Agnostic qualities in Hodges' model

In the previous post I highlighted "Holistic approaches to learning are agnostic as to method." 

I added that there would be more to follow as Hodges' model can be viewed as agnostic on several levels. The following is taken from a paper on Hodges' model and its application in forensic nursing:

Hodges’ model claims to be person-centred and situated (Jones, 2008). What exactly does this mean for forensic nursing? The utility of Hodges’ model lies in it being agnostic. By ‘agnostic’ this means that the model is not dependent upon, dedicated to, sanctioned by, or owned by any particular discipline (even nursing). It was not designed with a particular media, clinical setting, situation or organization in mind. It is true, however, that the model was formulated within academia and health and social care, being taught and applied by community mental health nurses, learning disability and health visiting students. Apart from the history and universality of the model’s cruciform structure and its inherent 2 x 2 matrix form [often referred to as a Johari window (Luft and Ingham, 1955)], the model is also culturally neutral. This is an essential requirement to reflect and enact nursing values and codes of conduct (Nursing and Midwifery Council, 2008).

Doyle, M., Jones, P. (2013). Hodges’ Health Career Model and its role and potential application in forensic mental health nursing. Journal of Psychiatric and Mental Health Nursing. 20, 7, 631-640.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2012.01961.x/abstract

Technologies for Development: Project - founding ideas

Reading the website of the project (posted yesterday) I noticed that their founding ideas can be mapped to Hodges' model. As depicted below some are pretty obvious, notably the POLITICAL domain and the SOCIOLOGICAL.

Their first founding idea is placed in the interpersonal domain. This is very subjective exercise - literally playing with words - but here I am prioritizing individual cognitive access above physical access. I am thinking of individual participants. As Nanotechnologies for Development state the first idea also focuses on countries - the group. So maybe I am wrong, if there is a wrong when using models - idealisations - in this way?

Staying with the group, access and participation are also a crucial matter of human rights - education, health information, health and social care, employment, freedoms, and security - freedom from violence, unlawful imprisonment...

These founding ideas clearly denote underpinning values, note in-particular the way risks and benefits are included at the individual and the group level.

In the SCIENCES domain from the beginning acknowledges time, process, project management. Nanotechnology needs to be understood in terms of the environments we inhabit. Not just us, now; but grandchildren... too. Not just the physical environment, but that embodied under and within this other divide: skin.

Within the mechanistic domains how will consultation about benefits and risks be negotiated and communicated to the humanistic domains?

How will the individual - group : community - commercial enterprise and innovation be squared?
 
This individual-group distinction is becoming ever more significant - of which more to follow.

individual
INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

The first founding idea of this project is that developing countries should not be denied participation in advanced modern technologies.	The third core idea is that such developments entail risks and benefits that need to be addressed from the beginning.
The second that they should do that in their own culturally-specific ways. Our approach rejects any a priori distinction between traditional and modern technologies, but rather seeks innovative ways to connect indigenous and globalized knowledge and practices.	The fourth founding idea is that choices about those benefits and risks need to be made in a democratic way.

Source: Technologies for Development: Project Founding ideas

Four domain link pages updated

The four links pages are still out there and recent interest prompted a review. Given the total number of links included, it is no surprise how url domains are taken over - vape, fitness... It felt good using a links checker and finding and deleting these 'broken' sites and some that are plain dead-ends: the 'domain for sale'. There may be a few more to sort in there...

The pages are archaic in terms of approach - they are not responsive but the format is fine on a desktop and should work on a tablet. The pages started in 1997-98, you don't do this now! People search in real-time for what they need. Besides not everyone may agree with the subjects I have included and the domain in which I have placed them? What is missing?

The intention is to indicate as with another resource the potential scope of Hodges' model in the knowledge and subjects that can be encompassed. I'm not sure of the longer term future of these pages, as I look to new hosting for Drupal.

Over the coming months I will emphasise research, TEL - technology enhanced learning, e-learning and Drupal resources.

Keen to reduce the maintenance overhead, two rows have been removed and categories moved about. As a result there are a couple of 'vacant' columns in there.

