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)

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.

Le Ballet Mécanique (1924, Fernand Leger) & the axes of Hodges' model

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

individual

Le Ballet ?
Le Ballet ?	Le Ballet ?

group - population

The Ballet mécanique faq
http://www.antheil.org/faq.html

My source: Budick, A. (2013) Hymn to progress, Life&Arts, FT Weekend, 14-15 December. p.16.

Listening to Jay-Z

Listen to Jay-Z's Magna Carta Holy Grail:

- but if it is care fundamentals you seek ...

Big Bang - Aisha Caan

Big Bang & The Four Elements by Aisha Caan

Big Bang V by Aisha Caan

Aisha Caan

Aisha Caan - Albemarle Gallery Exhibition

Albemarle Gallery

HSJ: The NHS and fundamental change ...

 ... governments typically try to will the end but not the means: they try to shift the habits of the NHS while protecting buildings and people; or in Lord Darzi's pithy phrase, they change "the anatomy of the NHS rather than its physiology". p.16.

Finding the pith in Hodges' model (and the problem of refactoring - where would you like to start?):

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

individual

PURPOSE cognitive geography (the 'physiology' of mindsets)	Anatomy & Physiology PROCESS  structure, buildings,geography time, events, space
(habituated - ) PRACTICE (collective purposes) team integration	the NHS (organisation) POLICY workforce, funding  local, regional, national, global

group - population

Seddon, N. (2013) Opinion: Learning from international innovators, HSJ, 12 April. 123: 6346; 16-17.

Every incredible view...

The Shard, London, UK

Every incredible view, whether achieved 

by natural, artificial or conceptual means
relies upon a structure, a framework.

Image source: The view from The Shard
http://www.theviewfromtheshard.com/

My coat, Your coat, the Community cloakroom

'Untitled' 2012 (coats, wire, screws), by Jannis Kounellis

"Such wall-mounted three-dimensional pieces seem to me to talk the language of painting rather than sculpture. So does a massive, poignantly flopping black cross created from several navy coats tied together with wire and screws, hung against a wall. Each coat is a human measure, a stand-in for a human presence." p.20.

Wullschlager, J. (2012) Arts: Beauty in a burlap sack, Financial Times, 8-9 December. p. 20.




Bunzl, J. (2001) writes:

"Expressed in terms of a community-building process, we could thus identify the entity of the nation state as representing the equivalent of the individual person: the prime agent through which community or chaos in the world will ultimately be determined." p.20.

Additional link:
Parasol unit (Jannis Kounellis exhibition)

Bunzl, J. (2001) The Simultaneous Policy – An Insider’s Guide to Saving Humanity and the Planet. New European Publications.
Image source:
Wullschlager, J. (2012) Arts: Beauty in a burlap sack, Financial Times, 8-9 December. p. 20.

Slides from IPH Conference Belfast 11 Oct 2012

Here are the slides from the IPH Open Conference in Belfast. There were several very helpful questions from the floor. With fifteen minutes for the presentation and ten for questions, the 23 slides were ambitious but they were delivered in the allotted time. Many aspects could be developed further and emphasized. In particular the way that public health policy and practice has switched from needs based approaches to assets. This also reflects the trend in self-care and the recovery model in mental health. (I have added needs-assets to one slide.)

If any public health - public mental health practitioners are interested in exploring the possibilities then please get in touch. After several presentations the issue here is to extend this work so as to be able to test and apply existing and found knowledge to say something new... 

A Framework to facilitate Integrated Public Health from Peter Jones

I greatly appreciate the votes received for the abstract, the organisers for what was a free event to attendees, and the support and hospitality of Prof. Kernohan. 

Additional link: The Health Well

What is the foundation of h2cm? Gabora & Aerts 2009

I've described h2cm as a foundation, a substrate for the health and social care assessments that follow. And that's the question: what is there before the conceptual framework is populated? As a foundation the model is initially empty, void, null. In terms of theory, practice, values and judgements there are none. The piece of paper is blank. So is the screen. Once (quickly) learned, the professionals have the conceptual framework in mind (ready to call upon), but it is not exercised. Until they encounter a patient, client, carer amid a situation, the conceptual space is empty.

