Editorial: Exploring the relationship of threshold concepts and Hodges’ model of care from the individual to populations and global health

At the end of July I was contacted by the editor of the journal Revista CUIDARTE published by Programa de Enfermería de la Universidad de Santander UDES and invited to write an editorial. There were publication guidelines and a deadline: two weeks. Despite my astronautic aspirations my feet remained on the ground as I realised that I am surely filling a gap.

There were other family pressures at the time, but I already had the draft paper on Hodges' model and threshold concepts. After some thought and work the draft was reduced from 5600 words and 56 references to 3600 and 20 references. The example of Deprivation of Liberty was removed to include more generic subject matter in the themes of global health and development.

Whatever the reason (and editors please note...) I greatly appreciate this opportunity to further disseminate Hodges' model and threshold concepts. Greater still is the privilege to contribute to a community who provided me with one of the highlights of my nursing career in 2011.

Here is a video introduction (English):

Exploring the relationship of threshold concepts and Hodges’ model: https://t.co/BRMJRjguwK a través de @YouTube

— Revista CUIDARTE (@RevCuidarteUDES) August 31, 2017

Jones, P. (2017) Exploring the relationship of threshold concepts and Hodges’ model of care from the individual to populations and global health. Revista Cuidarte. 8(3): 1697-720.

h2cm presentation: Colombia Nursing Theory conference (slides from Feb)

As the slides from Milton Keynes and DTMD 2011 are posted, here below are the slides from February. There are some 'artifacts' in there - the question marks were included then replaced by the text as part of the animations (as with the stick figures). The Colombia slides provided the template for the ten minute talk last Thursday. It was a very useful experience, exercising discipline to cram sufficient explanation in to cover the slides in the brief time available. No time for animations. The Chairs for the sessions did a great job, providing a 3 minute warning.

Colombia remains a real highlight: three of the slides are in Spanish thanks to Luz Stella Saray and Prof. Wilson Canon Montanez for their translation skills. (Any mistakes are mine in data transfer / formatting). 

Hodges model Colombia 2011 with spanish from Peter Jones

The next event to prepare for is Dublin in November: a poster. This will really be different and I need to see what production / printing resources I can access, taking portability into account.

Hodges' model and three slides in Spanish: Paipa, Colombia Feb 24-25 2011

From the presentation of the Health Care Domains Model in Paipa last month here are three of the slides in Spanish - with many thanks to Luz Stella Saray and Prof. Wilson Canon Montanez for the translation. (Any mistakes below are mine in data transfer / formatting).

These slides were produced to illustrate how the model's care domains relate to some indicative health concepts, supporting the overall presentation.

The presentation was uploaded to Slideshare but I have deleted it as the formatting was slightly disrupted. I will revise and upload it again soon posting it here and no doubt in another post.

INTERPERSONAL creencias     estado de ánimo empatía     motivación       personalidad              estrés dolor                          buenas relaciones	CIENCIAS informática  nutrición temperatura      diagnóstico    neuropsiquiatría                          tecnología
SOCIOLOGÍA comunidad        relaciones crianza de los hijos semántica       cultura, arte, danza            costumbres     Familia,     lenguajes historia socia	POLITICA derechos humanos     autonomía presentación de informes Financiación $£€ Instituciones OMS    UNESCO  NACIONES UNIDAS:  OBJETIVOS DEL MILENIUM

PURPOSE PROPÓSITOS priority, care plan, choice [prioridad, plan de cuidados, selección]	PROCESS PROCESOS events, time, cause – effect [eventos, tiempo, causa - efecto
PRACTICE PRÁCTICA Counselling, team work, carers [asesoramiento, trabajo en equipo, cuidadores]	POLICY POLÍTICA professionalism, deprivation of liberty [profesionalismo, privación de la libertad]

PROPÓSITOS estado de ánimo Los pensamientos, las creencias proceso cognitivo salud mental, estrés, ansiedad comunicación educación, aprendizaje	PROCESOS Modelos y Teorías Inyecciones intravenosas e intramusculares, salud física anatomía, fisiología mediciones, distancia tiempo, peso Estadísticas, lógica Farmacología, medicinas objetivo
subjetivo Culturas Compromiso público Comunidades de PRÁCTICA funciones Idiomas redes sociales amistades privacidad	POLÍTICA quejas Cert Internacional de vacunación Administración y gestión Liderazgo, poder, registros Legislacion en salud mental, pobreza Organizaciones Normas - CIE 10 interoperabilidad consenso

Colombia: Two Nursing Journals AQUICHAN & CUIDARTE

Two nursing journals were brought to my attention in Colombia with two possible avenues to engage.

