 658 pp., $65.00

Addison Wesley Longman, Sydney, Australia

The word ‘handbook’ in the title could suggest that thisis a ready reference text for experienced health sciencesresearchers looking for concise information about dis-crete topics, such as the equation needed to calculateconfidence intervals, or the definitions of certain terms

such as ‘emic’ and ‘etic’. This is not so. This 658 pagebook is written primarily as a textbook for healthsciences students. It would be most useful as part of therecommended reading for a formal course in researchmethods, and would be a good text for this purpose. Itcan be used to some extent as a ready reference text (forexample, ‘emic’ and ‘etic’ are indexed) but is limited inthis (for example, ready access is not provided to com-monly needed formulae, nor commonly used terms suchas absolute risk, relative risk or the number needed totreat). These examples also hint at the relative strengthsand weaknesses of the book: it is most strong in thequalitative research domain.

Book Reviews 51

Overall, the Handbook aims to foster understandingof, rather than just providing the mechanical aspects of,research.

The Handbook would suit students of all health sci-ences disciplines, but would not be suitable as a principaltext for those interested primarily in the biomedicalaspects of health such as the study of epidemics, and theevaluation of diagnostic tests or of therapies. Coverage ofhealth economics is skimpy. Most surprising is the lack ofa substantial section on systematic reviews/meta-analyses(less than two pages are devoted to this). It is refreshinglydifferent from many other competent biostatistics andclinical epidemiology texts in two ways. First, the examplescited come from a wide range of disciplines, not just frominternal medicine and surgery; often examples in othertexts concentrate on medical topics such as cancer, bloodydiarrhoea and randomised controlled trials of medications.These examples are tedious for health sciences studentsother than medical students to read. Second, most of theexamples are Australian examples.

The introductory sections to health research, whichdeal with the logic of various research endeavours, are aparticular strength of the text. Students who accept that,as aspiring professionals, they should be interested inresearch, but who have limited appreciation of why this isso, will gain much from the introductory sections. The var-ious possible approaches to research are well described.So too are the effects of various underlying philosophieson research: they are described clearly and with respectfor the various points of view.

This book deserves to be considered as a referencetext by teachers of research methods in health sciences.Students who find other texts too mechanical or toomathematical may well find this text most approachableand useful.

Peteris DarzinsAssociate Professor, Monash University,

Monash Ageing Research Centre,Melbourne, Victoria, Australia

49

B o o k R e v i e wBook ReviewsBook ReviewsBook ReviewLIVE STRONGER LIVE LONGER: AN EXERCISE AND LIFESTYLE PROGRAM FOR OVER 40SMark Awerbuch (2001), 230 pp., $29.95

McGraw-Hill, Sydney, Australia

Mark Awerbuch’s Live Stronger Live Longer is intended tobe a text that provides a balanced exercise programme for

anyone interested in increasing their levels of fitness. Itprovides good coverage of the benefits of adopting a life-style change though nutrition and exercise and outlinestraining programmes for people over the age of 40 and forpeople with arthritis.

This book is divided into two parts. Part 1 is titled‘things to be aware of before starting the program’ andconsists of 10 chapters covering such topics as metabolismand muscles, overweight or fat, food and diet, exercise,and the principles of resistance training. Part 2 is titled‘getting down to it’ and consists of eight chapters coveringsuch topics as stretching, resistance training, cardiovascu-lar training, back pain and back exercises, and the import-ance of goals.

Live Stronger Live Longer was written by a consultantrheumatologist and pain physician who has an interest infitness and lifestyle. The motivation for the book was hisinterest and involvement in sport and the results from anumber of scientific studies demonstrating the healthbenefits of regular exercise in people with a wide range ofmedical conditions. He has drawn on his fitness experiencesand his medical background to develop training programmesthat are designed to build muscle and strength, prevent boneloss, restore flexibility, and minimise the loss of movementspeed.

At first glance, it might appear that a book on exercisewould be a dry topic. However, Mark Awerbuch writes inan engaging easy-to-read style, which greatly enhances thereadability of the subject matter. Each chapter commenceswith a quote pertaining to the topic under discussion andconcludes with a text box labelled ‘the bottom line’, whichsummarises the key message of the chapter. The book makesample use of diagrams and pictures to illustrate such thingsas the live stronger live longer pyramid, the muscles of thebody, and the correct position for each of the exercises inthe training programme. The book also lists further resources,for example, Websites, cost of equipment, contact details ofthe Arthritis Foundation and gyms affiliated with FitnessAustralia in each State and Territory, and a workoutsheet. The book does not include references but does havea 5-page bibliography of additional reading.

