Book reviews

A Handbook for Action Research in Health and Social Care

by Richard Winter & Carol Munn-Giddings. 2001. Routledge,

London. ISBN 041522 484 5. 281 pp. price: £15.99.

This book aims to do three things: first, to introduce potential

action researchers to the methodological and philosophical ideas

underlying the approach; second, to present case studies from the

broad field of health and social care; and third, to offer a step-

by-step guide or �how to� manual for the neophyte. The authors’

concluding remarks state that action research (AR) �has much to

recommend it� (p. 265), and the same could be said of this book.

There are four parts to the book. Part I, �The Nature of Action

Research�, outlines the key methodological elements of AR, and

looks briefly at several of its �strands�. There is a useful definition

of AR on page 8, which is loose enough to encompass the

diversity of AR, and emphasizes the practice context, and the need

for flexibility and responsiveness. Indeed, the concluding para-

graphs to this section (p. 62) provide as good a summary of AR as

I have seen.

Part II, �Examples: The Variety of Action Research�, presents 10

case studies by action researchers. I would have liked to have been

told whether these had been published previously. Nevertheless, the

case studies are generally very good, giving the reader a sense of

what is possible in AR in health and social care, and how AR

overlaps with practice development and change management

projects. I particularly enjoyed Brenda Dennett’s work (chapter 8)

with clients and staff in a learning disabilities service setting, which

shows just how a collaborative approach can generate new

knowledge and change practice. This chapter is just the sort of

advertisement AR needs!

Part III, �Undertaking an AR Project: a Practical Guide�, presents

ideas on �how to do� action research. There are some good ideas

here, interspersed with activities, cross-referenced to previous

chapters in the book. The material on reflexivity (pp. 212–213) is

particularly helpful. However, to my mind there are two problems

with Part III. First, the discussion of ethical issues is far too

simplistic, as there are serious potential ethical conflicts in AR that

are generally not well discussed in the literature. Winter and Munn-

Giddings suggest that a participant’s reputation at work is likely to

be enhanced by an AR project. This is by no means clear and,

indeed, Dennett’s case study shows how some staff can be alienated

and excluded in the workplace as a result of their lukewarm support

for change processes (p. 128). A second problem concerns the

material on data collection. Again, this is so simplistic as to be

almost no help to all but the absolute novice, and much more work

would be necessary for anyone engaging in an AR project for a

postgraduate qualification.

Part IV, �AR as a Form of Social Inquiry: A ‘‘Theoretical’’

Justification�, discusses some of the philosophical rationales for

using AR, as opposed to more �traditional� forms of research (i.e.

quantitative and qualitative methods used with no emphasis on

changing practice). This focuses on the arguments from a critical

realist perspective, and is an entertaining, if short, read.

In summary, this is a useful introductory book for those thinking

about using AR for the first time. It is generally well written, and

even the more philosophical aspects of the arguments (in Part IV)

are accessible. It should be useful to practitioners in a wide variety

of health and social care settings. In this, the authors have succeeded

in their intention and the case studies reinforce this conclusion.

However, the book presents only a short summary of the

methodological, practical and philosophical issues in AR and, in

places, it is rather simplistic for the more knowledgeable reader.

GRAHAM R. WILLIAMSON

Senior Lecturer

University of Plymouth

Chronic and Terminal Illness: New Perspectives on Caring

and Carers by Sheila Payne and Caroline Ellis-Hill (eds). 2001.

Oxford University Press, Oxford, UK. ISBN 019263 167 5.

178 pp. price: £24.95.

This is an excellent book, edited by Sheila Payne and Caroline Ellis-

Hill, with chapters contributed by leading academics who have

undertaken substantive research and endeavour in the fields of

caring and chronic or terminal illness. The book tends to focus on

the care of adults as opposed to children, with a focus on physical

illness or disability rather than mental health issues or dementia.

The book comprises nine chapters, with chapter one defining who

constitutes a carer as well as serving as an overall introduction to the

book and what the reader can expect.

Chapter one includes social support and social relations and

explores the nature of caring, including research and policy on

carers and caring. It also examines what is meant by chronic illness

and palliative care and challenges myths related to dying with

malignant conditions, placing an emphasis on living with chronic

illness and challenging negative stereotypes. In this chapter,

Sheila Payne and Caroline Ellis-Hill consider theories of family

functioning that can exacerbate or relieve stress or burden. They

also look at the growing interest in carers, the gendered nature of

informal caring, and carers’ contribution to community-based care.

Research on carers has focused on their roles as proxy informants

and verifiers of experiences, and has explored their needs, the

burden of caring and the lived experience of caring. A definition of

palliative care is given, along with an acknowledgement that the

majority of clients with chronic or terminal illness live at home for

most of the time, with relatively few dying in a hospice. Residential

forms of respite care are, however, recognized and are included.