In the future I need to investigate the full ramifications of SEO search engine optimization. I receive many requests offering SEO services, and to add links. Given the demanding update task if I can add a few paid links this will help me fund conference travels and studies. ...

As I return to revising my latest essay I'll let you grab a drink and browse, enjoy...(?)

Intra-Interpersonal	Sciences
Sociology	Political

Compare and contrast potential - Energy for Change Index and Hodges' model

The biopsychosocial model is quite all encompassing used as it is to help explain and represent pain, explain human development and balance the physical excesses of psychiatry.

For all its scope the biopsychosocial model is two domains short of Hodges' model.

Hodges' model is dated though, a child of the mid-1980s. The biopsychosocial model predates Hodges' and as models of nursing have fallen out of favour in terms of the attention they receive the biopsychosocial is subjected to critique as per:

Ghaemi, S.N. (2009). The rise and fall of the biopsychosocial model. Br J Psychiatry.195(1):3–4.

Hatala, A.R. (2012). The status of the “biopsychosocial” model in health psychology: Towards an integrated approach and a critique of cultural conceptions. Open Journal of Medical Psychology, 1, 51-62. doi: 10.4236/ojmp.2021.14009

A cursory check reveals a diverse and current literature on the biopsychosocial model. If this is positive for the general role of 'models' in health and social care education and learning then there is another encouraging source in the five energies for change with its five domains, as per the figure:

The five energy domains

• Spiritual
• Social
• Physical
• Psychological
• Intellectual

There is clearly great similarity with Hodges' model although in h2cm the spiritual combines all the four domains of which the political also replaces the intellectual. I would equate the intellectual with the psychological, accepting of course the existence of individual and group psychologies. Being intellectual and becoming intellectual to the extent of an individual realising their potential has long been recognised as a political matter and consequence (Freire). As such the Political domain within Hodges' model is central to its relevance within the field of engagement and innovation and beyond.

Whilst the energy for change domains have a specific derivation and (instrumental) purpose I would suggest that a possible strength for Hodges' might lie in the notion (which it is) that there is an underlying conceptual structure from which the domains arise. This structure might support the model's application in time, as well as assuring its longevity and the stamina of its champion.


My prompt: Land, M., et al. (2014) Pedal to the metal to improve the NHS. HSJ, 124, 6389, 26-27.

Image: (please see title and image link)

why - { Ctrl Alt Del } ?

individual
INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

Alt	Del
Why?	Ctrl

Ctrl provides the power to decide what/who is 'Alt' and What/Who is 'Del' -eted.
The masses are left to ask why?

My source: Peter Kurilecz - RECORDS-MANAGEMENT-UK at JISCMAIL.AC.UK

A Fresh Start: Ctrl + Alt + Delete - Neatorama

One of the programmers’ pet peeves was that whenever the computer encountered a coding glitch, they had to manually restart the entire system. Turning the machine back on automatically initiated a series of memory tests, which stole valuable time. “Some days, you’d be rebooting every five minutes as you searched for the problem,” Bradley says. The tedious tests made the coders want to pull their hair out.

So Bradley created a keyboard shortcut that triggered a system reset without the memory tests. He never dreamed that the simple fix would make him a programming hero, someone who’d someday be hounded to autograph keyboards at conferences. And he didn’t foresee the command becoming such an integral part of the user experience.

http://m.neatorama.com/2014/08/01/A-Fresh-Start-Ctrl-Alt-Delete/#!buNWwY


Additional link: The Holographic Principle
http://apod.nasa.gov/apod/ap090913.html

Gender models role models and cognitive models... Discuss?

As a male nurse I have been aware of gender throughout my career ever since my student days (late 1970s-early 80s) - mental health - and then as a student again for two years general nurse training. The cultural, professional and global changes over the past three decades and more have been quite profound all influencing the perspectives and realities of gender in nursing today.