Lund, Hobykrok B&B in the distance - the farm track

If we allow for the structure to permanently reside what then? Does this situation produce an array of potential? An array of potential concepts? Nurses are used to potential and actual problems (often re-framed as strengths). It seems this is the case with language, the amazing compositional scope of different words to produce sentences and meanings.

In a way I don't want to venture into this space. There are monsters there. I know the above is far removed from nursing. Where is  compassion, dignity, respect, plans and empathy in all this? ... Once the care concepts are realised then: yes - do lead the way. But before the light is turned on: no.

No: but there is no choice. The question needs to be asked and settled.

Liane Gabora gave a talk at Conceptual Spaces At Work. Checking back on her previous work I found this (SCOP: State COntext Property theory of concepts):

An important notion in SCOP is the ground state of a concept, denoted p. This is the ‘raw’ or ‘undisturbed’ state of a concept; the state it is in when it is not being evoked or thought about, not participating in the structuring of a conscious experience (such as, most likely, the concept ZEBRA when you began reading this paper). The ground state is the state of being not disturbed at all by the context. One never experiences a concept in its ground state; it is always evoked in some context. The notion of ground state is somewhat similar to the notion of prototype. The ground state is a theoretical construct; it cannot be observed directly but only indirectly through how the concept interacts with various contexts (which may include other concepts). p. 436.

Gabora, L., Aerts, D. (2009) A model of the emergence and evolution of integrated worldviews, Journal of Mathematical Psychology. 53, 434–451.

Reflections [V] Conceptual Spaces At Work: Zwarts

As per previous CS@W posts Joost Zwarts' Constructing Conceptual Spaces for Lexical Semantics provided one of several examples at the conference of data analysis derived from large datasets. The abstract included:

The similarity structure of a conceptual space can be determined using lexical data or pile sorting, but it can also be based on some sort of analysis of the values involved. Using the work of Geeraerts et al. (1994) on Dutch clothing terminology, Zwarts (2010) demonstrates how a space of “shirts” can be constructed (either using graph or MDS techniques) along such lines, with fruitful results.  

This talk outlined the way features can be identified and decomposed. Key to this are classifiers which Zwarts listed as:

1 Psychological classifiers (piles)
 From similarity judgments or sorted piles
2 Lexical classifiers   (words)
 From common lexical descriptions
3 Analytical classifiers  (features)

The presentation provided a small example based on containers, which for me was very helpful as data is a real issue for my study of Hodges' model. There are datasets out there - nursing, classification systems - and secondary data sources to consider. As mentioned above Zwarts took a dataset comprised of 38,000 possible items from the clothing domain and used 244 from the sub-domain of shirts. [Geeraerts, Grondelaers, Bakema (1994). The Structure of Lexical Variation. Berlin: Mouton de Gruyter. ]

I am probably simplifying things but discussion of Hamming distance recalled for me old Byte articles on bit-classifiers. Whether a sign of progress (maturation) or my focus, but in the 1980s there were many articles on data structures and algorithms, for some reason quad trees proved quite an attraction. There was an approach to clinical classification by Johnson (1987) that adopted a ZIP code format. As Zwarts related his presentation I wondered where a primary care problem might reside in Hodges' model: (1000, 0100, 0010, 0001)? Alternately where is the emerging problem that is nudging this individual towards possible relapse?

Graphviz was used and multidimensional scaling. The talk became more technical, understanding aided by graphical examples as classical categories were introduced: A category C is classical iff it can be defined by a particular set of feature values. The conclusion brought together the technical aspects of the data examined: convexity is too strong, connectedness somewhat too weak, but that there is a clear notion of coherence. There was much here to learn from.

Johnson, B. (1987) Health Code, The Guardian, 23 July, 16 (see also (1990) Journal of Health Care Computing).

The following page is out of date but cites Johnson:
http://www.p-jones.demon.co.uk/infselct.htm

(I don't want to upset searches on Google for 'conceptual spaces', so I've two more further posts this month on the conference concerning CSML and OntoSpaces.)

