Arriving at Hodges' model via guided discovery ...

Following Brian Hodges’ lead in his notes, I have engaged a great many learners with a guided discussion through the following questions:

Questions	Answers	Outcome/Significance
Who do we care for?	The person, individual, patient, client, carer.The group, family, community, national/global population. The 'duty of care'. The Planet.	It is the individual (guardian) who consents to care. The subject at the top of the vertical axis of Hodges’ model is first identified. It is the person who consents to care (or their guardian); then the group occupies the bottom of the vertical axis.
What do we do to help deliver care?	We attempt - complete tasks and interact in ways that are both mechanistic and humanistic. We use procedures, equipment, devices, technologies, physical interventions; and the self – empathy, rapport listening, being present. Team work with effective communication, coordination and collaboration are also essential.	To care is to act. The horizontal axis is added, with humanistic to the reader’s left; and mechanistic to the right. The axes are then complete, revealing the model’s ‘fixed’ structure. Interdisciplinary can be identified and further discussed.
What skills and knowledge do we need to care for the individual, family and populations?	Here we are concerned with the content of the given situation. This can encompass the whole curriculum and acknowledges experiential learning.	The epistemological and ontological scope and scale of health is revealed from self to planet. The importance of context and situation can be stressed. Including first-aid and its rules and risk assessment. Discussion visits and demonstrates the significance of each of the domains of Hodges’ model and the spiritual to participants. The relevance of Hodges' model to the 21st century, as a bio-psycho-socio-POLITICAL model is emphasised.

Previously: 'Hodges' model'.

Nurses - Ask 5 complimentary questions

I received an email from RCNi subject heading - 'Q. What questions are nurses asking?'

An invitation to sign-up and ask five free questions: https://rcni.com/ask 

Question 1

Is there a model of care, or nursing that encompasses the sciences, mental health, sociology and political domains of care?

Several models of care and nursing frameworks integrate diverse domains beyond purely biological aspects, encompassing scientific, mental health, sociological, and even political dimensions. These models emphasise a holistic approach to patient well-being, recognising the complex interplay of various factors in health outcomes.

• Social Model of Health: This model focuses on salutogenesis, examining what contributes to health rather than just illness, by considering broad social, economic, environmental, and cultural influences on an individual's well-being .
• Person-Centred Nursing Framework: This framework extends beyond individual biological health to include the person's intricate cultural context, family, spirituality, and life experiences, defining health as encompassing intellectual, social, and spiritual dimensions .
• Biopsychosocial Model of Care: This approach integrates biological, psychological, and social factors to address a patient's holistic needs, moving beyond the biomedical model's sole focus on physical illness .
• Dual Registration Degrees: Educational programmes for nurses and social workers combine life sciences with social work principles, law, and policy, preparing professionals to understand factors influencing health, social justice, structural inequalities, and anti-discriminatory practises .
• Multidisciplinary Team (MDT) Care Model: While not a nursing model itself, the MDT approach enhances patient care by integrating expertise from various professionals, including specialist doctors, nurses, psychology counsellors, dietitians, and pharmacists, to deliver individualised treatment plans and coordinate care .

Modern healthcare increasingly recognises the necessity of comprehensive care models that extend beyond traditional medical approaches. These integrated frameworks, including the social model of health, person-centred nursing, and the biopsychosocial model, provide a foundation for understanding and addressing the multifaceted nature of health, incorporating scientific, mental health, sociological, and policy-related aspects to improve patient outcomes. [Five references provided - hence poor formatting in transfer.]

Question 2

What model of care has the conceptual scope to critique parity of esteem in mental health nursing?

Critiquing the concept of parity of esteem in mental health nursing requires models that move beyond a purely biomedical focus to embrace holistic, person-centred, and culturally sensitive approaches. These models emphasise equality, social justice, and comprehensive care, addressing the historical imbalance between physical and mental health provision.

• Biopsychosocial Model: This model offers a conceptual framework to critique parity of esteem by considering biological, psychological, and social factors in a patient's health, aiming for holistic needs rather than just biological ones . It contrasts with the biomedical model, which has historically led to paternalistic decision-making in healthcare .
• Culturally Sensitive and Competent Care: Essential for critiquing parity of esteem, culturally sensitive care requires nurses to appreciate diverse cultures and adopt personalised, flexible approaches to mental health support . Culturally competent care, underpinned by equality and diversity principles, involves behaviours and attitudes that value patients' diverse backgrounds, improving satisfaction and outcomes .
• Person Centred Care: This approach is crucial for addressing the historical paternalism in healthcare, ensuring patients participate in decisions about their care and re viewed as individuals with unique experiences rather than just labels or symptoms . Recent mental health reforms, such as the Mental Health Bill 2025, aim to embed person-centred and equitable care further .
• Holistic Care: The Nursing and Midwifery Council (2024) emphasises assessing spiritual needs to provide effective holistic care, recognising that "seeing the whole person supports better care" . This aligns with the biopsychosocial model's aim to meet holistic needs and challenges the organisational and practice divisions between mental and physical healthcare .