Since 1987-88, when I discovered Hodges' model I was also bound to wonder about gender in terms of:

• the number of male nurse theorists and their contribution (should this matter!)?; 
• other male nurse theorists globally and the influence of other cultural perspectives;
• the need to consider gender of course in terms of 'standpoint' within research;
• Is Hodges' model gender biased as its structure and basis comprised of categories of care concepts is a very masculine activity? (Even though the intention in identifying the boxes is to transcend and integrate them.) Please see below (and no pun intended).
• Therefore nursing (still primarily a female profession) may ignore/discredit the potential of the model?

Possibly, the stand-out feature of Hodges' model is its invitation to categorise and typify. There could be gender-based consequences in how the model is perceived and received, which in turn could affect interest and participation in research on this subject? In designing studies of the model the feminist standpoint might be useful?:

“What, then, about the further charge that making clear-cut classifications of this kind is a very masculine thing to do? … It reaches its peak in empirical science as we know it, itself a very male affair, and it embodies the desire to have control of things and to know what is likely to happen. It issues in the kind of binary opposites we have found feminists, especially postmodernist feminists, decrying so vigorously-antimonies such as thought/language, nature/culture, reason/emotion, theory/practice, white/black, and especially men/women.” Crotty, (1998) p.171.

Crotty, M. (1998) The Foundations of Social Research: Meaning and Perspective in the Research Process. SAGE Publications Ltd.

This post was prompted by an item on GANM (Global Alliance for Nursing and Midwifery)

Slides: Workshop on Hodges' model at 5th Threshold Concepts Conference Durham 11 July 2014

See also previous post:

http://hodges-model.blogspot.co.uk/2014/07/h2cm-workshop-at-threshold-concepts.html

H2CM workshop at Threshold Concepts Conference 11th July 2014 Durham

Prior to the workshop I did not know how many people would be interested. In the end I had four attendees. With the session located in a large dining hall I had to improvise. I explained the model on paper sat in the middle. The presentation worked on the laptop, with a little swapping of seats for vision. As always with Hodges' model (I believe) the questions and discussion that ensues is primary engagement and this can mitigate environmental limitations. This is also why I believe Hodges' model is applicable to the global community.

I had twenty 2-sided A4 templates to hand-out. The format was as follows:

• What is Hodges’ model?
• A concept sorting exercise
• A case study exercise
• Some examples of links to threshold concepts
• Q & A - discussion
• Feedback

The exercises appeared to go very well, prompting, as hoped, people to think about the model as presented, their own work and threshold concepts. The case study seemed quite realistic and yet it is of course fictional.

Where did I slip up? In at least three ways: I did not have my own feedback form. This is frustrating as I've used these routinely in sessions delivered in residential and nursing homes. I did not complete all the slides. We ran for 85 minutes starting 5 minutes later than intended. On reflection I could have attended for the two days as there were, some really relevant presentations on the Thursday also. I'm really grateful to the people who took part in the workshop. Their work included computer science, law, migration and mathematics.

Durham from TC2014 website

They suggested I identify existing threshold concepts from the health and social care literature and relate these to Hodges' model. Another suggestion pointed to a pre-populated conceptual space using Hodges' model that can act a guide. I've wondered about this before in terms of how to avoid the care reduced to a checklist critique. Although lists play an evidence-based role in assuring safety and situational awareness, the check box mentality is viewed as undermining nursing and high quality personalised care? There is definitely scope for a paper combining #h2cm and threshold concepts.

The TEL course at Lancaster is proving a challenge as anticipated, because I do not have first-hand access to learning management systems and the more formal educational context. I am working on this with an ongoing secondment application, but I never hold my breath.  Doing the TEL course is (also) a test, it forces me to focus and produce small studies and very quickly too. I had wondered about using the workshop to this end, but in light of very helpful supervision and discussion with peers online I directed attention to a semi-structured questionnaire and the reflective content of LMSs used by local students.

Significantly, the four participants in Durham is more than needed for a 4000 word study, so the workshop is a great experience and further 'demonstrator'.

I am still reflecting on the workshop and will be in touch with several people as a result. I would also like to thank the organisers for my being able to contribute. The slides will also be posted online soon. I will add some notes to act as instructions.

