Aust. J. Rural Health

(2001)

9

, 98–100

Blackwell Science Asia

Book Reviews

Nursing Research Processes: An Australian Perspective (2nd Edition)

K. Roberts and B. Taylor. Melbourne: Nelson, 2000.414 Pages. ISBN 0170091198. Price A$55.90.

My bookshelf holds at least 30 nursing research texts. Thiscollection was started in 1985, at the same time as my researchcareer commenced. The content of these early texts was basedon stages of the research process. The focus was on how todo research within the confines of quantitative approaches.Those early texts were startlingly similar in terms of organisa-tion and content and all were from north America. In the1990s, the shape of general research nursing texts changed asnurses embraced qualitative approaches somewhat hesit-antly, usually with a small section devoted to grounded theory,participant observation and phenomenology but claiming toprovide a comprehensive overview of approaches. More recently,in an effort to balance both quantitative and qualitative researchapproaches, an equal distribution of material is expected.When students ask me which general nursing researchbook they should acquire, I suggest a recent text, butotherwise it does not matter too much. So why would weneed yet another text?

Kathryn Roberts and Beverly Taylor are the authors of thistext, both of whom are experienced nurses, teachers andresearchers. The focus is on how to do research by using quant-itative, interpretive and critical approaches. The text is organisedtightly through the use of these paradigms. The intended audi-ence includes both undergraduate and postgraduate nursingstudents. Persons new to research can be guided through theresearch process, others with more research experience can selectparticular sections of the text and points of interest. Relyingheavily on research conducted in Australia in the last decade,the authors have been able to incorporate examples of everyaspect of the research process. This book differs from otherbooks on research precisely because it has Australian content.

Who can contribute to nursing research? In selectingexamples of Australian research, the authors decided that anyknowledge that has contributed to nursing ‘in any or all of itsdomain concepts (person, environment, health and nursing),regardless of the work role or disciplinary bias of its author’would be presented. Nursing research, they argue, must bedirected primarily to the improvement of the quality of clientcare and this appears to be an organising feature.

Asking a research question is given the emphasis itdeserves. This section is particularly useful for beginners.

Reviewing the literature lists possible resources. Consultationwith the lecturer is the first step in the review process, followedby talking with colleagues and library staff about the topic.This is followed by the usual library search and CD-ROMsearches. Obligatory sections on the use of primary andsecondary sources are clearly presented. There is a usefulcheck list on pages 53–57 to guide the review. In fact there aremany such lists throughout the text, all of which are checklist tools ideal for anyone reading and reviewing research.

The least innovative section of this book refers to theoreticaland conceptual relationships to research. It is a replica ofearlier 1980s and early 1990s texts. Postmodern concernsare not part of this discussion, perhaps avoided deliberately,so as not to confuse novice researchers.

Quantitative research methodology is competentlypresented by Kathryn Roberts, while Beverley Taylorprovides an overview of grounded theory, phenomenology,ethnography and historical research under the headingqualitative research, while critical methodologies compriseaction research, feminism and critical ethnography. Regard-ing action research, Taylor appeals to nurses to think of thisprocess as similar to the nursing process.

In the chapters to follow, a range of methods are presented.It was pleasing to see the use of photography, story-telling andvideo approaches as legitimate approaches to generatingdata. Discussion on rigour in qualitative research is sparse.Analysis sections are comprehensive and useful.

Disseminating the findings is given the space it deserves.More importantly, nursing research utilisation is given the finalword, and its use is directed primarily to the improvement ofthe quality of client care. The reader is challenged to ask aboutbarriers to using research in practice and invited to incorpor-ate research-based knowledge to inform their practice. Teachingnurses to be research consumers occupies the last section.Research terminology is demystified in a comprehensive glossary.

The appeal of this book lies in its Australian context, clearexposition and structure. Australian researchers should beproud that their work and research findings have beenincorporated in this ‘first’ Australian nursing research text.Testimony to its appeal is that the book is in its second print run.

Tina KochProfessor of Nursing

Royal District Nursing Service andthe School of Nursing and Midwifery

Flinders UniversityAdelaide, South Australia

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BOOK REVIEWS

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922001009AUSTRALIAN JOURNAL OF RURAL HEALTHBOOK REVIEWSAbstracts00Graphicraft Limited, Hong KongBook Reviews

Straight from the Heart: Tales of Tragedy and Triumph from the Nurses of the Australian Outback

M. Griffiths. Roseville: Simon & Schuster, 2000. 312 Pages(including index). ISBN 0 7318 0891 6. Price A$29.95.

This is the third book written by Max Griffiths that tells thestory from the heart. Griffiths’ association with the AustralianInland Mission (AIM) spans a number of years, from theearly 60s as a board member, to his appointment as super-intendent in 1973, to his retirement in 1985. Griffiths relatesthe stories of his time overseeing the building of hospitalsand the establishment of health and education services forAboriginal peoples across remote Australia. A map of Australialandmarks AIM and frontier services provided and supportedfrom 1911 to 1990. Although the stories focus mainly on theNorthern Territory, South Australia and Western Australia,virtually all of remote Australia is included in this book.The stories cover an expanse of time and territory.