Effective critique of parity of esteem in mental health nursing necessitates a shift towards models that integrate biopsychosocial, culturally sensitive, and person-centred approaches. These frameworks are vital for fostering equality, social justice, and comprehensive care, moving beyond traditional biomedical limitations to address the full spectrum of patient needs. [Eight references.]

I'll leave it there. I think. PJ

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My emphasis: In the spring I tried to engage and see if I could write a short article about Hodges' model for RCNi. After an online chat and following up by email, Hodges' model isn't for them apparently. It was kindly suggested that I try another journal.

I must improve my prompt writing.

I must improve my prompt writing.

I must improve my prompt writing.

I must improve my prompt writing.

Nurse, you must improve your prompt writing ...

IP? No! Not 'intellectual property' the other one . . .

'Interested Persons'

- also vested in data, information, knowledge, 

who knew how, what, why, when, where ...

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

identity - witness - involvement recall - memory Knowledge - Answers	The (sudden) power of situation, circumstances,  time and place. Events
Society Team - Teamwork Social Justice	Interested Persons Coroner's Court

My source:

Marriage, M. In Search Of Lost Time, FT Magazine. FT Weekend, 22 February 2025, pp.21-27.

https://www.ft.com/content/f94a71ee-0c42-4839-9521-e7866975fa72

Hodges' model: What is the Question? (ii)

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

What is the basis for meta-cognitive and meta-conceptual claims for Hodges' model? Does Hodges' model have a role in secondary education and if so, what is it? If Hodges' model facilitates reflection and is reflexive how is this achieved and demonstrated? Is Hodges' model a meta-semantic framework and if so, is this what provides genericity? What is the foundation of the axes in Hodges' model and what characteristics can be described?

Is Hodges' model safe? "Cold, Warm, Hot, Hotter!" nearer to 'navel gazing' than 'reflective practice'? Are 'concepts' sufficient to explain the structure of Hodges' model, and account for its claimed role(s) in assessment, planning, evaluation and assurance? Is Hodges' model a constant: as the contemporary model? Are 'individual', 'group', 'humanistic', and 'mechanistic' sufficient as conceptual anchors; and if so are they sufficient to give rise to the two continua that then invoke four knowledge (care) domains?

Can Hodges' model simultaneously preserve, protect and assure 'patiency' whilst also facilitating self-care? What forms of literacy are encountered by users of Hodges' model and are they accessible to the public, patients and carers? Hodges' model: Show me the praxis. What does Hodges' model say about holism (and consequently reductivism) and why should anyone listen?

Is there such a thing as a generic 'model of care' in a multidisciplinary world? Is there a 'logic' to the seemingly diametric opposition of 'power' as exercised here and the two individual domains in Hodges' model? If claims for Hodges' model of universality, genericity and global scope are 'true' is this also a risk for healthcare professions and specialisation, as it supports the 'universal worker' and automated processes?

 

Hodges' model: What is the Question? (i)

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

Can Hodges' model assist student nurses in assessment and  evaluation of their well-being through their course of study? What sort of 'spaces' do we find in Hodges' model and do they matter or meta?	What is Hodges' model? Is there a theory implicit in Hodges' model? What theories might underpin this 'model'? The Demarcation problem: Hodges' model - is this science or non-science?
Does Hodges' model display consistency when used within a specific cohort of students and across disciplinary student groups? What is a 'span' and 'career' in the 21st century, and why do they matter to the individual and group?	Created in the 1980s is there a political need for Hodges' model in the 2020s? What are 'legacy' problems in healthcare and nursing, and how can Hodges' model characterise them?

 

Prompted by post-graduate study and avoiding reference to methods and/or methodology, plus:

How come so many researchers can't clearly specify the questions they are trying to answer? How come so many people are happy to bandy methods and sample sizes around in research bids without ACTUALLY STATING THE QUESTIONS THEY ARE TRYING TO ANSWER? Drives me absolutely 🥜🥜🥜🥜

— Nicky Cullum 🇪🇺 (@nicolacullum) December 15, 2020

 

Over many years, many questions have arisen.

Resnik, David B. A pragmatic approach to the demarcation problem. Stud. Hist. Phil. Sci., 2000, 31: 2, 249-267.