Patient Education and Discharge Planning Manual for Rehabilitation.

Patient Education and Discharge Planning Manual for Rehabilitation Wascher KB, ed. Gaithersburg, MD 20878, Aspen Publishers Inc, 1995, 3-ring binder, 762 pp, illus, $249.

This book is a comprehensive source of information designed to help health care providers meet educational needs of patients and their caregivers during rehabilitation. Topics include organization of materials, patient-tracking forms, letters of introduction, patient rights and responsibilities, patient information, and discharge planning.

The manual suggests that each patient receive a personal notebook when admitted. The notebook can be assembled by members of the patient care team by copying handouts from the book. (Pages can easily be removed for copying from the book's large 3-ring binder.) The tabbed section titles and logical sequencing of contents facilitate subject location.

The book is divided into eight parts. Part 1 describes primary diagnoses commonly treated in rehabilitation settings: brain injury, spinal cord injury, stroke, total hip replacement, total knee replacement, amputation, open reduction internal fixation, multiple sclerosis, and Guillain-Barre and post-polio syndromes. Each diagnosis is defined, related anatomy and physiology are explained, and causes and management issues are presented. Part 2 contains information regarding related medical complications, such as seizures, perceptual problems, visual changes, autonomic dysreflexia, spasticity, and heterotopic ossification.

Part 3 is similar to part 1, except that it focuses on secondary diagnoses in a rehabilitation setting: diabetes mellitus, hypertension, and arthritis. Handouts describe insulin injection, blood pressure measurement, and arthritis.

Psychological adjustment to illness or injury is addressed in Part 4. Handouts include stress recognition and management, fatigue, depression, and alcohol abuse. Stories from persons with brain injury, spinal cord injury, and stroke are located here. These stories provide a more personal perspective than other sections of the book.

Part 5 focuses on body systems and details basic management issues for skin, bowel, bladder, lungs, and circulation. For example, the skin system is described in terms of basic anatomy and function and pressure-sore risk, identification, and prevention. Handouts on bowel management include normal bowel function, incontinence, digital stimulation, constipation, and bowel medications.

Nutrition is the subject of part 6. Topics include well-balanced diets, low-fat diets, low-cholesterol diets, high-fiber diets, and tube-feeding techniques. This is a small chapter, and the handouts are not as detailed as they are in other sections.

Therapy services are presented in part 7, a relatively lengthy chapter. Many subjects are addressed; however, the scope of information is limited. For instance, handouts on braces and splints address neck, trunk, and extremities but contain illustrations only of common wristhand orthoses. Handouts on range-of-motion exercises and wheelchair positioning have no illustrations. Home modification handouts are informative, as are those explaining how to build a wheelchair ramp. Exercises for knees, hips, and below- and above-knee amputations are succinct and well illustrated. A section on equipment has drawings and instructions on using a walker, cane, or crutches for assistance in walking and climbing curbs or stairs.

The manual concludes with part 8, an overview of issues related to sexuality. Two additional chapters are also provided as an addendum to this manual. These chapters address medication safety and national resources for patients. Addresses and phone numbers are current as of January 1995. Outdoor adventure groups and sports associations for persons with disabilities are also listed.

The book's ultimate audience is the patient or caregiver. Subject areas are addressed in a manner easily understood by the layperson. A useful glossary is included. The print is large, with many areas highlighted and bulleted and important points listed. Illustrations, charts, and tables accompany written text. Information appears to be current and accurate. A three-page bibliography is provided, but there are no references.

As a comprehensive source of patient education materials, this book has particular relevance to physical therapists in rehabilitation settings. It would also be useful for staff in-service programs or for training of rehabilitation aides. Health care administrators may wish to use it to help meet accreditation requirements for patient and family education.

Sondra E Dunkle, EdD, PT Idaho State University Pocatello, Idaho

Dr Dunkle is Professor, Physical Therapy Department, and specializes in neurological rehabilitation and gerontology. Research interests include balance and factors that influence student interest in gerontology.