On Rehabilitation Medicine: A Theory-Oriented Contribution to Assessment of Functioning and Individual Experiences.

van Dijk AJ. Delft, The Netherlands, Eburon Publishers, 2001, paperback, 242 pp, ISBN: 90-5166-844-9, approximately $21.50.

The author of On Rehabilitation Medicine offers a biopsychosocial framework for use in understanding the process of rehabilitation. The book discusses the contributions of earlier models of disability and the conceptual deficits in them that led to the development of this author's model. Dr van Dijk describes an approach that emphasizes the importance of the patient's cognitive and physical adaptation process that occurs throughout rehabilitation.

Following a brief introduction discussing the purpose for writing the book, the author divides its content into 4 parts. The format of each of the parts is similar, beginning with a brief introductory chapter and concluding with a brief summary of the content. Within each part, the lengthy chapters also end with a summary of the content discussed. This format provides a continual review of the material for the reader.

Part 1, consisting only of the first chapter, discusses Bangma's "SAMPC method" that is used in the Netherlands as a basis for rehabilitation medicine. The SAMPC addresses the 5 areas common to daily life that have a significant effect on the course of rehabilitation: somatic, activities of daily living, social, psychological, and communication. The author developed his biopsychosocial approach based on the perception that the SAMPC method and the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) models do not provide a complete explanation of the observed process of reintegration into the community.

The introduction to part 2 presents a discussion of the concept of rehabilitation, and chapter 2 is devoted to an analysis of the term according to the author's biopsychosocial theory. Chapters 3 and 4 carry the discussion further by examining the influence of rehabilitation on the functional and psychosocial adaptation of patients to their changed circumstances. Chapter 4 briefly raises a very pertinent issue by suggesting that research supporting the efficacy and effectiveness of rehabilitative services is necessary before it can be claimed that rehabilitation provides any meaningful assistance to the patient's process of adaptation to disability. Chapter 5 summarizes the material included in earlier chapters of this section.

The information provided in parts 3 and 4 progresses from a theoretical analysis of the activities of daily living to observations of the patients' performance of these activities. The author applies his biopsychosocial view of the rehabilitation process to determine the impact of the disability on the patient's ability to adapt.

The book provides an extensive bibliography drawn from a variety of rehabilitative disciplines, which offers a good overview of rehabilitation issues. The individual chapters would benefit from greater use of graphs, and sub-headings and variations in font should be used to make it easier to locate a particular section. The incorporation of an introduction and summary in each part and in several of the chapters may be helpful for someone unfamiliar with the author's topic, but this results in some unnecessary repetition of the material. The author's stated intent was not to design a text for clinical application; however, if he had added clinical examples that illustrate how to approach the issues raised in each chapter's case studies, readers would be more engaged in the subject matter, and he would not have needed to reinforce important points through constant repetition.

This text provides a perspective that is different from that of rehabilitation texts that utilize the medical model. It offers a holistic view of the process of rehabilitation from a behavioral perspective. Experienced rehabilitation practitioners who wish to explore the boundaries of their role in preparing patients to interact more fully with their chosen environment will find this information useful. The theoretical nature of this book makes it an appropriate supplemental textbook for any postgraduate behavioral science courses taught in any of the rehabilitative disciplines. Although the content will stimulate lively discussion and generate ideas for multi-faceted research projects, it does so at a level beyond that of most professional students.

Denise G Bender, PT, JD, GCS University of Oklahoma Health Sciences Center Oklahoma City, Okla

Ms Bender is Assistant Professor in the Rehabilitation Sciences Department where she teaches in the areas of geriatrics and behavioral sciences. She has a clinical specialization in geriatrics.