- 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

Sunday, January 20, 2008

The symbol '+'

Apart from a multitude of symbolic meanings the figure below also provides the structural foundation for Hodges' model and as symbols.com notes:
Cross from symbols.com

The cross with arms of equal length is an extremely old ideogram used in most cultures. It is also one of the basic gestalts in Western ideography (as opposed to the basic elements, which are derived entities). The cross is found in every part of the world, in prehistoric caves and engraved on rocks.
In my interview with Brian Hodges' over 10 years ago in May 1997, Brian provided an account for how he arrived at this structure (summarised below). As mentioned elsewhere on this blog, the website, symbols.com and other sources - the cross, or 2x2 matrix is a common device to explain and structure. The four elements, the four humours (or humors) yellow bile, black bile, phlegm and blood, the seasons; there are so many things that can be characterised in this way.

With '+' as a starting point for me to reflect on Hodges' model I see each line as an individual. This agent or subject could include patient (person) and health care worker; lecturer and student and many other examples.

The act of cros-sing, the intersection of the axes represents two human beings being in a situation.

Space and time brings people together:

and also forces us apart - physically and temporally.

Adding an arrow to one end of these axes creates the dynamic of communication.

The angular distance in the alignment of those arrows offers hope -
  • in our common humanity we are never in 180 degree opposition;
and yet acknowledges:
  • the isolation of the individual -
  • and the challenge.
The work that must done. Hence the primacy of communication skills and values; in order to bridge individual being, ti:me and space.

Perspective is helpful here as an extension:

While we may get close to another person, through relationships that entwine the lines - be they spun by professional obligations, friendship, family ties, or intimate sexual relationships - the two lines are always distinct: part of an elaborated knot.

Is it just the special ties that must forever seek to be one+

The best way to explain h2cm is to review the questions Brian Hodges originally posed.

To begin, who are the recipients of care? Well, first and foremost individuals of all ages, races and creed, but also groups of people, families, communities and populations. Then Hodges asked: what types of activities - tasks, duties, and treatments - do nurses carry out? They must always act professionally, but frequently according to strict rules and policies, their actions often dictated by specific treatments including drugs, investigations, and minor surgery. Nurses do many things by routine according to precise procedures, rather like the stereotypical matron with machine-like efficiency? If these actions are classed as mechanistic, they contrast with times when healthcare workers give of themselves to reassure, comfort, develop rapport and engage therapeutically.

This is opposite to mechanistic tasks and is described as humanistic; what the public usually think of as the caring nurse. In use this framework prompts the user to consider four major subject headings or care domains of knowledge. Namely, what knowledge is needed to care for individuals - groups and undertake humanistic - mechanistic activities? Through these questions Hodges’ derived the model axial structure.