Hodges' Model: Welcome to the QUAD: August 2007

- learn about the conceptual framework Hodges' model. A tool that can help integrate HEALTH and SOCIAL CARE, INFORMATICS and EDUCATION. The model is situated, facilitates person-centredness, integrated - holistic care and reflective practice. A new site using Drupal is an ongoing aim - the creation of a reflective workbench. Email: h2cmng @ yahoo.co.uk Welcome

Monday, August 27, 2007

INTERPERSONAL links: Holistic Bliss or Tristram Shandy ... III

The INTERPERSONAL domain links are to my mind (no pun intended) fairly obvious, at least that first row complements the SCIENCES top row opposite.

Basically, who needs a talking therapy and who needs a drug therapy?

The two uppermost care domains are intended to represent the INDIVIDUAL axis, so just as the SCIENCES [ANATOMY & PHYS] domain covers physical care; so the INTERPERSONAL domain encompasses emotional and mental health care.

Hodges' model is comprised of four care domains, but it is these two [INTERPERSONAL : SCIENCES] applied to the individual that even today we struggle to balance in theory and practice.

A key factor in Brian Hodges' early nursing career (and mine) has been the role of institutions, organisations and the formal policies and structures they represent. This can be depicted as:

OTHERS family, society : INSTITUTIONS (both 'group')

As to the INTERPERSONAL links themselves - I arrived at mental health through reading a psychology text on Wundt and introspection, then James..... PSYCHOLOGY being of central importance in this domain has two listings, with MENTAL HEALTH and closely related THERAPIES also sharing the top row. I may swap these around: PSYCH-OLOGY as a cognitive science should be placed rightmost, while MENTAL HEALTH and THERAPIES should be further to the left being more 'humanistic'. What do you think?

Do the sciences have to be corralled in the SCIENCES domain? I think I remember Bryan Magee and John Searle in conversation noting that many disciplines with science in their title are probably not sciences - in that upper right hand quadrant sense. Maybe it is just that -

cognitive science : "SCIENCE" (physics, biology, chemistry)
social science : political science

- are still running wild out there, untamed and as yet unbroken? Cognitive science has however, clearly come of age and the 21st century will undoubtedly be the century of the brain when anatomy, physiology and genetics are linked to thought and individual (and even social) behaviour.

Already the content here highlights cognition (thought). The inclusion of other link categories in this upper-left set can be explained with recourse to cogitation. After PSYCHOLOGY, PHILOSOPHY (with ETHICS) is the rather obvious 'ology'.

For better or for worse our culture is driven more by IDEAS and ideology than philosophy. Call it the informal philosophical engine that drives CREATIVITY.

COMMUNICATION lies at the heart of all things human-e. Given the millennia that the patient-physician relationship has been around, you might expect it to be perfected by now. Well health and social care workers and the public they serve are still trying to reach empathic nirvana (although that may be to take communication a bit too far).

Hodges' model has a role to play supporting reflection for all.

IDEAS, COMMUNICATION lead us to belief and a central component in psychological therapies. Belief is also a thread can be used by one individual to lead others positively or to subvert other individual's capacity to think critically. It is in this INTERPERSONAL domain that good and evil are so proximal they create heat, fanned by a culturally driven winds of history and media from the South. Be-life indeed. Here then - THEOLOGY is purposefully placed with TRANSDISCIPLINARITY. If it is to serve humanity Religion must be bound and integrated into the corpus of knowledge and that includes reconciliation with the SCIENCES. We cannot deny myth and yet myth cannot deny evidence - a debate that will go on......

The economic emphasis placed
currently on creativity is quite remarkable, not just at a national level (cue ramble...). Cities recognise that their future development, sustainability and very survival depends on the generation and flow of ideas. Some things do not change. In myth a special place has been reserved for the isolated thinker, the one individual who takes themselves away for weeks-months, to be touched by the spiritual realm, to return to the community delivering insight, creative sustenance. Now creative individuals are needed more than ever. The isolation is virtual, the community potentially global. The energies of individuals are directed at solving problems concerning more mundane matters of cost, risk, flexibility and growth. Those creative outputs are distilled through team work and although they are then diluted they remain invaluable - such is the scale of the problems to be solved. Just as the great rivers that feed our cities have their sources - often remote and isolated in the high mountains, so ideas and creativity begin with one individual. That flow of personal knowledge now finally enters the ocean of KNOWLEDGE MANAGEMENT - EXPERT SYSTEMS (decision support systems).

