1. Baker, Sharon RN, MS, CNS, CNRN, Reviewer

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Advanced Concepts in Multiple Sclerosis Nursing Care


By J. Halper. New York: Demos Medical Publishing, Inc. $39.95. ISBN: 1-888799-53-6. 302 pages.


The book is a comprehensive systemic approach in providing a physical examination for the primary care provider. The book begins with the basic principles of the interview process. This section provides the framework for the physical examination. It introduces to the reader the concepts of basic interviewing techniques, such as questioning confrontation and reflection. It reminds the medical profession that the patient history should be approached in a more patient-oriented focus than a disease-oriented focus. This holistic approach is needed to provide a more complete physical history that includes all aspects of the patient's life. The interview section of the book also provides several suggestions and examples of ways to ask patient sensitive questions that often clinicians avoid or ask inappropriately, thus alienating the patient altogether. The remaining chapters in the first section include the consideration of different cultures, patient responses to illness, and the importance of nutritional status in understanding the patient's presenting problems.


The book then applies a structure to the interview and brings the history together to form the patient's story. The last sections of the book identify how to examine a patient from head to toe with use of actual disease pictures to give you a flavor for what the disease process would be like. Basic anatomic structure discussion reminds the reader of where the specific structures are located and their function. The conclusion of the book describes age-specific functions and disease processes. It reminds us that we should all be devoted and compassionate when we begin our interview with the patient and to always remain caring in listening and observing the patient's story.


Although the book is suggested for physicians, I recommend this book for clinical nurse specialist/nurse practitioner beginning in the clinical arena. The book provides a reference for beginners as a comprehensive review of systems, with different system diagnosis pictures as a point of reference. This book can also support an educator or professor in instructing a novice physician or nurse in the art of interviewing a patient, different cultural beliefs, and a comprehensive head-to-toe physical examination. This book will be more valued at an advanced level in nursing or beginning medical education.