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Maintaining Health in Primary Care: Guidelines for Wellness in the 21st Century   Back Bookmark and Share

Published by Elsevier Science
By Jennifer R Jamison
Price: _40

As a practitioners guide, this recently published handbook on maintaining health for primary care practitioners provides a comprehensive resource for health information which may prove useful as a framework for ill health risk assessment for individuals. It identifies the need for a shift from the biomedical model to a wellness paradigm with a strong focus on communication as a key prerequisite for good practice. As a reference book, it provides a good source of seminal and contemporary research literature and the idea of web accessible patient information sheets is innovative and useful. The layout of the book presenting both theory and practice is supported by clear readable tables, checklists and summaries which make it easily accessible for both the quick overview and more in depth study. The supporting website is easily navigated and contains useful links referred to in the book as well as the patient information sheets.
This said, from a health promotion perspective the limited acknowledgement and exploration of the contribution of social and environmental dimensions to health is disappointing although not surprising as the books basic premise is that health improvements for individuals come about through self-care where individuals take personal responsibility for their health. Information through effective communication is considered to be the main vehicle through which to promote self-care with clients. These ideas are more in keeping with health education than health promotion. Unfortunately the web based handouts use medical language that is likely to be inaccessible to many people, so while the book provides information on the importance of the readability of written material and how to assess this the handouts themselves use terms such as progressive neurological deficit (handout 4.1) which is unlikely to be understood by the majority of clients. The paramount focus on health education obscures the valuable role that public policy plays in determining health. The risk of this and perhaps the greatest weakness in the book is the potential for victim blaming contrary to the philosophy of health promotion. As an information source for health professionals on ill health risk factors, this book has much to offer but the promotion of self-care without due cognisance to the broader factors which influence health limit its overall value.
Jane Sixsmith
National University of Ireland, Galway

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