I have a little mantra that I share with students. It's not perfect as there is much overlap; but I figure that what
aptitude is to engineering so attitude is to caring.

HEALTH PROTECTION and PROMOTION, SELF CARE are all about attitude.
Of course, money in the form of departmental budgets (those institutions do matter) and family income can make a huge difference, but if the right attitudes are not present then you may as well - "go fish!".

In light of the above STUDY SKILLS and EDUCATION and TRAINING speak for themselves - on this occasion at least. One of the original purposes of Hodges' model was to facilitate reflective practice
(more to follow). We are familiar with the mechanical tools in use everyday to the extent they are taken for granted. Now the focus of training is more likely on the software tools that translate IDEAS into art, artefacts and conceptual frameworks.... ;-) These graphical and design tools must be learnt and the HUMAN-COMPUTER INTERFACE and its ACCESSIBILITY 'quotient' can prove to be either a brick wall or a leg-up for the individual user (even if networked or a collaborative tool - see SOCIOLOGY links).

If the SOCIAL domain reflects the worlds of the others, then the last INTERPERSONAL row REST & RECREATION reflects something of me and my family.

"Next!" - the SOCIOLOGY domain links....

Saturday, August 25, 2007

São Paulo - A City Without Ads + BBC Paxman and secular sanity*

It's not often I get to bookshops and less often still that I buy anything. I did both recently - walking out with a copy of the latest Adbusters magazine. I've listed their website for quite a while [POLITICAL: activism] and must say as a consumer, community mental health nurse and would-be human ecologist there's a lot to read and think about....

Sustainability : Advertising : Well-being : Public Mental Health

Now, subscribed to their e-letter the Sao Paulo item proved a real revelation. A breathe of fresh... fresh... vision no less!

“The Clean City Law came from a necessity to combat pollution . . . pollution of water, sound, air, and the visual. We decided that we should start combating pollution with the most conspicuous sector – visual pollution.”
So, add to this the news at the end of 2006 or early this year of European cities starting to take light pollution seriously, to the extent of turning the lights off for a night and hey change really can happen.

If amid the advertising information overload what Adbusters refers to as mental pollution ('brain damage') there is a vacuum in terms of values, self-respect and social responsibility...; others will fill that void with what is most likely to be another form of pollution.

Jeremy Paxman, BBC presenter and media luminary was on the Beeb's radio 4 this a.m. highlighting the need for media with a conscious. His lecture at the Edinburgh TV festival made the news. He criticised the BBC and the media in general regards quality, public service and the pursuit of the bottom-line. An Adbusters article describes problems in the Canadian media. This appeal has been heard before: but I wonder if there's a realisation finally sinking home that in a 21st century society how do you achieve secular sanity? In the UK the spate of terrible gun-crime killings, youth gangs, the TV phoney phone-in scandals and the need for inspirational creativity in the media is really fuelling debate. If the media reporting is correct this past week then some elements of the media - music industry included - are into trafficking. From a very early age the public is subject to an info-toxic OD. Is this the real reason why in health care we need information prescriptions?

How can society change to become sustainable, while struggling to swim in this advertising torrent?

I've no universal panacea Mr Paxman for the rehab of the prison population, the feral kids on the streets and the quest for an agreement for quality standards and public service throughout the media; but if as you say you want to hear from people - well, amid your busy schedule take a look at this interpersonal-social resource.

Look upon it as one of the cognitive antidotes for our times.

Geel, Belgium A Model of "Community Recovery"

This message appeared on the PSYTEACH list and may be of interest:
Dear Colleagues,
Those of you who teach courses dealing with mental illness or history of
psychology will be interested in a new website produced by my colleague,
Jackie Goldstein, on the city of Geel, Belgium, which has a 700 year old
community-based system for caring for people with mental illness. If you
are unfamiliar with Geel, I think you will find both the system and its
history of great interest. The system, founded on the legend of St.
Dymphna, presents an approach where the citizens accept, support and
integrate people with mental illness into the community. It presents an
interesting alternative to the medical model of treatment, and
stigmatizing attitudes towards people with mental illness.

The website is a good teaching resource for instructors and for students
doing research in the area of mental illness.

Jackie has been doing research on Geel for a number of years and has
produced the website in response to enquiries about the system. She
would welcome feedback about the site. Her e-mail address can be found
there. The website is


Stephen L. Chew, PhD
Professor and Chair
Dept. of Psychology
Samford University
Birmingham, AL 35229-2308

Thursday, August 23, 2007

TED Jaw-dropping Photosynth demo and other links

Here are some links as we head for the weekend....

