Medical and Psychosocial Aspects of Chronic Illness and Disability, ed 2.

Falvo DR. Gaithersburg, MD 20878, Aspen Publishers Inc, 1999, hardcover, 464 pp, illus, ISBN: 0-8342-1198-X, $52.

The author's stated purpose for this book, which it fulfills, is to serve as a reference text for nonmedical rehabilitation personnel, such as rehabilitation counselors and rehabilitation counselor students, who may have little or no medical background and who work with persons with chronic disability. It could also be used as a resource for other individuals in the rehabilitation field.

This book is fairly broad in scope, providing not only basic information related to chronic illness and disability, but also a review of most body systems and their disorders. It begins with a discussion of the psychosocial and functional aspects of chronic illness and disability. A chapter on nervous system disorders covers some topics (eg, traumatic brain injury, epilepsy, multiple sclerosis, Parkinson disease, spinal cord injury, post-polio syndrome) fairly well, whereas other topics (eg, stroke, cerebral palsy, spina bifida, amyotrophic lateral sclerosis) are discussed to a lesser degree considering their frequency in rehabilitation settings. The chapters on hearing and visual disorders appear to provide adequate information, and the chapter on mental disorders addresses the major etiologies frequently encountered by the rehabilitation practitioner.

Chapter 7 presents substance-related disorders and their effects on body systems and functions, and it notes the potential link between substance abuse and chronic illness or disability. Discussion of disorders of the blood and immune system is quite sufficient at a basic level for the topics dealing with hemophilia, sickle cell disease, and human immunodeficiency virus infection. A chapter on musculoskeletal and connective tissue disorders addresses only the major types of connective tissue disorders. The types of treatment described for back pain, chronic pain and rheumatoid arthritis are limited at best. Chapters on cardiovascular, respiratory and integumentary disorders appear to be adequate. Those chapters addressing endocrine, renal, and gastrointestinal disorders also appear to provide enough information on the major disorders of these systems.

The discussion of various forms of cancers in chapter 16 is relatively thorough and includes a broad discussion of types of cancers, staging and grading, diagnostic procedures, and potential treatment. A generic discussion of some types of adaptive devices used in rehabilitation is provided in chapter 2. A short concluding chapter describes the ever-changing nature of the health care system and some of the major problems resulting from managed care.

The scope of the book seems to be relatively sufficient for the nonmedical health care provider or physical therapy aide, although it is generally inadequate for physical therapists or physical therapist assistants. Most chapters begin with foundational information (eg, basic definitions), a discussion of normal structure and function, and then identify associated medical or other problems associated with the given topic. Simple, clear, and adequate illustrations are provided as needed to highlight the content. Major treatment interventions and the psychosocial and vocational implications related to the topic are covered. A reference list is included for those chapters that have citations, and an extensive bibliography is provided for all chapters.

Within each chapter, newly introduced medical terms and phrases are presented in bold print followed by their definitions. The reader may also refer to an alphabetical glossary of medical terms located in one of the appendixes of the book. Other appendixes include a brief glossary of types of general medications, a list identifying trade and generic names of medications used for various types of mental disorders, and a glossary of diagnostic procedures. An appendix of case studies presents the reader with examples representing the 14 chapters that relate to a body system, disease, or disorder. The case description followed by questions requires both knowledge and application of material discussed in the book.

The content quality of the text, which is quite readable and written at a relatively basic level, is generally good. A few minor discrepancies were noted related to the physical therapy profession--for example, the book implies that the academic education of physical therapists is at the baccalaureate level and does not mention other types of professional degrees and it refers to physical therapy assistants as opposed to physical therapist assistants. Other than these observations, the reader will find a relatively broad overview of medical and psychological aspects of a variety of types of chronic illness and disability.

Paulette Cebulski, PT, PhD University of Michigan-Flint Flint, Mich

Dr Cebulski is an Associate Professor and Director of Department of Physical Therapy. Her doctoral work .focused on education and counseling, and she has also taught in a rehabilitation counselor education program for several years.