After 41 years of listening - now it's your turn [ please ]...

If you are a researcher, author, lecturer or editor ... (you get the gist already...) and the project that currently has your undivided attention (well, almost) is a draft paper or literature review on any of the following:

metamodels of care / nursing / healthcare / global health
metacognition of care / nursing / healthcare / global health

holistic care / nursing
integrated care / nursing

models of care

models of nursing
theories of nursing

models of healthcare

conceptual frameworks in health, social care or education
(across - theory, practice, commissioning, funding)
history, current state, future of the above..

(I could add more)

- then please consider this request.

If there is no reference in the work to Hodges' model, as in:

The Health Career Model

Hodges' Health Career Model

Hodges' Health Career - Care Domains - Model

The Health Career - Life Chances - Model

- then I would humbly suggest to you that the work in front of you is incomplete.

Yes. I am variously disappointed, dispirited, desperate* since the terms of a well thought out, comprehensive search strategy should surely pick up a breadcrumb leading to Hodges' model? Fellow mentors and supervisors I need some help.

But, help with which one you may well ask?

Well, here's some background to account for the seeming lack of version control:

The Health Career Model

 &
Hodges' Health Career Model

These were the original titles for the model. The 'health career' has always referred to the idea and phenomena of 'life chances' (see bibliography in sidebar for Hughes).

Hodges' Health Career - Care Domains - Model

The original website from 1998 appeared to cause some confusion with visitors taking career to relate to work and professional opportunities. The 'care domains' addition sought to distract from that, to emphasize the care knowledge quality of the model.

The Health Career - Life Chances - Model

I have always tried to include Hodges' in the titles I have employed. More recently, it appears that using a name appears to accentuate the perception for others that the model was "Not invented here". Plus, there may be copyright and other proprietary provisions.

The reference to Hughes and life chances goes back to 1958, but seems even more relevant now given the importance of epigenetics, technology, sustainability, ecology, universal health care, access to information and healthcare knowledge and global health.

So, even if not germane to the main arguments of the paper or work at hand I would hope that the model might at least be referenced, as per:

Maffissoni, André & Vendruscolo, Carine & De Lima Trindade, Letícia & Zocche, Denise. (2018). Redes de atenção à saúde na formação em enfermagem: interpretações a partir da atenção primária à saúde. Revista Cuidarte. 9. 1-13. https://revistacuidarte.udes.edu.co/index.php/cuidarte/article/view/549

Many thanks!

'Nursing the Nation' poem Molly Case at RCN Congress 2013

The past fortnight has been quite intense in terms of conferences and the focus upon nursing education; plus as was pointed out to me I travelled from Jordan to Jordanstown. The conference in Jordan began with a beautiful prayer and I heard of this poem while away:

Your help needed to develop an instrument to measure ‘e-health literacy’

Researchers from the University of Copenhagen, Denmark and Deakin University, Australia are developing an instrument to measure ‘e-health literacy’ in current and future users of healthcare.

To develop this instrument they are undertaking a comprehensive consultation with a wide range of stakeholders. This includes the perspective of users of the healthcare system, as well as the perspective of ‘experts’, i.e. researchers, healthcare professionals, managers and policymakers.

They are looking for help with this task to ensure that the research is comprehensive, asking for your views and observations on what a person needs to be able to do in order to use digital health services (e-health). To do this there is an online survey, which takes about 3 to 5 minutes to complete.

Please complete the survey no later than Wednesday, 1 August 2012. The researchers will collate statements from all respondents over the next month or so. In a second e-mail, they will ask you to group and rank individual statements in terms of importance.

The output will be a comprehensive map of the key elements of e-health literacy. This information will be integrated with data generated from workshops with both health care users and professionals. The final goal is the production of an internationally relevant tool to measure e-health literacy.

If you wish to receive a copy of the results of this research, please indicate this on the last page of the survey.

...

My source: Patient Information Forum via twitter

Health literacy conference: measures & references - conceptualising and conceptual frameworks

Keynote 2 was delivered by Prof. Richard Osborne - What is the purpose of measuring health literacy: changing people, places or policy?

Overall the conference helped me by explaining some of the main tools including this presentation:

• REALM - Rapid Estimate of Adult Literacy in Medicine
• TOFHLA - Test of Functional Health Literacy in Adults
• Newest Vital Sign

Prof. Osborne mentioned the following resources:

DeWalt, D.A., et al. (2004) Literacy and Health Outcomes: A Systematic Review of the Literature, Journal of General Internal Medicine. 19,12,1228–123.

Jordan, J.E., Osborne, R.H., Buchbinder, R. (2010) Critical appraisal of health literacy indices revealed variable underlying constructs, narrow content and psychometric weaknesse, Journal of Clinical Epidemiology. 64, 4, April 2011, 366-37. (I located this on Science Direct)

A quick look at Jordan et al. shows that the full size table outlining the measures is very informative.

