Hodges' Model: Welcome to the QUAD: Fundamentals of Care - mapped to Hodges' model

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Monday, April 02, 2018

Fundamentals of Care - mapped to Hodges' model

I came across a paper on 'fundamental care':

Jackson, Debra & Kozlowska, Olga. (2018). Fundamental care - the quest for evidence. Journal of Clinical Nursing. 27. 10.1111/jocn.14382. 

The definition Prof. Jackson subsequently pointed to is as follows:
"Fundamental care involves actions on the part of the nurse that respect and focus on a person’s essential needs to ensure their physical and psychosocial wellbeing. These needs are met by developing a positive and trusting relationship with the person being cared for as well as their family/carers."
I've taken the fundamentals of care from the International Learning Collaborative and mapped them to Hodges' model. The psychosocial list has been divided across the two applicable domains - you'll see what I've done.

individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group

PSYCHOsocial fundamentals of care

  • Communication (verbal and non-verbal)
  • Privacy
  • Education and information
  • Emotional wellbeing
  • Choice
  • Having values and beliefs considered and respected

Physical fundamentals of care

  • Personal cleansing (including oral/mouth care) and dressing
  • Toileting needs
  • Eating and drinking
  • Rest and sleep
  • Mobility
  • Comfort (pain management, breathing easily, temperature control)
  • Safety (risk assessment & management, infection prevention, minimising complications)
  • Medication management

PsychoSOCIAL fundamentals of care

  • Being involved and informed
  • Dignity
  • Respect
  • Education and information
  • Having values and beliefs considered and respected
  • Social engagement, company and support
  • Feeling able to express opinions and needs without care being compromised
  • Having interests and priorities considered and accommodated (where possible)

Relational fundamentals of care

  • Active listening
  • Empathy
  • Engaging with patients
  • Compassion
  • Being present and with patients
  • Supporting and involving families and carers
  • Helping patients to cope
  • Working with patients to set, achieve and evaluate progression of goals
  • Helping patients to stay calm

As this domain seems to be 'empty', I  will add some thoughts in the POLITICAL domain... 

You can imagine a series of layers here. 
As per the physical fundamentals above include - safety and homeostasis would be uppermost. Difficulties in the above instantly raise alarm bells and the old chestnut construct of dependency. 

The lack of specifics on mental health suggests something that is incomplete and appears to assume a certain degree of functioning?

The psychosocial actions invariably overlap and with the relational. We are hopefully socialised into dignity, respect, compassion, empathy and related attributes. What impacts  on a person's privacy, dignity may vary from person to person to some extent. This however introduces the humanistic care of engaging with people, their carers and the need to be person-centred. On privacy ... and preserving the integrity of an individual (and their 'group'), there are of course (duty of care and) professional standards (in this domain) that help guide our advocacy and accountability.

Clearly, there is much to do..


Previous posts on 'fundamental-ism'