There is scope for English speakers with abstracts provided in English and for me the editorial of Aquichan is quite pertinent to h2cm - Visibility of Nursing Knowledge.

I can not locate a cover image for Cuidarte hence the photo of some flowers.

CUIDARTE

REVISTA DE INVESTIGACION - PROGRAMA DE ENFERMERIA

Universidad de Santander - UDeS

revistaenfermeria at udes.edu.co

Bucaramanga, Colombia

AQUICHAN
mariae.moreno at unisabana.edu.co

Universidad de La Sabana
Facultad de Enfermería y Rehabilitación
Campus Universitario del Puente del Común, Km. 7, 

Autopista Norte de Bogotá D.C.

Students at Paipa Nursing Theory Conference 24 - 25 Feb 2011

I will post a few more photos as I sort and (hope to) receive them.
Still pinching myself here - a great experience!

I've emailed a few nursing lists that I subscribe to as GICS - the three universities who organised this conference and are planning another - are keen to reach out to the academics and students of other nations.
If anyone would like more details / contacts please get in touch with me: h2cmng at yahoo.co.uk.

On the Friday it was quite sunny and being asked for photos I struggled myself in the sun it was really bright (lovely!):

Happy International Women's Day also - and great to see some guy's and at a nursing theory conference too! Best wishes to all!

Notes (ii) from Paipa Conference: Q & A

Q. What is the appeal and relevance of Michel Serres to the Health Care Domains Model [h2cm]?
c/o Fred Manrique / UPTC 

(As per the paper - Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons. 2008)

A. I cannot remember how I came across this French philosopher (Bruno Latour?), but in 2004 I started to read some of his translated texts. Serres' work is not easy to read, but rewards perseverance. Thus enthused I wrote (in my spare time) and eventually submitted a paper to a prestigious nursing journal. This was rejected - twice. Using the feedback I was able to produce the paper that found publication in the informatics field. This is listed in the W2tQ bibliography. Serres' ideas were remarkable in how they spoke to me and reflected in many ways the conceptual framework of h2cm. I need to read more of Michel Serres' work. Ideas of particular appeal include his use of several tropes:

• Harlequin: the uninvited guest (disease, illness?), mischief (health taken-for-grantedness), chaos (the unpredictable);
• blanc: in my presentation I included a blank slide. There it represents every new person, new page - no judgements, positive regard. A page for lifelong learners and being able to self-reflect.
• Hermes: the Greek God, the messenger - information and Serres' early study of information science. The 'underworld' - nursing and medicine - are not for everyone. The importance of ports as a means of information and cultural exchange - today economies see themselves as information ports and the rise of information portals.
• Serres states (as do other commentators) that the Internet will provide opportunities for new scholars, outside of established academic institutions.
• borders, boundaries - the middle: in life we often have to ask do we continue and cross the middle?
• The Planet: Serres is concerned for how we treat the planet. The health care domains can also be utilised to explore the physical and psychological impacts of climate change and the need to attend to human ecology. We are rocking the boat - Earth is our boat.
• ... plus many others - fluid, dynamics, life - rivers - choices, narratives, Home, Angels, statues.

Finally, within "... S E R R E S ..." you will also find H2CM!  

Please see the bibliography for the paper.

Additional links:

Michel Serres on this blog.

http://michelserres.blogspot.com/

More Q and A to follow plus photos and slides. Photo source (PJ, Copenhagen shop window, 2010).

Notes (i) from Paipa Conference: Q & A and sessions

Questions from the delegates (once more interpreted by Andrea Ramirez) at the plenary session on Friday 25th February included  - with my response (extended here):

Q. Could you please give some specific examples of the model's application and its achievements?

A. The model was created by Brian Hodges to facilitate reflective practice and encourage holistic care - especially balancing physical and mental health - psychological - care. In the mid-1980s the model was used in several locations in England and the Isle of Man. The model was taught and learning assessed through case studies in community mental health nursing, learning disability and health visiting.

As highlighted in the presentation unlike other models of care h2cm has not had the benefit of specific research. The models of care we use must be evidenced based. The website and blog represent a call for research in the health care domains model. This is why I appreciate so much this invitation to Colombia and being able to present what I believe is a very useful and increasingly relevant care resource.

In terms of achievement there are an as yet limited number of papers published and listed on the blog in a bibliography.