Table 2 - Selected results of critical appraisal of indices that directly test patient abilities 

- includes the question:

Is the instrument based on an underlying conceptual framework?

I am also a little dizzy with the repeated mention of domains

- but seriously this is why I believe h2cm definitely has a role here.

Here's another reference (the last of 72 listed) I've just downloaded and look forward to reading:

Jordan, J.E., Buchbinder, R., Osborne, R.H. (2010) Conceptualising health literacy from the patient perspective, Patient Education and Counseling, 79, 36–42.

Presentations from the conference will be available in due course.

Health literacy conference - definitions & Hodges' model

Well yesterday was a very useful and enjoyable day both in learning about health literacy [HL] and trying to get the message out there about the potential of Hodges' model.

The keynotes a.m. and p.m. were all very informative the speakers leaders in this field - inc.

Prof. Don Nutbeam who talked about definitions of health literacy:

• functional literacy
• communicative and interactive literacy
• critical literacy

One of many take home points being that a person can have high health literacy, but low general literacy. The other and new literacies that I have illustrated on W2tQ and on my poster were mentioned. Prof. Nutbeam's description of health literacy in absolute and relative terms brought out the meerkat in me (well, ok I sat up - I didn't stand on my chair and look all around). As is often the case it's something we kind of know, but without the eloquence that specialism, expert thought and structure brings.

The absolute form of health literacy is applicable in clinical care - conceptualised as RISK;
while the relative form of health literacy has greater application in public health as an ASSET.

Clearly, Hodges' model can be related to Prof. Nutbeam's work both in theory and practice especially with the communicative / interactive and critical forms. Perhaps the health care domains model could also form part of an assessment to measure functional literacy; one that is hybridized across the literacies, e.g. SCIENCES care domain = drug dose / admin calculation or nutrition task?

From the outset the need to conceptualize health literacy was noted. This had me scribbling away - conceptual navigation - conceptual envisioning ....

My poster did erm... stand out next to the A0 - A1 and greater efforts. I'll investigate the possibility of future support if needed from a local university to produce something - A1 would be brilliant. At the end of the day in the panel discussion I was able to highlight Hodges' model and I am grateful to the people who approached me afterwards and look f/w to hearing from them.  In turn I will try to effect some connections on behalf of others - my local council and children's services.

The other sessions were brief at 15 mins, but nonetheless demonstrated the vibrancy and creative potential of health literacy. I'll post more on HL - other sessions, references, call for papers, news of other events, 2012 and the significance of HL to Hodges' model and my interest in informatics.

Before I close - the lack of anyone present with central policy gravitas was raised in questions and the previous support of DoH was stressed by a delegate in response. As I understand DoH also originally contributed to the funding of the HL initiative and steering group.

I wonder if some health literacy practitioners could make an impression on policy makers through the acknowledged need to get people back to work? If so, they could help carry the HL flag for the rest of the community; and should they need a design for that flag.... ;-)

Health literacy conference & Hodges' model

The poster is completed for the health literacy conference today in Manchester. As befits such a broad conceptual framework my effort is general in scope and seeks to highlight (my interpretation of) health literacy themes mapped to Hodges' model. At only A2 in size - that's four A4 pages there will be grander and better produced posters; but it is great to be able to attend, contribute and network.

I've also looked at the programme again and there are some intriguing talks to follow and researchers to meet. In preparing the poster I came across the following paper:

Murray and Johnson et al. The association between cognitive ability across the lifespan and health literacy in old age: The Lothian Birth Cohort 1936, Intelligence, 39,4, July-August 2011,178-187.

I've based one of the slides on a previous post and will add another on W2tQ soon. In writing this I noticed that on the tags front 'literacy' totals 25 (26 now!) and 'lifelong learning' = 27. Some synergy there then.

Previous literacy posts:
http://hodges-model.blogspot.com/search/label/literacy

Thank you for stopping by / reading too, there were 481 visitors recently.

Image source: http://www.cucocreative.co.uk/articles/iso-paper-sizes/

Grand Challenges for Global Health: 15th - access to clean, clear, knowledge

Dear HIFA2015 colleagues,

The news item below is forwarded from the Global Health Council, which reports the mHealth Summit taking place this week in Washington DC. It is especially good to see that Bill Gates is giving a keynote address. This suggests that the Gates Foundation may be poised to address the 15th Grand Challenge for Global Health, as proposed by international health leaders in The Lancet:

"The Gates Foundation identified fourteen challenges [Grand Challenges for Global Health] but a fifteenth challenge stares us plainly in the face: The 15th challenge is to ensure that everyone in the world can have access to clean, clear, knowledge - a basic human right, and a public health need as important as access to clean, clear, water, and much more easily achievable."