TED CONFERENCE - Jaw-dropping Photosynth demo

(Thanks to David McKendrick at Open Software Library for this item)

Internet Maps [c/o the MAPPING-CYBERSPACE list]

Voyager - (so just how far can you run in 30 years?)

LearnByDoing with Pam McLean who led me to -

Worknets wiki

Regenerosity - Community-Building through Active Participation

Next time - Lemon Washing-Up Liquid....

Perceptions Of Nursing And Of A Midwestern Associate Degree Nursing Program

Last October I posted that Asst. Prof. Shannon Frodge [Maysville Community & Technical College, KY] had contacted me about her Master's study:

Study on Student's Interest in Nursing (Grades 6th-12th)

Shannon found that h2cm provided an appropriate framework and wondered if I could help with an image of Hodges' model. Well Shannon's study is now successfully completed and I've some reading to do. To see h2cm represented in work like this makes the effort so worthwhile, but it's the focus of Prof. Frodge's that really counts as nursing competes for recruits.

Many congrats and thanks Shannon for the reading I've to catch up on and more to follow...

Saturday, August 18, 2007

POLITICAL links: Holistic Bliss or Tristram Shandy ... II

Having mentioned the other day that health and social care related subjects are placed at the top of the links pages, of course the POLITICAL page - as awkward a cuss as ever - differs. The political topflight is missing some obvious candidates. Although there are related links in there somewhere amongst the four links pages I have not explicitly listed:

  • mental health law
  • (patient - carer, long-term) advocacy
  • consent and capacity
  • confidentiality
  • professional (and other) codes of conduct
  • health and safety
  • or global health
Perhaps I should list these or other missing political categories? If we stop and think about it though - what do you need before you can deliver coherent health and social care? That top row are the critical determinants: the starting blocks. If DEMOCRACY, JUSTICE and LAW are absent or taken away where is care? Why in so many developing countries is health care so poor - native/ethnic medicine practices can only go so far?

In promoting 'DEMOCRACY' this in itself is a challenge of our (Western) times, given the apathy that exists in local and national politics. No surprise then that CITIZENRY & LEADERSHIP (C&L) are not far behind with their hands raised. There's a chicken and egg here: should C&L be on the front row? Then the people would have the Government they deserve on the second row. Can they be side-by-side?

HUMAN RIGHTS should be on that top row; however, HUMAN RIGHTS are surely dependent upon DEVELOPMENT to overcome POVERTY and effective LEGISLATION?

We need cognitive capacity to boot-load our person-al operating system first thing in the morning, although in terms of HUMAN RIGHTS and an individual and family's capacity to exercise choices ECONOMICS is where the buck stops. While vital money is not enough: International STANDARDS make the world go around from paper size, device operation to INFORMATION STANDARDS. I like this word GOVERNANCE because it does not have to be central, it can be peripheral - grassroots - as well and takes many forms: national, corporate, financial, clinical, information, civil, and green. Sometimes political change needs to start on the edge, that's where others can get on-board.

Communities are social entities, nebulous things as I still recall from an old course essay: Community care means whatever you want it to mean: discuss? So if community is social, then why is COMMUNITY INFORMATICS [CI] in the political links domain? Well, CI very broadly speaking seeks to promote and assure the study and use of informatics developments, specifically communications and information technologies for groups within a population who may otherwise remain disadvantaged, and so find themselves on the wrong side of the so-called digital divide. Whether your arrival is positively or negative framed in terms of social inclusion or social exclusion you must pass through Customs and Excise:

c/o the political domain.

NEWS is quite a strange thing or these days a many splendoured-multimedia-mobile kind of thing. You see the messenger is always transformed into a bizarre beast: a POLITICAL animal. The animal has long been on the endangered list, it is rarely sighted and the SCIENTISTs next door call it a 'Trust'. Because its appearance is so remarkable children are wary; so in a poll they elected to call the creature a 'can-U-really'.

Who 'owns' the news, controls it, governs the media - what difference does it make? What is news these days? The quality of health care information and news and overall what counts as news is at issue. Big brother once the epitome of totalitarianism is now equated with total trash.

Connected to the news is the global family's and a Nation's ability to SEARCH the web without censorship?

Finally then what categories are missing here politically? It's true war & peace, mass marketing, weapons of mass depletion, crime and punishment, crimes against Earth, plus management have gone AWOL.

ORGANISATIONS are in there, but personnel and human resources are not. Should they be? What do you think? What's in your political set?