Here is the view from my B&B I enjoyed some lovely walks into Lund, plus using the bus. With a map that stayed in my laptop bag, I enjoyed getting lost on two occasions.

Reflections [IV] Conceptual Spaces At Work: Parthemore, Unified Conceptual Space

In my notes on Hodges' model, nursing theory and conceptual spaces I've referred to Rosch, Gärdenfors and there is much of note in my copy of The Big Book of Concepts. There are gaps to fill, key sources to find and digest including the history of concepts. In Empirical Investigations in Conceptual Spaces Theory and the Unified Conceptual Space Joel Parthemore really helped this effort. His presentation began with: What is a concept? Which begs the question: What is a concept within Hodges' model? Is it a single entity?

Joel's slides included the following:

In the Beginning Was...

• Classical definitionism: concepts are like entries in a dictionary.
• Classical imagism: concepts are like pictures in the mind.

And then came their descendants:

• Prototype and exemplar theories (Rosch)
• Informational atomism (Fodor)
• Proxytypes theory (Prinz)
• Conceptual spaces theory (Gärdenfors)

Listening to Joel introduce his work on unified conceptual spaces I can relate several points to Hodges' model especially the following.

• Attempt to describe how all of an individual conceptual agent’s conceptual spaces map or weave together into a single unified space, a “space of spaces” describable along certain common axes.
• By extension, how all of the individual conceptual agents’ unified spaces map together, in linguistic human society, into a single, common unified space.
• Unlike CST, UCST is explicitly enactive: concepts are located not in the agent nor in the environment but in the interaction of agent and environment.

A couple of speakers brought up the question of a 'space of spaces'. Centeredness also preoccupies us in health and education. We are desperate to pick up the patient and the student and put them at the center of things. I keep wondering (see link below) about the extent to which structure and a theory of cognition are interdependent in terms of the resulting conceptual spaces? Since the late 1980s Buzan's mind-mapping has struck me as not being 'grounded'. This may not be an issue in many applications, but for a generic conceptual framework some underlying structure (dimensions) seems essential.

Joel also considered this:

• One major shortcoming of currently available mind-mapping software is the lack of any well-defined theory of cognition (let alone theory of concepts) underlying the application.

I hope I can make contact with Joel and return to this. He indicated papers and further projects with colleagues and a piece of software.

Additional link (Hodges' model - nexus, structure):

http://hodges-model.blogspot.co.uk/search?q=nexus

How solid is the framework? Paper: Perceptual ratings of opposite spatial properties...

In researching conceptual spaces and h2cm I came across the following source:

Bianchi, I. , Savardi, U., Burro, R. (2011). Perceptual ratings of opposite spatial properties: Do they lie on the same dimension? Acta Psychologica, 138, 3, 405-418.

As constructed h2cm makes several assumptions with its axial structure. Is the placement of humanistic – mechanistic and individual – group on continua truly representative of the opposites of continua?

It seems that to address this question we must investigate cognitive linguistics. Bianchi et al., raise the following for consideration:

The idea that two contrary properties lie on the same continuum has formed the basis of various methodologies used in experimental research in the field of Psychology since the late sixties (e.g. the differential semantic method, Likert scales, etc.); however, an increasing number of methodologists are facing problems connected to the assumption of unidimensionality in opposite scales ... (p.405).

I wonder to what extent the original purposes of h2cm can support the existing continua? Nursing and the scope of nursing should also be able to substantiate the model. Nursing is person-centred. 

The idea that opposites presuppose an underlying continuum has been a default assumption in linguistics and cognitive semantics for more than two decades even though it has been noted that in every-day language people describe their perceptions in terms of opposites (“you are driving fast”, “the walk is long”, “the room is small”, “it's hot today”) instead of using unidimensional scales (respectively, velocity, size and temperature) (p.406).

Additional links:
http://hodges-model.blogspot.co.uk/2009/08/combining-h2cm-informing-science-and.html
Hodges's model