In 2016 the conference will be in Nova Scotia, when available I will add the updated link in the sidebar.

For portals, speak patients' language ( c/o Healthcare IT News )

Mike Miliard's 

For portals, speak patients' language 

in Healthcare IT News is a reminder of accessibility and engagement at the level of a communities languages.

This is one of the reasons why I am committed to using Drupal, to try to make use of its Internationalization capabilities amongst others. 

Thanks to Mike's post I'm now familiar with a 'full court press' as a hospital - enterprise wide no less - seeks to achieve defined patient engagement levels by accessing their electronic health record.

This begs the question of what constitutes the patients' language? I don't just mean the purely linguistic forms of Chinese, Korean, Russian and Greek mentioned in the article. The effort is driven by the statutory demands of meaningful use, but what of the patient's general literacy, IT and health literacies? How do patients make sense of their own health (or another in the role of a carer) not just in a given language, but culturally from a medical sociological and public health perspective? What is the community's vocabulary when it comes to health?

How can we assure that meaningfulness? How can we affirm that use and critically translate use into patient benefits and self-efficacy?

You could also entitle Mike's article as

4 portals speak patients' language

individual

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

Health Literacy, Accessibility	Measures (health literacy, patient engagement, health and well-being, clinical outcomes)
Cultural Diversity, Languages, Carer	Internationalization 'Meaningful Use', Standards, Legislation, Policy

When we focus on languages we must remember that listening is a great gift. Whether as health and IT professionals, educators, patients and carers, listening to the care domains can help us integrate diverse social, clinical, policy and technical objectives.

What do these portals say to you?

Mike Miliard twitter

disABLED: What's behind a symbol?

individual

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

	NY State

Well done NY excellent MOVE!

(and hope to visit next year)

My source: James Moore, Clash of Symbols, The Independent 20 June 2014, p.35.
 
Image source from upper right:
http://in-abled.com/blog/2014/04/would-martin-luther-king-jr-care-about-disabilities/
http://en.wikipedia.org/wiki/Disability

Book: The Empathy Exams & Michel Serres Institute

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

group

	The Natural Sciences
Local, Society & Socio-	-Economic

As recent posts reveal I'm overwhelmed with reading at present. Material that is essential for the TEL course and reading more tangential and yet potentially enjoyable titles. It will be a busy summer as all this is brought together(!?). Especially as I've a literature search in mind as a module submission - progress permitting.

The publication of Jamison's book this (N) spring sits well after the findings last year about the benefits of reading fiction in increasing empathy.

Since 2008-2009 I've lost touch with the work of Michel Serres:

Jones, Peter, Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons (Aug 15, 2007). SOCIAL INFORMATION TECHNOLOGY CONNECTING SOCIETY AND CULTURAL ISSUES. Available at SSRN: http://ssrn.com/abstract=1842504 or http://dx.doi.org/10.2139/ssrn.1842504

- having only just found the Institute. I only scratched the surface of Serres' oeuvre in the above paper and must recharge my reflective capacity.

Book cover image: http://www.ew.com/ew/article/0,,20800427,00.html

My source: The Empathy Exams
FT Weekend, June 7-8, 2014.

h2cm - Latest paper published in International Journal of Person Centered Medicine

The latest paper on Hodges' model is now published online:

Using a conceptual framework to explore the dimensions of recovery and their relationship to service user choice and self-determination

Abstract

The concept of recovery is widely applied within service delivery in the field of mental health. The dimensions of recovery were explored using a singular conceptual framework known as Hodges’ model, which is shown to be suited to this particular task. This arises from the model’s structure, in that it encompasses the individual-group and a care domain specific to the political aspects of both health and social care. The evidence was found by relating recovery to the model’s care domains, which is also relevant to the experience of mental health service users and developments over the past decade in mental health service provision. Particular attention is given to the ‘Recovery Star’. This can be used as a key-working and outcomes tool. The discussion is also placed in a context of the current socio-economic climate, notably the ‘politics of recovery’ at a time of austerity.