Straight from the Heart

is a heart-wrenching collectionof personal and community stories of ‘tragedy and triumph’.The stories are scattered chronologically from the early 1900sto the 1980s throughout the 19 chapters and take the readerfrom Oodnadatta, Beltana, Radium Hill, Leigh Creek, Birds-ville, Mary Kathleen, Marble Bar, Port Hedland, FitzroyCrossing, Halls Creek, Victoria River Downs to Alice Springs;just to name a few of the outback towns included in this historyof remote nursing.

Griffiths conjures up the image of the ‘fatal shore’ in hisdescriptions of the isolation, lack of resources, the need forimprovisation, time required to travel from one place toanother, the need for patience, tolerance, ingenuity, selfdependence and strength of character when working andliving in geographically remote areas.

The reader is reminded of an attitude of earlier times,through the description of a cartoon depicting an Aboriginalwoman as: ‘a curiosity in her own country … sitting on thefootpath of a city street holding her baby while a group ofwell-dressed whites stood looking down on her’ (p. 18).

The emerging health and education needs of Aboriginaland Torres Strait Islander peoples are poignantly retold:‘Bush mothers with new born babies need to get as much restas possible before returning to their usually harsh living con-ditions …’ (p. 16). Past technologies, such as the ‘coolgar-die safe’ with legs standing in jam tins to ambush ants, arecontrasted with the revolutionary technological changes ofthe pedal radio, the flying doctor service, and the railwayfrom Adelaide to Alice Springs.

The stories provide a historical overview of the role andfunction of the initial remote area nurses in Australia. Eachnurse was also a registered midwife. The AIM worked on atwo-nurse policy, providing each AIM hospital with a backup

nurse. The reader cannot help but compare these experienceswith those of modern day nurses in remote areas.

The final chapter brings the reader back to the futurewith promise of a new autonomy, professional empowermentand acknowledgement of the real role of the nurse in the out-back through implementation of the ‘nurse practitioner’ role.The author contrasts this with the drive to attract doctors tothe outback with high wages and the John Flynn Scholarshipsincentives and a positive aim to ensure that history does notrepeat itself.

Professor Jennifer Watson

Centre for Clinical Nursing and ResearchNorthern Territory University

Darwin, Northern Territory

922001009AUSTRALIAN JOURNAL OF RURAL HEALTHBOOK REVIEWSAbstracts00Graphicraft Limited, Hong KongBook Reviews

Vaccination the Facts, the Fears, the Future

G. Ada and D. Isaacs. Sydney: Allen & Unwin, 2000.241 Pages (including index). ISBN 1 86508 223 6. PriceA$24.95 (paperback).

This authoritative and scientific, yet readable, book is writtenby two Australian experts in the field of vaccination: GordonAda, a notable Australian immunologist, and David Isaacs,an infectious disease paediatrician in Sydney and a memberof the Australian Technical Advisory Group on Immunisation.

The book begins by outlining the nature of infectiousdisease in humans and then gives a short but fascinatinghistory of vaccination. I particularly enjoyed the antivaccina-tion poster from 1906, indicating that there will always besome people who are sceptical of immunisation practice.

The book proceeds to describe current vaccines andvaccination procedures and goes into considerable detailabout the human immune response and how vaccines work.A highlight of this book is the chapter on individualresponses to infection and vaccination, describing the largeamount of variation in the way that the immune systems ofdifferent people react to the same infectious agent or to thesame vaccine. This concept is crucial to the understandingthat there will always be some individuals in a populationwho remain susceptible to a particular disease despite havingbeen vaccinated. It also explains why there will always besome individuals in a population who become very ill witha disease, despite underlying good health. Both chapters onthe immunology of vaccination are written in two parts: part1 is a summary of the main points and part 2 is a detailedexplanation of complex processes. The chapters are designedso that readers who are not interested in the complexitiescan read part 1 only and move onto the next chapter, whilethe detail is there in part 2 for those who are interested.

Next, vaccine safety is discussed, highlighting thefact that as vaccine-preventable diseases become rare,

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AUSTRALIAN JOURNAL OF RURAL HEALTH

adverse events after immunisation become relatively moreprominent. Examples are given of how unfounded fears ofadverse effects have resulted in reduced vaccination cover-age rates and a subsequent increase in disease. The bookcontinues by outlining common parental concerns aboutimmunisation and barriers to vaccination. The first partof the book finishes by describing programs to eliminatecertain diseases from the globe, such as has been achievedfor smallpox.

The second part of the book concentrates on newadvances in vaccination: innovative ways to improve vaccinesand immunisation practices; the challenges involved inmaking vaccines against infectious diseases such as malariaand HIV infection; and possibilities for vaccines against

non-communicable diseases such as autoimmune disorders,cancer prevention and fertility control.

I recommend this book to any parent who wants to invest-igate the risks and benefits of childhood immunisation. Ialso strongly recommend the book to health professionals atall levels as it outlines scientific, historical and futureaspects of vaccination in a single readable text. Finally,the enthusiastic style makes fascinating reading for anyoneinterested in one of the greatest achievements in publichealth of the 20th century.

Christine Selvey

Centre for Disease ControlTerritory Health Services

Darwin, Northern Territory

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