- 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, February 21, 2016

Domain-specific vignette development in polyarthitis: Arends, et al. (2015)

This paper by Arends et al. (2015) sheds further light on the use of vignettes and the difficulties (for me) in categorising care phenomena. There is a great deal of overlap in the three domains that the authors apply to patients with arthritis. Their domain-specific focus is also of interest.

Independent functioning extends across the interpersonal and sciences domains of Hodges' model as mental functioning and physical. Sports, holidays, hobbies and other activities while usually social in nature can be solitary pursuits. In this example even if the context is social as per the domain, it is the impact upon the individual that the researcher's note:

"Changes in life domains caused by a chronic disease can have psychological and social consequences for patients and can affect their identity"... (p.1896)
In the quote below, copied across the domains of Hodges' model, volunteering is political in nature, but the reward in this instance - voluntary work in a nursing home - could be intrapersonal, derived from the interaction with and making a difference to the residents, staff and visitors.

So, it is vital to capture - or freeze the context in some way, vignettes it appears are one way to achieve this.

"The 11 vignettes all have a main character that is diagnosed with RA. In each situation, the impact of the disease on daily life is described as the main character always encounters a limitation or difficulty. The stories are set in three different domains:
the social domain,
the leisure activities domain,
and the independent functioning domain...
humanistic ---------------------------------------  mechanistic

In the independent ...

psyche        identity 

functioning domain, the topics are gardening, household tasks, and running errands.

Topics of the vignettes in the social domain are activities with partner, children, family, and friends. In the leisure activities domain, the topics are sports, holidays, hobby,

and volunteering." (p.1900)

Arends, R., Bode, Y., Taal, C., & Laar, E. (2015). Exploring preferences for domain-specific goal management in patients with polyarthritis: What to do when an important goal becomes threatened? Rheumatology International, 35(11), 1895-1907. DOI: 10.1007/s00296-015-3336-8