With thanks to the editors, referees and to Gerry Bennison and Dawn Talbot for assisting in the beginning of this paper including their directions on the Recovery STAR; and for very helpful advice on the final drafts provided by Dr. Andrew Shepherd, and Prof. George Kernohan.

Would you let a robot take your blood?

A Robot With A Hypodermic Needle 

Written by Lucy Black
27 July 2013

Would you let a robot take your blood? The answer to this question illuminates our real relationship to machines that aspire to rise above the robot vac. Is there another sort of uncanny valley?

Veebot is a very clever use of some basic image processing plus some very accurate positioning mechanisms. It first locates a good vein using infrared. Once it has a target it switches to ultrasound to make sure that there is enough blood flow to make it worth inserting the needle.

More...

My source:
International Society for Presence Research: June
http://ispr.info/

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

group

trust, confidence, anxiety, expectations, 'needles' - phobia, previous experiences, model of the 'other', intelligence, physical tests to differentiate mental health problems, subjective feelings - 'creepiness' human pa	safety, measurement, imaging, mechanics, technology, electromagnetic spectrum, infra red, ultrasound, motion, accuracy, research, trials, evidence, logic, blood sample,  appearance, (surgical robots R-here) factors in             RFT - 'right first time'
public awareness, interaction, relationships, community of practice - acceptance, publicity, media, dissemination	investment, policy, certification, law, standards, testing, supervision, labour relations

L-earning a Living with McLuhan

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

group

In 1964, Marshall McLuhan predicted that the future of work would involve -

"learning a living"... .	production
communities of practice	earning a living

Source:
Parchoma, G. (2006). A proposed e-learning policy field for the Academy. International Journal of Teaching and Learning in Higher Education, 18(3), 230-40. (p.232).
Reading for module 2.

Never give up on someone ...

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

group

Never give up on someone with Mental Illness – 

when 'I' is replaced with -
'We'  'illness' becomes 'Wellness'

Thanks to colleague Julie Draper - apparently this is doing the rounds on Facebook and elsewhere.

Interested in writing? [ II ] Hodges' Health Career - Care Domains - Model

In the side bar beneath the bibliography (on a desktop) I've listed a few topics worthy of critical attention. The real need is to link practical application of Hodges' model and further some theoretical underpinnings for the model. This is now happening and it's quite a challenge as I chase questionnaires and write up a draft report for next week. This report is set out as a paper using an author's template from a nursing journal.

Trying to get the message out on writing about this free, holistic bandwidth defining, holistic wrangling, (self-) caring info-portal I blogged an appeal of sorts in 2010. Here we are again. The existing topics in that list relate to the original purposes of the model, plus a few 'extras':

• reflection;
• curriculum development;
• case formulation;
• holistic care;
• conceptual spaces

I'll revise the above as a result of this post and ongoing studies at Lancaster University. I will also add the journal to the most recent recovery paper. Expanding on the above for the benefit of anyone interested in using Hodges' model, reflection (as in 2010) is for me the primary purpose of the model.

Reflection: I'm sure that Hodges' model can complement existing and established approaches to reflection. It would be interesting to compare the use of Hodges' model with a control in clinical reflection, reflective practice with a patient/client, and in clinical or managerial supervision. (You see why this is a challenge, and I appreciate it is easy to generate suggestions!)

Curriculum development: If you need a map that incorporates an academic compass (sat-nav even) look no further. Where are the curricula hot-spots and how are they distributed?

Case formulation: There is an existing draft that needs to be revisited at some point, but the scope here is huge in terms of disciplines and applications. As mentioned above it is coming up with questions and research methods.

Holistic care: Is it time to revisit this phrase? Break it apart and put it back together if it still fits?

Is it a damaged good(s)?

Is this a broken currency as it originally did not include the patient as an active participant? Is it one of several linguistic tropes, said in earnest yet what does it mean? How do we measure it? Could there be a role for Hodges' model in defining or measuring it in theory (through the health record) in practice through outcomes that are demonstrably holistic? Does this make sense...? What is this holistic bandwidth that PJ witters on about? Is an informatics metaphor too far, or this a means to a definition?