A couple of individuals have contacted me for advice on using the model in academic work, which has also been posted on the blog.

In my presentation and the plenary I did not mention the planned workshop in the afternoon!

Q. What has been the experience of applying the model in the practice (clinical area) and in the community?

A. The model is used in two centers for forensic psychiatry (low and medium secure) where the inclusion of the interpersonal and political care domains are pivotal in the tensions between the custodial context and need for person-centred nursing care that arise.

In forensic nursing the model informs care philosophy and is also represented in care documentation. A paper is in production describing the model and this application.

The model is I understand being used in a research project investigating bullying within midwifery. I will post more details on this when I have them. The researchers approached me seeking permission to use the model, I indicated the model's origin - as in "It is not 'mine'", and furnished a letter indicating the model's status. I understand the appeal of the model in this instance may be in scoping the research project.

Currently the model is helping me in my role (as a Nursing Home Liaison Specialist) to plan and deliver education sessions to residential care staff on communicating with people who are coping with dementia.

Being simple in structure and basic content once learned the model is accessible as an aide memoire, while you are assessing, planning and evaluating.

I have also used the model when working on informatics projects, as the model can help integrate the SOCIAL and TECHNICAL aspects of ICT.

More Q and A to follow plus photos.

Presentation(s) at 1st Int. Congress of Nursing Models and Theories in Colombia

I will revise this post over the coming week and add more, including one of the Spanish slides.

Many thanks to Danny Eduardo Rodriguez for meeting me at the airport (and to everyone who waited  with Eduardo). Hearing my name and seeing the university transport proved instantly reassuring. Thanks also Eduardo for the in-session translation - a great help and for your efforts to ensure I felt at home and a part of things: I certainly did. ... 

Well I am due to leave Paipa soon for Bogota El Dorado airport and the trip home via Paris. It is a beautiful day in Paipa. Very warm, bright sun, from my room I can see people water skiing on the lake.


Yesterday's presentation, workshop and Q and A session were very well received through a lecture and workshop. These would not have been as successful with the brilliant work* of Interpreter Andrea Ramirez on both occasions.
I had started to add some Spanish translations to my slides and these were checked and extended by Luz Stella Saray and Prof. Wilson Canon Montanez, (UDeS) to whom I extend sincere thanks (a good photographer too!).


In the morning session Andrea related each slide in Spanish after my account. For the workshop I had emailed the case study in English with a Spanish version c/o Google translate. This had been checked and improved and the format we followed was for students to read the case study and then individually draw out the aspects of Alice's case (fictitious yet based on 20+ years of experience) which they feel significant across the care domains. During this exercise for 20-25 minutes Andrea assisted again with some questions from individual students. Then in groups of 4-5 they collectively reflected on their 'results'. Finally each group in turn offered one item for each of the four domains. Astute questions from the floor and discussions followed. Not having done this before, with the addition of translation I was surprised at how well it worked: instant teamwork!

At 5.30 Luz had arranged to meet to discuss nursing in England. A little jet-lagged, I thought she meant with 2-3 colleagues, but in the end the room was filled as we were joined by 60-70 students in a circle. I can't believe that 90 minutes passed. The students and faculty are so very enthusiastic, charming, friendly and knowledgeable. Two days is not long to learn and make judgements, but from the student's questions they seem acutely aware of the specific health challenges and issues they face in Colombia. Their professor's approach in pursuing this meeting reflected an awareness of 'nursing as it is learned and practiced elsewhere'. I advised I was not able to speak generally, outlining my specific role and location. I let them know I was drawing from matters I do know (as highlighted on W2tQ) and personal experience. The notion of 'basic nursing care' is clearly and unsurprisingly universal given this encounter.

You do need to consider such travel very carefully: your health, security, travelling alone... The organisers took care of this assuring a personal meeting at the airport, transport and accommodation. The journey was hard for me from the UK. A short hop Manchester to Paris 1.15-30 was followed by an 11 hr and 10 hr flight back home passing through Bogota. Travel is difficult due to the condition of the roads, driving laws and the traffic situation that the populous of Bogota faces; but where there are 'gaps' (pot holes!) there is a way through.

I never would have believed I would set foot in South America. To stand under Orion and see Canopus was another dream come true. As Space Shuttle Discovery set off on her last flight I was making discoveries of my own in helping others do the same.

