International Nurses Day - Closing the gap: My Project for a Global Conceptual Framework for Nursing

As International Nurses Day is celebrated tomorrow on the 12th May the emphasis and work here at W2tQ lies with Hodges' model. The project is to publicise h2cm's international potential in providing an avenue to help unify nursing theory, practice and assure future research.

Fawcett wrote of the metaparadigm of nursing - namely the inclusion of the concepts of person; environment; health; and nursing.

These concepts are incorporated into Fawcett's criteria on model validation which are listed in bold-italic below.

I have also ventured some reflections on the current status of h2cm when compared against these criteria.

Assumptions underlying the conceptual model are made explicit.

It is not sufficient, but the structure of Hodges' model renders the assumptions within the model explicit. The structure identifies eight initial key concepts:

INDIVIDUAL, GROUP (population); HUMANISTIC, MECHANISTIC; SCIENCES, POLITICS, SOCIOLOGY, INTERPERSONAL

A complete description of all four concepts of nursing's metaparadigm are presented.

Reflection soon reveals that several environments are suggested:

PHYSICAL, ORGANISATION, COMMUNITY, HOME, RESIDENCES, DWELLINGS, COGNITIVE (conceptual), SYMBOLIC, ABSTRACT, VIRTUAL, FORUMS, COLLEGES

Propositions of the conceptual model completely link the four meta-paradigm concepts. 

This is feasible, reasoning from the foundation of the model's structure.

The internal structure of the conceptual model is logically congruent.

This does need to be demonstrated. Initial recognition of logical congruence might be found through the conjoining of disciplines, that is frequently taken for granted: PSYCHO-SOCIAL; SOCIO-TECHNICAL; SOCIO-ECONOMIC.

The conceptual model is socially congruent, socially significant, and socially useful.

I have claimed on numerous occasions that the model is agnostic, universal, accessible, and has educational potential. These and other qualities need to be critically examined.

Empirical evidence in support of the model has accumulated from many derived theories.

The two final criteria are the most challenging. Empirical evidence supporting Hodges' model is available, but again must be tested through research. If someone has time - could you please compare the frequency of a set of political concepts in the nursing literature since 1985?* The emergence of health literacy and self-efficacy, threshold concepts, conceptual spaces, the rise of the semantic web and developments in software can all potentially support h2cm. Producing a roll-call of some of the latest trends in contemporary education, research and culture is not good enough, specific studies are needed.

The total contribution of the conceptual model to nursing knowledge. 

There is a long, long way to go, but the contribution has begun ... every journey ...

Of course, it is almost 20 years since publication of Fawcett's criteria. Has the concept of congruence changed in that time? What is socially significant and useful now? What should the social and political weighting of evaluative criteria be in 2012...? There is a body of critique upon Fawcett's and other evaluative tools within nurse education.

Perhaps a new set of criteria could be defined using h2cm itself? For a model of nursing (health and social care) to be fit for purpose, acceptable and viable across the globe, there are new concepts to be represented. While that would certainly close a gap, it does not seem a rigorous or valid way to proceed. I will seek out other more recent criteria and present them here at some point.

Fawcett J. Analysis and Evaluation of Conceptual Models of Nursing, 3rd ed. Philadelphia, Pa: FA Davis; 1995.

*Many thanks - if someone should pick this up, which ever axes, concept or issue.