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Book reviews

STATISTICAL METHODS FORHEALTH CARE RESEARCH

Edited by BH Munro, Philadelphia, PA: JBLippincott, 2001, ISBN 0 7817 2175 X

This is the fourth edition of a text f irstpublished in 1986. The editor is Dean andProfessor of the School of Nursing, atBoston College, Massachusetts, USA. Thebook aims to explain the statistical methodsthat appear most frequently in the healthliterature. It is therefore targeted at thehealth professions in general, with noparticular emphasis on a student or graduatereadership.

The book is organized into two sections.The first, which makes up approximatelyone-quarter of the text, deals with the orga-nization and presentation of data along withan introduction to inferential statisticaltesting. The section on data presentationgives some suggestions about style, animportant aspect that is often overlooked instatistics texts.

The second section presents a number ofdifferent statistical techniques — basic tech-niques, including t-tests, analysis of vari-ance, correlation tests and non-parametricequivalents, along with more advancedtechniques, such as factor analysis, struc-tural equation modelling, logistical regres-sion and path analysis. Given that it has

extended the usual repertoire of tests, thetext could have gone further to addressBayes’ theorem, Receiver Operating Char-acteristics, and Bland and Altman limits ofagreement, which are valuable in healthresearch.

Each chapter begins with a list of objec-tives to guide the reader, along the lines of‘… by the end of this chapter you will …’,and at the end there are exercises, with solu-tions supplied. The chapters deliberatelyplay down the mathematics involved on thereasoning that this will be done by acomputer — a style that will appeal to mostreaders. The examples used in the text onbased on analysis by SPSS. However, thebook is not a guide to the use of SPSS, but itis a useful help to understanding the outputfrom the package. This is valuable as SPSSoutput can sometimes confuse the occa-sional user. (On a specific note, the authorscontinually refer to the output displaying thesignif icance value as p=0.000. This is acommon cause of confusion and it is betterreferred to as p<0.001; the SPSS settingused allows only three decimal points.)

There is a useful glossary, and the bibli-ography is fairly extensive, with a largely,although not exclusively, nursing flavour

I would recommend this book as a usefuladdition to a library for physiotherapists. Itis also worth considering as a personal buyfor those with a research involvement. It is a

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particularly good initial reference for peoplewanting to come to terms with the moreadvanced techniques.

Denis MartinAssistant Director

Scottish Network for Chronic Pain Research

Queen Margaret University CollegeEdinburgh

PHYSIOTHERAPY IN RESPIRATORYCARE — AN EVIDENCE-BASEDAPPROACH TO RESPIRATORY ANDCARDIAC MANAGEMENT

By Alexandra Hough, Cheltenham: NelsonThornes 2001, ISBN 07487 4037 6 £24.75

It was my pleasure to review a comprehen-sive book that explains and discusses themanagement of patients with respiratorydisorders with a special focus on the role of,and techniques employed by, physiothera-pists. The book covers acute, chronic andrehabilitative management, includingspecial needs for all age groups.

Apart from discussing medical and phys-iotherapy management, heavy emphasis isgiven to the education of patients, high-lighting the physiotherapist’s changing rolefrom treating a condition to injury preven-tion and health promotor. For example,evidentially supported detailed informationwas devoted to the encouragement ofsmoking cessation.

Topic content was well supported byupdated references that are of considerableassistance to students, clinicians and thoseinvolved in research. A unique feature ofthis book was the case study in each chapter.Readers are invited to analyse the problem,and consider the goals and specific objec-

tives of management in each case. Asuggested answer is then provided. This isof particular help to students and juniorphysiotherapy, who enjoy the challenges ofcase management, but who also need direc-tion and confidence to ensure that they arethinking in the right direction.

A literature appraisal is included at theend of each chapter. This reflects one viewof how an article or statement can beappraised. This is a powerful tool to teachyoung readers how to critically evaluate apublication, encouraging them not to acceptan author’s conclusions at face value.

The first chapter provides an overview ofthe physiological basis of clinical practice. Iconsider this essential in providing studentsand clinicians with the foundations for theirclinical reasoning. Sound clinical reasoningenforces a student’s critical and analyticalability, thereby facilitating independentlearning.

Students often find blood gases difficultto understand. However, Chapter 1 explainsan interpretation of blood gas results in away that is easily understood (there is,unfortunately, a typographical error herethat may confuse).

Before goals and management objectivescan be established, patient problems must beidentif ied correctly, and prioritized. Theappropriate assessment procedures andtechniques are essential, and the opics underthis chapter heading are comprehensive.Certain assessment techniques, such as the‘six-minute walk test’, were covered in thechapter on pulmonary rehabilitation,however. Perhaps a full list (with a briefintroduction of each test) could have beenincluded in the ‘Assessment’ chapter to helpstudents to acquire an overview of systemassessments. Some readers, particularlythose from other disciplines, may expect tofind a topic such as a ‘six-minute walk test’

56 Book reviews

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