Nurse Education in Practice 10 (2010) e20

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Nurse Education in Practice

journal homepage: www.elsevier .com/nepr

Book Reviews

Healthy Places, Healthy People. A Handbook for CulturallyCompetent Community Nursing Practice, Dreher et al. (2006).Sigma Theta Tau International, Indianapolis

The role of nurses in communities and their contribution to thehealth and well-being of communities is not a new concept. Themanner however by which nurses pursue their engagement withcommunities is subject to the ebb and flow of all societal relation-ships. In this book, nurses are challenged to rethink the ways inwhich they practice in the community and encouraged to focuson the health status of the community as a whole as opposed todealing with individual cases of health and illness. This requiresa fundamental change in thinking and an expansion of the skill-set of nurses working in communities.

The model put forward has roots in both epidemiology andanthropology. While recognising the value of epidemiology in com-munity nursing, the authors point to its cultural blindness. Culturalanalysis is however offered by an anthropological approach. In con-sidering the diversity of culture in communities the authors alsorecommend that nurses need to go beyond considering ethnicityas the primary factor for consideration. All communities have theircultures which must be considered. These insights are difficult toobtain from an epidemiological analysis alone, thus throughoutthe book the dual analysis from both cultural and epidemiologicalapproaches are evident.

The authors stress the need to consider community health as notpurely an aggregate of the illness/wellness of the individuals but thepotential for health and the health framework of the community as awhole. This demands a rethink on how to carry out assessments andimplement plans. This point is made succinctly through the use ofthe example of nurse carrying out an assessment of a woman whois either pregnant or not pregnant whereas a community assessmentmay reveal a low or high level of ‘community pregnancy’. Practicalexamples are indeed frequently employed in this book and help inillustrating and clarifying the arguments being forwarded.

The book is divided into 3 parts which offer the reader a clearpathway in following the arguments being advanced. Part 1 (Chap-

doi:10.1016/j.nepr.2009.02.007

ters 1 and 2) lays down the theoretical context of the book basedon the epidemiological and anthropological background men-tioned above. Part 2 (Chapters 3 and 4) offers a clear frameworkfor community and cultural assessments based on these ideas. Part3 deals with planning (Chapter 5) and implementation (Chapter 6)of measures to realise changes in community health.

The strength in this book lies in Parts 1 and 2 in offering a com-prehensive framework by which nurses may contextualise and car-ry out community health assessments. Part 3 however, disappointsslightly in the measures recommended for planning and imple-mentation. Strategies for implementation based on consensusand conflict are put forward but remain somewhat abstract in con-trast to the guidance offered on assessment. While the authors rec-ommend the building of strategic alliances and networking bynurses in shaping community health, it is not clear how skills todo this will be developed. The relationship to other health profes-sionals and agencies in this regard is also somewhat unclear. Largeparts of Part 3 would appear therefore to be aspirational andtentative.

That being said however this book offers an excellent resourcefor all nurses at both undergraduate and graduate levels who areinterested in expanding their knowledge in this area. Although ofUS origin this book is capable of being used in others countriesas the ideas and theories offered are international, a testament tothe soundness of the theoretical underpinning.

Tom O’ConnorUCD School of Nursing,

Midwifery and Health Systems,University College Dublin,Health Sciences Building,Belfield, Dublin, Ireland.

Tel.: +353 17166430.E-mail address: tom.oconnor@ucd.ie (T.O’Connor)