Thursday, August 16, 2007

Holistic Bliss or Tristram Shandy and the Web Hydra I

Building the h2cm website a decade ago the links pages -


- were planned as a feature from early on. They started as TWO pages but have become FOUR and far more general in nature than originally planned. I first envisaged a core h2cm nursing set into which students - life-long learners could all dive.

Perhaps there's a project there for students: Specify what you consider to be a core set of links resources and justify your answer in terms of either one of the following or a combination of - models of care, health-social care policy, self-care, multidisciplinary teams? .....

Like many potential h2cm developments (XML templates, ...) which I've shared with contacts over the years, the core h2cm links set never saw the light of an HTML page. The main target audience for the links pages remains as the health and social care community (although given h2cm's universal scope I'm jumping around on this (sadly) cold-tin-roof shouting: "Hey everyone - oveeerrrr here!").

If you look at the four links pages and the model's axes INDIVIDUAL-GROUP & HUMANISTIC-MECHANISTIC you might conclude that a re-organisation is needed. So as the other potential developments are still outstanding (Drupal, ...) maybe this deserves some explanation?

Why? Well, there is too much there and many visitors may be put off? I navigate these links spaces quite readily (which as author is not surprising I suppose), but being critical the pages do represent a management overhead, a distraction from other tasks. Seeking a positive side maybe this generic set of links have emerged out of a human attempt (most searches/links resources are of course now machine-based) to push the 'holistic frontiers' and our conception(s) of what it is to care?

You'll notice on several links pages that the first row of links acknowledges the intended audience. I do not want students to have to scroll for the health and social care related resources. So, these are placed near the 'top'.

Although a domain links page is presented as a single 4-column table, it is valuable to take the main headings and view the four care or knowledge domains links together. This is listed below, if the formatting holds! (Probably need a graphic for this...)

Over several posts we'll explore the links pages one by one. Already a few things stand out...

What's there. What isn't and whether there's a why: initial observations welcome....

P.S. Shame about the weather last w/e in NW England.

Psychology I II Mental Health Therapies Anat&Phys Care T&P Evidence BP Research
Philosophy ---- Ideas Communication Theology Health Inform. II Info Sources Diagrams
Health Promotion Study Skills Education DSS Visualiz. II MarkupLangs Ajax & XML
HCI Accessibility Creativity Graphics Environment Virtual Reality Science Astronomy
------------------Rest & Rec----------------- Maths, Logic Engineering Programming [Toolset]
7 Ages Health Prom Patients Practitioners Development Democracy Economics Policy
CSCW ------ Sociology I II Qual Research Activism Citizenry Employment Human Rights
Anthropology History Art & Culture I --- II Info. Gov Standards Open Source Comm. Inform.
--------------------------------------------------- News ------ Soft-Hardware --- Search -------- Org
--------------------------------------------------- ---------------------- Commercial ---------------

Sunday, August 12, 2007

Assen NL + Northern England CHE group Oct 13 Rivington Park Arts, Horwich

Sunday 0500 last week arrived home from Assen, Netherlands with Matt and Lawrence my son's friend having attended the Assen cycle Tour. It really was an international field and they really flew. Some unfortunately more than others.... The first race Matt came off!! - scaphoid # so we got to see the Dutch health service at work and very impressive too. Thanks to the staff at Wilhelmina Hospital - great job (I notice the TT circuit also keeps them busy). Closing my eyes while waiting for the Radiographer (like you do) Wilhelmina did not 'sound' like a hospital. Excellent attention to the 'hospital' environment - the colour, some nice curves, the signage was spot on too.

At the close of the holiday-cycle tour the sunset at Calais was beautiful.

Returning to the human ecology thread, I can confirm that the next Northern England CHE group event will be on Saturday 13th October 11-3pm at Rivington Park Arts. The group would like to thank David Ruaux for providing us with a room and facilities.

The theme for the meeting is well-being and I'll post more details nearer the time. Leave a comment or e-mail me h2cmng AT yahoo.co.uk and we will add you to the mail list.

Well I'm getting to know my ready-made case-load. It really does not feel like I've been away some 2.5 years. This is what Hodges' model was born for and it's great to get the therapeutic juices flowing again. I've not yet stabbed anyone (injections!), but that won't be long. Actually, I think a delay here is positive evidence that injections and medications are used much more carefully now; especially with older adults and they are reviewed regularly. A trend that has been in train for many years.

Speaking of trains - wonder if it will be clear tonight and in the early hours...?