The accompanying chapters all include specific studies of carers

and caring and provide accounts of the research as well as drawing

on policy and implications for further research. In chapter two,

Journal of Clinical Nursing 2002; 11: 848–849

848 � 2002 Blackwell Science Ltd

Mike Nolan looks at the positive aspects of caring and draws from

his large portfolio of work, which includes family care, moving

beyond burden and the support required by families. In chapter

three, Caroline Ellis-Hill covers the experiences of spouses caring

for partners who have had a stroke or suffer from other chronic

neurological conditions. In chapter four, Karen Rose presents her

longitudinal study on carers providing palliative care and Paula

Smith, in chapter five, looks at experiences of family caregivers in

palliative care.

Chapter six, by Magi Sque, follows the concept of the book but

provides a broader context in the study of dying. Particularly

illuminating is the example of brainstem death. Aspects of organ

donation and consequences for carers are also included, providing

important exploration and perspectives, bearing in mind recent

events and impacts in the UK relating to organ retention. The

contextual meaning of death and bereavement in relation to chronic

illness, palliative care, natural death, accidental death and donation

all need to be studied and would contribute to our understanding

the broader picture. Christina Lee in chapter seven, provides a

gender-based analysis of women’s experiences of family care-giving

and in chapter eight, Frances Sheldon, Pauline Turner and Bee Wee

go on to discuss the contribution of carers to professional education.

In the final chapter, Caroline Ellis-Hill and Sheila Payne draw

together conclusions for the future, relating to interventions,

implications for practice, further research and conceptual issues

on caring and chronic and terminal illness.

It would have been helpful to read more about services, for

example where intermediate care and continuing care fit. Aspects

relating to user and public involvement in services would also have

been of interest. Minimal information is provided about the authors,

only their titles. Some biographical information, setting the authors

in context with their work would have been of interest. In my view,

this is an excellent book and is highly relevant for people with an

interest in carers and caring and living positively with chronic and

terminal illness.

BRENDA ROE

Senior Lecturer in Gerontology

Keele University

Making IT Work by Carol D. Cooper. 2001. UWIC Press, Cardiff,

UK. ISBN 1-902724-35-6. 143 pp. price: £12.99 or £600 + VAT

for multi-licence CD.

A book that aims to teach students the basics and practicalities of

IT to help them in research and the presentation of their work is a

welcome change from the weighty tomes dedicated to the complexities

of technology and applications software. Divided into colour-coded

chapters, the amply illustrated and clearly laid-out pages of the ring-

bound workbook enable readers to dip into whichever topic is most

relevant. These range from computer basics and library tools,

through electronic mail and Internet/information sources, and

culminate in sections on presenting finished work using word-

processors, spreadsheets and presentation software. Each chapter

has a very useful opening section which describes why the chapter is

relevant, for example �Why do you need to use CD-ROM literature

databases?� Each section is regularly interspersed with hints and

exercises that successfully reinforce the text and a comprehensive

section on further reading completes each chapter.

However, there are some negative aspects to the book. Very often

I find that students are shown or told to do something without

understanding why they need to do it. This is an important issue,

particularly in relation to IT matters. In this book, the section on

CD-ROM literature databases, for example, launches into a

description of Boolean operators without adequately explaining

the generic problems associated with querying large indexes.

Students need to understand the reasons for conducting their

searches in a carefully organized way before they are shown the

techniques by which they limit and focus their queries. The section

on electronic mail quickly raises the issues of Internet service

providers and free web space before discussing how to use e-mail

software, or even why you might use it. There are also repeated

spelling mistakes, which for a book stating that �For any document

to be credible it should contain correct spelling� is inexcusable.

Overall, the book is a valuable resource for all students who need

to make use of IT in the course of their studies. Irrespective of

where students are based, much of the text is highly relevant and

useful for newcomers to both IT and electronic-based research

methods. From an IT perspective, whilst not aimed exclusively at

the PC platform, the book is heavily weighted towards Microsoft

solutions as these are what the majority of students at UK

institutions are likely to be using. The topics that are less

application-specific are useful to all.

One problem with books of this type is that some factual

information will become out of date very quickly. The solution

adopted by the author of this book is to complement it with her own

support web-site, which appears to be updated on a regular basis.

This helps to keep the contents of the book up to date with

technological advances and provides additional and updated links to

new Internet resources.

JULES SMITH

Principal Computing Officer

University of Plymouth

� 2002 Blackwell Science Ltd, Journal of Clinical Nursing, 11, 848–849

Book reviews 849