If we were able to put the care record into an appropriate text analysis program is there a measure of the conceptual span - the holistic bandwidth of care - somewhere in there? Could there be a disciplinary or task-based mesh, a tag cloud that could be superimposed on Hodges' model to represent care as holistic bandwidth?
Very early on in the web site's history a page was added on the multicontextual nature of health (and social care). This contexts page like the others has not been properly researched, which I recognise is a risk for readers in terms of 'evidence based sources' and a risk for me since of course the Web is a rather public arena to air initial thoughts.
Since the site and this blog are a call for research in this area, I'm sure a search would reveal a literature, but without recourse to said literature I'm not sure how explicitly - my incomplete - notion of holistic bandwidth has been studied in care contexts. On the context page I included several basic diagrams to indicate how Hodges' model might be used as a 'measure'. This page plus the others need revising with a bin (icon) close to hand, in the meantime how can we measure holistic bandwidth?
We could add the problems identified in each care domains, e.g.:
INTRA-interPERSONAL = 3
POLITICAL = 2
SOCIOLOGY = 5
SCIENCES = 6
Continuing in a fit of numerics we could throw in some multiplication - 3*2*5*6 = 180 ?
'180' is much more impressive than a paltry '16'.
What next...? Could the domain scores be weighted in some way? Is it valid to assign a primary domain? And while we are at it where does self-care fall (intra-interpersonal surely)? Wither the literary heavyweights of severity, chronicity, strengths, recovery and well-being. ...? Oops - how could I forget - dependency measures are nothing new; but the literature bearers are not the issue.
If we still frequently fail to deliver holistic care, then what is holistic bandwidth (actually measuring)? Is it -
- The scope of care [in one or all of - assessment, planning, intervention, evaluation, outcome]?
- Simplicity [breadth]?
- Complexity [breadth and depth]?
- (Rapid) care integration [time, connectedness]?
- Concordance: clinical problems + patient (carer) problems + outcome set?