This book would make an excellent textbook foranyone connected with the fitness industry. In addition, itwould be a useful reference for health professionalssuch as occupational therapists and physiotherapists whohave an interest in lifestyle programmes, fitness and painmanagement.

Chris LloydSenior Occupational Therapist,

Integrated Mental Health Service, Gold Coast Hospital,

Southport, Queensland,Australia

March 2003501Book ReviewBook ReviewsBook ReviewsBook Review

52 Book Reviews

THE ESSENTIAL U & IYoland Wadsworth (Ed., in ongoing collaboration with Merinda Epstein) (2001), 225 pp., $27.50

Victorian Health Promotion Foundation, Melbourne, Australia

The Essential U & I is a one-volume presentation of thefindings of a lengthy grounded study of whole systemschange towards staff–consumer collaboration for enhanc-ing mental health services. The book documents a uniqueAustralian participatory action research project focusedaround ‘working towards achieving a respected place forthe voice of the service-user’ (p. 1) within the mentalhealth system, and building into this system ways for con-sumers and staff to continuously collaborate in enhancingmental health services. This research successfully adopteda range of mechanisms that enabled both mental healthconsumers and staff to participate as researchers andresearched, and sought to understand the whole servicesystem context in which consumers and staff relate toeach other.

The book is written in a style intended to make thesemechanisms and what was learned from the projectaccessible and useful, rather than as a conventionalresearch report. It contains many cartoons, diagrams andquotations to explain how the project was carried outand to illustrate the diversity of perspectives explored(e.g. consumer, staff, researcher, educator). As a compen-dium of work originally presented in five separate volumes,the book contains a substantial amount of the originalmaterial, and offers commentary on this material andmany useful signposts to the original sources.

The book is organised into four sections. The prologuesets out the context in which the project was developed,and outlines the methodological principles adopted. Thesecond section describes initial mechanisms for con-sumer feedback and staff–consumer dialogue in an acutepsychiatric hospital. The third section summarises howthe project team set about building structures to supportstaff–consumer collaboration in the hospital, outlining anextensive repertoire of strategies used. These strategiesare both practical and applicable for enhancing consumer–staff collaboration across the human services sector. Thissection also goes far beyond a description of collaborativestrategies to present a candid account of what was learned

about organisational and professional cultures that makeit hard for service-users to give feedback, and for staff —and the system — to genuinely hear and respond to it. Inthe fourth section of the book, conditions for effectingpositive change and the elements of a quality improve-ment model for building staff–consumer dialogue intothe routine organisation of a human service system arepresented.

It is always timely for professionals to consider thehuman impact of their behaviours, practices and attitudeson the people they work with. This book provides cleardirections for how to go about this process in a way that istrue to all perspectives. Human services workers who aimto function in an empowering manner can learn appreciablyfrom the descriptions in this book, not least about thelevel of ongoing support that empowerment processesrequire. Occupational therapists who work publicly orprivately in schools, disability services, aged-care services,general hospitals, community health services and rehabili-tation services will benefit from reflecting on the manyexamples and stories in this book. Finally, this book isimportant for those engaged in educating occupationaltherapists to guide undergraduate and graduate curriculumdevelopment, as well as for those interested in partici-patory action research methodologies and their use inbringing about service system level change.

Ellie Fossey1 and Jill Gray2

1Lecturer, School of Occupational Therapy,La Trobe University, and

2Subject Co-ordinator, Department of Psychiatry,University of Melbourne,

Melbourne, Victoria, AustraliaMarch 2003501CorrectionBook ReviewsBook Reviews

CORRECTIONCorrectionThe publisher would like to draw the reader’s attention toan error in the following book review:

Miles, J. (2002). Putting it all together: A practical guideto lifestyle management [Book review]. Australian Occu-pational Therapy Journal, 49, 220–221.

The price of the book should have been $100.00.

The author apologises for this error and any confusion itmay have caused.