Palliative care nursing: Principles and evidence for practice. Edited by Sheila Payne, Jayne Seymour...

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Palliative Care Nursing: Principles and Evidencefor Practice. Edited by Sheila Payne, JayneSeymour and Christine Ingleton. Open Uni-versity Press, 2004. 808pp. (paperback). £29.99,ISBN: 0-335-21243-3.

The editors of and contributors to this book arevery well known as leading researchers in palliativecare nursing and the world of palliative care ingeneral. It aspires to be a core text for palliative carecourses and related health and social care coursesthat are set at post graduate and post registrationlevel. Organised into four sections the first twofocus on the illness experience, the third section onloss and bereavement and the final section addressescontemporary issues in nursing and palliative care.

This weighty book is excellent as an introductionto key issues in palliative care. It offers thepractitioner the opportunity to deepen their under-standing of how death and dying and bereavementare constructed and experienced in western society.As a guide to the seminal writing on approaches tounderstanding and articulating palliative care this textis a very useful resource. It deals eloquently with thebig ideas and offers a theoretical framework thatmight underpin how palliative care is approached andpatients, their families and carers are supported. Thisbook is a very useful counterbalance to writing thatfocuses on the patient and their illness, to theexclusion of any discussion on the context, setting,experience and social construction of the dyingexperience. Jessica Corner’s chapter for example, onWorking with Difficult Symptoms offers a challen-ging critique of why and how symptom managementdominates thinking and writing in palliative care. Herconclusions offer a useful starting point for nursesand their colleagues who work with patients who areseen as having difficult symptoms. Another strengthof the book is that threaded through all four sectionsof the book there is an emphasis on the needs ofcarers and families for care and support. MerrynGott engages with the rhetoric of user involvementand raises some fascinating questions about howpractitioners in palliative care can and should engagewith these issues.

As a resource for nurses who want information andan evidence base (or how to find it) for their everydaypractice this book is less useful. There are chapters on

assessment and on pain that provides an overview oftheories, evaluation and management but otherchapters on providing care focus on the principlesand not the detail. Consequently, there is a minimaldiscussion of the different cancers and long-termconditions that often precipitate the need for palliativecare. There is a disappointing lack of discussion onproviding culturally sensitive palliative care within anethnically diverse society and the chapter on ethicalissues at the end of life provides a brief overview butdoes not discuss the implications of recent andproposed changes in legislation around end of lifedecision making and mental incapacity for palliativecare. Issues that practitioners have to engage with anddiscuss with patients and their families. Similarly,although the impact of an ageing population and theneeds of older people who are dying are identified it isa missed opportunity that the palliative care needs ofthe oldest old are not more extensively discussed.

For the nurse who wants to understand thecontext of health care and how health policy hasshaped service provision and the relationshipnursing has with medicine there is little discussion.One could almost assume from this book that thewider health service and doctors have very little todo with palliative care provision. It is also interest-ing that there is a chapter on palliative care ininstitutions but not an equivalent one on palliativecare in primary care. These criticisms however onlyreflect how very difficult it is to encompass thesubject of palliative care within one text.

Overall this book represents a significantcontribution as a textbook on palliative careand is to be recommended for practitionersengaged in further and specialist education. Thequestion remains for how much longer there willbe texts for nurses and texts for doctors andtherapists? So much of the material in this book isof relevance to all and the title may actuallymilitate against it achieving the breadth of read-ership it deserves.

Claire GoodmanDirector,

Primary Care Nursing Research Unit UCL/KCL,Department of Primary Care and Population Sciences,UCL Archway Campus, London N19 5LW, UK

DOI: 10.1002/pon.884

BOOK REVIEWS 81

Copyright # 2005 John Wiley & Sons, Ltd. Psycho-Oncology 14: 79–82 (2005)