The Person as Patient: Psychosocial Perspectives for the Health Care Professional.

The Person as Patient: Psychosocial Perspectives for the Health Care Professional Ramsden E, ed. Philadelphia, PA 19106, WB Saunders Co, 1999, paperback, 274 pp, ISBN:0-7020-2230-6, $39.95.

This book focuses on the psychosocial aspects of interactions between health care professionals and patients. It pays attention to theory and systems views and uses them as a basis for describing and discussing psychosocial growth and development across the life span. The overall purpose of the book is to "inform our judgments, and lead us toward a new way to view people who are patients, so we may be more effective in clinical decision making." The book presents a good mix of theoretical constructs and practical applications of the theory.

Ramsden presents the steps of the scientific process and how these steps result in theory development. She then describes a system of ecology that includes the biological, psychological, and societal factors that affect patients and therapists alike. Subsequently, Ramsden describes how adaptation, cultural context, cognitive development, learning and learning theory, and memory affect human development throughout the life cycle. The theory and conceptual tools and processes introduced in the first 3 chapters of the book provide the background for the next 6 chapters, which are devoted to human growth and development and its relationship to the psychosocial aspects of patient-illness-disability and patient-therapist interactions.

The book describes the growth and development of the infant and young child, adolescent, adult, and elderly adult. In each of these descriptions, the basic developmental tasks and psychosocial elements of the life phase are presented. Case studies and anecdotal clinical situations are used to show how different life stages present different challenges and affect patient-practitioner interactions. The life-span portion of the book is rich with references to theory and recent research concerning actual patient conditions and circumstances. Particular attention is given to normal aging, aging with illness, and living with chronic illness.

The second part of the book addresses the psychosocial aspects of the patient-health care professional interactions. The chapter on self-efficacy by Lehman and Roller is an important contribution to our psychosocial consideration of patient-therapist interactions. The purposeful inquiry into the self-efficacy of our patients has not been routine. The authors emphasize the importance of such inquiry and determination.

In chapter 12, Bruckner presents bioethics in a relevant context for physical therapists. Her use of case studies to show how ethical constructs and the ethical decision-making process are applied in real-life situations is extraordinarily helpful for both beginning and experienced therapists.

Ramsden provides a thoughtful process for making clinical judgments combining cognitive and affective processes from the therapist's perspective. Her attention to communication focuses on how we communicate and the communication styles we use.

This book successfully addresses the psychosocial perspectives of patients across the life span. It connects theory and conceptual constructs with real-life experiences. This book is an excellent text for students in professional physical therapist education programs. It can be used across the curriculum.

Beverly J Schmoll, PT, PhD, FAPTA
University of Michigan-Flint
Flint, Mich

Dr Schmoll is Professor of physical therapy and currently serves as Interim Chancellor for UM-Flint.