To conceptual spaces I need to add threshold concepts and there is a literature here for health and social care, something to build upon and post here....

Interested in writing?

Two items can be readily brought together here: 

----- Forwarded Message -----
From: JS Drummond
To: NURSE-PHILOSOPHY AT JISCMAIL.AC.UK
Sent: Tuesday, 22 April 2014, 18:00
Nursing Philosophy (Post)-Graduate Student Essay Prize

Hi Folks,

To interested parties, there is still time to submit an entry for the (Post)-Graduate Student Essay Prize to the Journal, Nursing Philosophy.

Details are on the IPONS website. http://www.ipons.co.uk

Best Wishes,
John Drummond (IPONS)
Sent on behalf of Derek Sellman, Editor, Nursing Philosophy

The latest paper on Hodges' model -

Exploring the Dimensions of Recovery and User Experience

- has progressed to the point were I am awaiting contact from the production office of the International Journal of Person Centered Medicine.

In addition to the (Post)-Graduate appeal with IPONS there may be an opportunity through h2cm. If there are any student nurses and other health care learners interested in models of care and the future, I would be pleased to offer some support on a paper. Perhaps there are personal tutors out there who could also engage? I can't offer a prize, but there is surely a prospect with the journal Advances in Nursing Sciences:

Models of Care for the Future
Vol 38:1 - June 2015
Manuscript Due Date: October 15, 2014
As nations worldwide seek to establish models of care that provide quality and efficiency, nurse leaders are emerging to play a significant role in the development of these models. For this issue of ANS we are seeking manuscripts that provide theoretical underpinnings of creative models of care, as well as evidence that supports their implementation. Manuscripts should be clearly grounded in a nursing perspective; the content can include philosophic, theoretic, empirical or ethical aspects related to the model.

I do have form here - two submissions without success - but the very helpful feedback did result in a publication elsewhere.

With studies of my own I can't write another paper alone, but perhaps I can help others. It's time for me to not just think about the model, but do something with it too. It feels strange finally having questions out there in the field - a small study.

Earlier this week a colleague referred to the model's elegant parsimony. This is definitely a quality of Hodges' model and one that merits exploration with new explorers.

Blog birthdays, a missing model and history

Eight years ago today this blog was born. Last month I came across a backup of some old emails and discovered one of my first related to Hodges' model. This was while attending Bolton College for the Post Graduate Certificate in Education in 1997. I had a project to complete and in researching nursing theory came across a resource by Judy Norris then at the University of Alberta in Edmonton. There was one a model of nursing missing. I'd also visited Alberta (ALTA) twice in 1979 and 1989: wonderful holidays.

19 ‎March ‎1997, ‏‎09:28:38

Hello there.

I'm fairly new to the net and E-mail, but fairly conversant with other aspects of I.T.. I would be very interested in being involved. My E-mail is read once a week, when attending college.

Both nursing informatics and nursing theory have been keen interests for some time. Over Easter I'll have more time to explore and learn.
There is one 'model', which I don't think you have listed, although it is debatable whether it qualifies as a model - the health career model.

Perhaps I could write something up with references, and key questions?
(And also consider the list of work for volunteers.)

Bye for now

Peter
P.S. I hope ALTA is still as beautiful as I remember it.

So, h2cm became the preoccupation and now there is a small research project to complete these next six weeks, Hodges' model within the residential care sector.

Nursing theory links: H2cm Links II (any updates?)

Acknowledgement: Judy Norris
Thanks Judy for your encouragement all those years ago and with this post.

Angling for Ideas

The Angler by Paul Klee (1879-1940, Switzerland)

This is just a rock pool I reflect	So is this, even before Pollock just a single drip in the ocean
Fishing for praise	Here we trawl, as we do we maul. Why owns the holistic ocean? Does it bleed, does it leak? Abs-orbs all angles? just?

Image source: http://en.wahooart.com/@@/8LT48X-Paul-Klee-The-Angler