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Asian/Pacific Islanders, and Native Americans; and their social and demographic characteristics, health indicators, risk factors for coronary heart disease, and typical eating patterns. An extensive, research-based bibliography provides the reader with a wealth of resources. Although designed for the United States, information from this report can be used in other countries if cultural dif- ferences are taken into consideration.

Suggestions for basic methods of selecting, preparing, and consuming foods that contain lower amounts of saturated fatty acids, total fat,

and cholesterol are included and could be used as the basis of handouts prepared for patients. Two additional NCEP publications, Eating to Lower High Blood Cholesterol and Eat Right to Lower your High Blood Cholesterol are excellent booklets for patient education. A major advantage of NCEP publications is that single copies usually are free and multiple copies are reasonably priced.

Rene Clark, RN, EdD Consultant in Pediatric Nursing and Cholesterol Management and Member, NCEP Expert Panel on Cholesterol Levels in Children and Adolescents

Respite for Caregivers of Alzheimer Patients: Research and Practice M. Powell Lawton, Elaine M. Brody and Avalie R. Saperstein Springer, New York, 1991, 164 pp., US$24.95.

This book, written by researchers at the Phila- delphia Geriatric Center, describes a respite ser- vice project designed as an intervention study. The project attempted to evaluate the potential of respite to improve the wellbeing of family caregivers of persons with Alzheimer’s Disease and to reduce costs by delaying or avoiding in- stitutionalization.

Chapter 1 discusses respite services as an ele- ment of the long-term care system. Respite is defined as services designed to provide caregivers with temporary or short-term relief away from a disabled person and includes in-home services, day care, and short-term placement in nursing homes. Respite leads the list of services desired by profes- sionals and families. This chapter provides an ex- cellent review of Alzheimer’s Disease, caregiver strains, and the range of respite programs as well as a review of research evaluating respite programs.

Chapter 2 describes the respite program used as an intervention. The study was a randomized ex- periment in which 316 family caregivers were of- fered respite and an equal number were followed, but not offered respite services. Respite services in- cluded institutional respite, day care and in-home respite care provided by formal and/or informal caregivers. Some money was made available to

members of the experimental group to pay for ser- vices. The project provided information and refer- ral, transportation, assessment, education, case management and counseling.

The research, discussed in Chapter 3, utilized a randomized longitudinal experiment-control design with follow-up interviews after 12 months. Chapters 4 and 5 discuss the results of the pro- gram. Barely half (51.6%) of the Experimental Group utilized respite. The majority of families using respite chose only in-home respite. The authors discuss barriers to the use of respite ser- vices. Many caregivers in the control group, acting on their own initiative, utilized respite. Respite had no meaningful effect on the psychological state of the impaired person. There was a total lack of impact of either the experimental program or the actual use of respite on appraised caregiver burden or on the physical or mental health of the caregiver, even for those caregivers who were originally most stressed. Controlling for ex- traneous factors, subjects in the experimental con- dition remained in the community only 22 days longer than those in the control condition. How- ever, caregivers evaluated respite very positively.

Chapter 6 provides information for those plann- ing respite programs and Chapter 7 summarizes the book and draws conclusions. Many assertions

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are made, not based on the data derived from the study. The overall premise is that respite is good and respite programs should be developed and maintained. However, the data indicate no advan- tages derived from the utilization of respite except that caregivers like it, although they may not use it very often. There should have been more discus- sion regarding whether or not these programs

should be developed and maintained if they have little effect on the various outcome measures.

Analee E. Beisecker, PhD Associate Professor, Preventive Medicine University of Kansas Medical Center Kansas City, Kansas

Empathy in the Helping Relationship Ruth C. MacKay, Jean R. Hughes and E. Joyce Carver (Editors) Springer, New York, 1990.

Hildegard Peplau most appropriately wrote the foreword to this new, valuable resource. She states “This work is intended to simultaneously inform the readers and to involve them in further debate or investigation of empathy.”

The authors should be congratulated for their thorough review of the literature over the last three decades. Compiled here is everything nurse educators or administrators need to know in order to understand and dialogue about empathy. The emphasis on role-modeling empathic skills as the best approach to teaching students or staff the use of this valuable skill is well documented through- out the text.

The contents are divided into four major sec- tions: (1) Empathy as Concept; (2) Empathy: A Personality Factor and a Skill; (3) Empathy in Health Care Practice; and (4) The Challenges of Applying Theory to Practice.

As a member of a task force charged with look- ing at the issue of consumer expectations of health care professionals, I found Chapter 2, The Sign@- cance of Empathy most helpful. This chapter con- siders the significance of empathy from a global perspective in relation to the major trends and issues within the health care system. The fact that empathy requires a high touch skill in a high tech health care world is emphasized. In Chapter 4, one can find names of programs available to train educators and health care professionals in the skill of empathic communication.

Although the approach to ensure transfer of em- pathic skills from the learning lab to the clinical setting are as yet unconfirmed, the editors give us a number of strategies and strongly encourage research interest in this important area of nursing practice.

Review of their own investigations, in addition to other scholar’s work, makes this an exceptional resource for those interested in researching or teaching empathy. As a psychiatric liaison nurse, effectiveness in my practice is often, if not always, related to empathic understanding of other’s feel- ings, situations, and thoughts. This is true when the other is my patient, my colleague, my student or any other member of the health care team.

The authors challenge nurses in practice and education to continue to refine the concepts and tools set forth in this book. Most patients state that they want to feel cared for during hospitaliza- tion. Caring is more than courtesy or cheerfulness, indeed it includes empathic listening. If this is what the 1990s demand of health care providers then this text will assist administrators and educators to reward those who are empathically proficient in the clinical setting. These three Canadian nurse scholars have provided a guiding light to lead the way towards that goal.

Noreen C. Thompson, RN, MSN, CS Psychiatric Liaison Nurse University of Kansas Medical Center Department of Nursing Services Kansas City