Head Injury: Information and Answers to Commonly Asked Questions, A Family's Guide to Coping.

Head Injury: Information and Answers to Commonly Asked Questions, A Family's Guide to Coping Sturm CD, Forget TR, Sturm JL. St Louis, MO 63146, Quality Medical Publishing Inc, 1998, paperback, 314 pp, illus, $21.95.

The purpose of this book is to provide information to families of patients with head injuries. This book presents information about patients with severe head injuries in particular and is intended to supplement the discussions with health care providers. The book is divided into 2 parts. The first part concerns acute care and contains 11 chapters covering family interviews, the brain, types of injuries, medical tests and procedures, symptoms and behavior, surgical interventions, the intensive care unit, prognosis and outcomes, emotional reactions and coping strategies, and the social worker's role. The second part of the book covers rehabilitation. Its 3 chapters include information on therapy, rites of passage, and head injury prevention. A glossary of medical terms, an index of questions, a list of additional resources, and an index are also provided at the end of the book. The book is written by 2 physicians and a registered nurse with contributions from health care providers in pastoral care, social work, and nursing.

Each chapter of the book is divided into 2 sections. The first section includes information related to the chapter topic. The second section presents a question with the answer following it. Some information from the first section is duplicated in the second section as well as between chapters. The redundant information may help some family members absorb more information through repetition. Family members may also choose to read either the first section or the second section depending on what style works best for them. The questions from all of the chapters are listed in the index of questions in the back of the book, so a reader can scan the list for a specific question. Medical terms included in the glossary are in boldface in the text for easy reference, and illustrations are used to further clarify information in the text.

The chapters contain valuable information for the families of patients with head injuries, but they do not seem to flow smoothly from one chapter to the next. The chapters also seem to be out of order when the book is read from beginning to end. Some information is used in one chapter before it is further explained in a later chapter. Interviews of 3 different family members are dispersed throughout some of the chapters. This information may help readers relate to their situation, but the stories may be too optimistic for many patients with severe head injury.

This book contains an abundance of information about patients with head injury, but it does not cover all aspects of head injury thoroughly. For the most part, the medical aspect of care is emphasized. A family member, however, may not obtain a clear picture about the physical problems, the cognitive impairments, or the behavioral disorders associated with severe head injury. The information about how family members can help or how they can best interact with the patient with a severe head injury is not comprehensive. The roles of all the health care providers who may be involved in the patient's care are not explained thoroughly. Only one chapter, written by a registered nurse, includes information regarding therapy, and minimal information is dispersed throughout other chapters. This chapter does not focus on the acute care aspect of therapy, rather it focuses on therapy provided in different types of rehabilitation settings.

This book is helpful and meets a need for coverage of the acute care aspect of intervention, especially intervention in the intensive care unit. The book tries to portray the variability among patients with severe head injury in order to present generalized information. The book's title would be more accurate if it emphasized the medical aspect of care for patients with severe head injury in the acute care environment. The writing style is clear and does not demean family members, but people-first language is not used consistently. My concern is that this book may be written at too high an education level for many families. Many families are also very overwhelmed in the beginning, and a lengthy book may overwhelm them even more. A health care provider may need to assist families in finding and explaining a specific section of the book, but the discussion between the family and the health care provider may be more valuable. The book, may be helpful to family members as a review after this discussion and a tool for sharing information with other family members.

This book may be a valuable resource for a hospital to have available for family members. Additional information, however, would need to be provided about the physical problems, cognitive impairments, and behavior disorders as well as therapeutic intervention. This book may also be helpful to physical therapists who are new to this area so that they can be aware of questions that families commonly ask.

Marianne Orest, MEd, PT

Fletcher Allen Health Care/Medical Center Hospital of Vermont Campus

Burlington, Vt

Ms Orest is Advanced Clinician performing patient care and clinical research in a tertiary care facility. She is also Clinical Assistant Professor at the University of Vermont where she teaches the traumatic brain injury and spinal cord injury sections of the curriculum.