Pain Management Patient Education Resource Manual (second edition), by director Judy Marcus and consulting editor Eleftheria T. Karapas. New York, Aspen Publishers, Inc. 620 pages, loose-leaf, $299.00.

The consulting Editor was assisted by ten editorial board members from a variety of settings. Eight board members are nurses and one is an osteopath and one a physician.

The contents of this large loose-leaf manual are divided into twelve chapters and an appendix. Each chapter is highly specific in content. The chapters are (1) effective patient education; (2) understanding pain; (3) assessment of pain; (4) pharmacological management of pain; (5) nonpharmacological management of pain; (6) acute pain; (7) cancer pain; (8) chronic pain; (9)pain in infants, children, and adolescents; (10) pain in the elderly; (11) psychological issues and (12) quality improvement issues. Patient sections in each chapter have a Spanish translating as well as English version.

Pain management is of great importance because, not only is it extremely appropriate in itself; it also is needed to generate full cooperation in the care process from patients. It also facilitates the focus on cure and rehabilitation to enable catylization of the emphasis on care and rehabilitation by all providers.

A depth in the understanding of the sources of pain, all their wide ranging variations, over a plethora of patients differences are needed by all. Although each chapter in the manual is specific as to its content all competent clinicians are aware of idiosyncrasies in it's presence. How each individual patient may experience and express it differently is a given. Pain reduction has the attention of researchers but it will remain a problem for some time into the future. The skills of pain reduction are an ethical as well as a scientific requirement to ease the suffering of patients.