Tikki Pang (WHO), Muir Gray (NHS, UK), and Tim Evans (WHO): 'A 15th grand challenge for global public health.' The Lancet 2006; 367:284-286.
http://www.thelancet.com/journals/lancet/article/PIIS0140673606680501/fulltext

When HIFA was in planning back in 2006, the lead author of the above paper, Dr Tikki Pang (Director of Research policy and Cooperation at WHO) said: 'HIFA2015 is an ambitious goal but it can be achieved if all stakeholders work together'. Bill and Melinda Gates are critical stakeholders. I look forward to see Bill Gates' presentation. Will the Gates Foundation take up the 15th Challenge? Will the Gates Foundation prioritise the challenge of health information for all by 2015?

Bill Gates keynote yesterday is not yet available on the web, but it will be soon at: http://mhealthsummit.org/conference/live-webcast

I hope that Bill Gates will use this opportunity to articulate a clear and specific vision from the Gates Foundation: a vision of a world where people are no longer dying for lack of access to appropriate, reliable healthcare information. With their support, there is no doubt this vision can and will be realised.

With best wishes,
Neil

HIFA2015 profile: Neil Pakenham-Walsh is the coordinator of the HIFA2015 campaign and co-director of the Global Healthcare Information Network. He started his career as a hospital doctor in the UK, and has clinical experience in rural Ecuador and Peru.  For the last 20 years he has been committed to improving the availability of healthcare information for health workers in developing countries. He has worked with the World Health Organization, the Wellcome Trust, Medicine Digest and INASP (International Network for the Availability of Scientific Publications). www.hifa.org  neil.pakenham-walsh AT ghi-net.org

My source:  www.hifa2015.org

Care design: c/o DDC Copenhagen

On Monday afternoon I explored the city of Copenhagen walking to several sites - the Tivoli Gardens, the Tycho Brahe Planetarium and other parts of this lovely city. I ended up spending a couple of hours at the Danish Design Center.

Like my occasional visits to London's museums, the DDC although very small provided a couple of pearls. One display across a wall upstairs outlined the main forms of design theory and practice:

• The USER as designer
• TECHNOLOGY in the design process
• New MATERIALS and smart design
• NATURE
• SOCIAL design and CARE design
• GREEN design
• ART design
• EMOTIONAL design
• REPLACEMENT due to changing fashions (built in obsolescence!)
• SERVICE and CONCEPT design

The following text was displayed to describe SOCIAL design and CARE design:

The population pyramid has changed shape. The working-age group is shrinking compared to the group of people of retirement age. In addition, there is the large segment of the so-called weak - particularly in the 3rd world. Thus, social design and care design will be big and important design areas in the future, because the solutions will seek to strengthen the health care sector and improve conditions in the 3rd world and for underpriviledged people in general. Parameters such as increased dependency, quality of life and dignity are crucial elements in solutions relating to social design and care design. DDC display; August 23 2010.

Many themes come together here. Some are represented in the tags below. Care design is much more than what we might consider as 'standard design' aspects, such as; user interface [UI] and user experience [UX]. Care design is even more dependent upon user engagement.

There is another dependency that as yet has a '?' in the data entry box.

Care design needs coherent forms of personal, social and civic responsibility. These are yet to emerge as think tanks, governments and health experts seek (urgent) solutions.

In comparison to the above the 200 character limit on labels (tags) on Blogger presents a very small challenge. I can well imagine the outline of a book on 'care design': the result would be a big tome; but this would not just be (PJ inspired) hyperbole. Care design is not new, but the DDC text above must accentuate the individual, and not just care design at the public and private sector hospital level. Care design in an individual context is mission critical. Heady content - for books, websites and policies - as befits our times.

Thank you DDC, Copenhagen: wonderful indeed...

Cost savings: 4-fold literacy = care literacy

The RCN's campaign I posted yesterday highlights the belief in and potential of nurses to 'think out of the box'.

There are many people, in many walks of life who are currently racking their brains and flipcharts to come up with ideas for cutting costs. In addition to the RCN, the government has its on-line campaign with the 'Spending Challenge'.

As for nurses there is an extra rabbit to pull from the hat: improving patient care.

Media discussion about the cloned beef - food supply story this week brought a point regarding the relative scientific literacy of the general population of USA and UK. This prompted me to consider discipline based literacy, what usually passes for 'basic grounding in ...' or competency. ('Literacy' has already been corrupted, now for another kick.)

For nurses with their subject disciplines, which can be represented in the health career model - what current public sector health (and social) care requires (demands!) is care literacy.

It is the ability of nurses (and other professionals) to be aware of what happens in the two adjoining boxes, or that one remote enclosure that can simultaneously engender and deliver:

• new insights - creativity and innovation;
• holistic integrated care;
• care literacy;
• and - cost savings that can still improve patient care.

See also:
http://hodges-model.blogspot.com/search/label/literacy