I am very grateful to GICS - the three Universities UPTC, UdeS and Unillanos who invited me and supported my attendance; plus my employer Lancashire Care NHS Foundation Trust and colleagues covering duty for new referrals at the Beechurst Unit, Chorley, Lancashire. This has been a marvellous experience, with many contacts made that I hope will grow in the future.

*Presenting in Spanish at the conference (Teoría “Marco de la Organización Sistémica” con enfoque en Familia), Dr Marie Luise Friedemann - RN, PHD and her husband informed me of Andrea's effectiveness and memory feat. Dr Friedemann, Profesora de la Universidad Internacional de la Florida, in Miami and I also hope to compare our respective interests.

1st Int. Congress of Nursing Models and Theories: Colombia 24th-25th Feb. 2011

I am delighted to report the news that the

Health Care Domains Model

will feature at this International conference.

In November I received an invitation to be one of the main speakers from the Grupo Gics Investigacion Team; and so next month I will be heading south to Paipa, Boyacá, Colombia.

This prospect would not be possible without the support of the conference organisers - GICS and Prof. Wilson Canon Montanez, Nursing Faculty of the University of Santander UDES (Bucaramanga-Colombia) and my employer Lancashire Care NHS Foundation Trust.

Recently a group of Nursing Faculties of three major Universities in Colombia (Universidad de Santander UDES, Universidad Pedagogica y Tecnologica de Colombia UPTC y Universidad de los Llanos UNILLANOS) have come together to organize the First International Congress of Nursing Models and Theories.

This congress will be held in the city of Paipa-Colombia 24 and 25 of February, 2011:
http://www.uptc.edu.co/eventos/cong_enfermeria/index.html

I very much look forward to this trip for several reasons:

• New people to meet and things to learn.
• This invitation literally puts h2cm on the map (so I must deliver)!
• It is marvellous to see faculty and nurses in Colombia re-invigorating thought about models of nursing.
• I have never travelled this far south - how will Orion look?

This will be a great adventure, but before then - where's my checklist: presentation(s), jab, tabs, passport...

2010-2011 posts, papers, studies and Drupal

Happy New Year everyone!

2010 saw 211 posts, 183 in 2009. As ever a mix of original material concerning h2cm, conferences and call for papers. Fingers x'd 2011 should run to approx 150 posts as I focus on work, studies and Drupal. The good thing for me is that all three of these can run along together and I intend to forge a union if at all possible.

At work my full-time role is clinical - nursing; Nursing Home Liaison. Increasingly we are finding what nurses on the ground have recognized for a long time. With this job comes an educational role, despite efforts to upscale the skills and knowledge of the residential care / nursing home sectors. H2cm is a gift in these quarters, in prompting and facilitating reflection, holistic and person-centred care.

Studies: On this front I'm trying to identify a research question from a bewildering mix of possibilities. Previously I've referred to the relevance and my interest in conceptual spaces:

Hodges' model: Background - Foreground and the Space Between

The socio-tech and conceptual space papers

Next paper? Conceptual Spaces and Hodges' model

Nursing theory - conceptual spaces: Where's my T-shirt?

Gardenfors' book - a quote and can that be, surely not ...h2cm?

That other 2nd-hand book - 'Conceptual Spaces'

This is definitely a worthwhile focus. I'm making enquiries to try to find a mentor. Strange, or maybe not actually, that I am a nurse mentor and sign-off mentor too and here I am coughing and spluttering in need of a mentor myself to help sort the wheat from the chaff. The 10K words on conceptual spaces is now 13K.

The co-authored h2cm and forensic nursing paper is completed with two revisions, but still needs a home.

I missed an opportunity with the h2cm and substance misuse paper. Trying to complete it in the summer of 2009 before my eye surgery I did not stick to the brief. I'm hoping a co-author can take the 5K words and help re-frame the content from a practice and service perspective. It really is refreshing to work with other people. I look forward to providing an update here later in the Winter - Spring.

As to Drupal - I've hit the wall that has "styling" written all over it. It seems if you start with a basic theme like Zen you are rewarded with an easy to negotiate palette, that is - you do it yourself. With more complete themes you need to read and orientate yourself with somebody else's handiwork. This is the next job and then move to Drupal 7 - released on the 5th.

In October I received an invitation to present at an international nursing conference in Colombia. I've submitted a presentation and have offered to do a workshop too. This was accepted. It all depends on travel and confirmation of arrangements so we will have to see.

More to follow on all the above and wherever you are

may I wish you a very happy, healthy, 

peaceful and prosperous 2011!

To follow: Line of sight, lines of insight ...