Nursing models of care: "There is another"!

It seems Star Wars forums continue to debate the meaning of Yoda's response to Obi-Wan that "There is another". 

The lack of practice-based debate in nursing and health education about 'nursing theory' and 'models of care, confirms that these academia sagas did indeed take place in a galaxy far, far away.

There is, as ever, positive and negative news too. The bibliography in the sidebar keeps growing. I'm hoping for news of additions dropping into the inbox before the end of the year. Not just prospective papers I know about (yes, there is another prospect!), but other work. In a way the latter is even more special. As these sporadics reveal that there are research heroes out there, on their own path and journey of discovery. Finding Hodges' model, they have applied it to their respective field.

Yesterday, searching for 'Activities of Daily Living' (first published in 1980) while writing the DASH post, on BMJ Careers I came across:

'What models do nurses use to guide their care?'

Is that 'models' plural?

Perhaps the response to the question says something about:

• nurse academia;
• how our medical colleagues view nursing;
• and more importantly - their understanding of nursing, the nursing profession, ongoing aspirations and relevance to self , health and social care in the 21st century?

In January, frustrated at the effort that is getting published (a shared experience then) and lack of attention to theory I posted:

Are you planning a health* study in 2025?

The literature trail for Hodges' model is not voluminous, but it is there:

• as a model of care, conceptual framework;
• person-centredness;
• integrated and holistic care;
• holistic bandwidth
• SDGs
• life chances, health career, prevention, life-style and literacies
• socio-technical approach
• global health;
• reflection and reflective practice;
• critical thinking
• mind-mapping;
• concepts, conceptual spaces, threshold concepts

- with much more to do, even in the above.

Please, call this a gentle nudge. Thank you.

Image: http://www.quickmeme.com/

Paper - (finally!) "A generic model and conceptual framework to prime curiosity across health and social care ..."

 It has been over a decade but at last the second* paper has been published in Journal of Evaluation in Clinical Practice:

Jones, P. (2025), A Generic Model and Conceptual Framework to Prime Curiosity Across Health and Social Care Disciplines to Facilitate Lifelong Learning. Journal of Evaluation in Clinical Practice, 31: e70252. https://doi.org/10.1111/jep.70252

ABSTRACT 

Rationale: The Corona virus pandemic highlighted the importance in continuity of the physical and emotional labour across all care sectors. Synergy between healthcare in hospitals, and community services must be allied with social care; and be central to integrated and efficient policy and service delivery. Services were found wanting in the pandemic and in recurring winter crises. The politics of funding for care delivered in rest and nursing homes remains contested, awaiting long‐promised governmental action. The workforce is recognised as dedicated, skilled, compassionate and yet under‐valued and under‐paid; managers face ongoing recruitment challenges, with a national shortage of staff, and high turnover of personnel. A National Care Service is awaited in England and Wales. 

Aims and Objectives: This study explores the ongoing care crisis, using the educational lens of threshold concepts, projected, analysed and synthesised of a generic conceptual framework, known as Hodges' model. Readers will understand Hodges' model and threshold concepts being equipped to explain both. 

Methods: The study is descriptive and uses a conceptual mapping approach supported by discussion and literature. Additional resources and avenues for ongoing study are also provided. 

Conclusion: In conclusion, Hodges' model is a pragmatic, practice‐based tool, that can support and sustain curiosity for workforce learning and development. 

Acknowledgements I would like to thank Messrs Mark Bird and Matthew Graham and the journal's reviewers for comments on drafts of this study; and acknowledge the effort of Dr Michael T. Flanagan in creating the informative threshold concepts resource (referred to above). 

https://onlinelibrary.wiley.com/share/author/IRPNBR2KHJNYJK8XUAW6?target=10.1111/jep.70252

*This paper was originally the first of a two-part work. Feedback from reviewers suggested the papers be standalone. United now, in one journal.

Many thanks to the reviewers, editor, editorial and publications team at JECP.

This paper has been added to bibliography in the blog's sidebar.

Universal and Generic: Hodges' model and conceptual frameworks, or

What the papers say . . .

The purpose of many research papers is to produce a conceptual framework, perhaps as a step towards a greater goal and objective.

Whatever the context or purpose of the conceptual framework:

• Theoretical Framework
• Conceptual Model
• Empirical Framework
• Descriptive Framework
• Analytical Framework
• Conceptual Framework for Policy Analysis
• Logical Frameworks
• Conceptual Frameworks for Program Evaluation
• Conceptual Frameworks for Organizational Analysis
• Conceptual Frameworks for Strategic Planning*

Hodges' model can be applied. This past week I saw a way to illustrate the scope of Hodges' model, which I will revisit. As ever, this merely scratches an itch on #MentalHealthNursesDay.

With apologies to authors and publishers - original citations follow:

Divya Sussana Patil, Ajay Bailey, Sobin George, Martin Hyde & Lena Ashok (2023) Unpacking the role of (INSERT [focus1..x/protected characteristic]) among (INSERT [Population]) for accessing healthcare in (INSERT [City, Town, Village, 3-words; Country]). Global Public Health, 18:1, DOI: 10.1080/17441692.2023.2274438


Ahuvia, I.L., Mullarkey, M.C., Sung, J.Y., Fox, K.R. and Schleider, J.L. (2023), Evaluating a treatment selection approach for (INSERT [modality, delivery]) single-session interventions for (INSERT [Life-stage, Condition/Diagnosis]). J Child Psychol Psychiatr, 64: 1679-1688. https://doi.org/10.1111/jcpp.13822

Xu H, Bayless TM, Østbye T, Dupre ME. Care sequences leading to the diagnosis of (INSERT [Disease] and [related]): An analysis of (INSERT [format / owner]) records. Alzheimer's Dement. 2024; 1-10. https://doi.org/10.1002/alz.13669

Original citations:

Divya Sussana Patil, Ajay Bailey, Sobin George, Martin Hyde & Lena Ashok (2023) Unpacking the role of transport inequalities among older adults for accessing healthcare in Bengaluru, India, Global Public Health, 18:1, DOI: 10.1080/17441692.2023.2274438

My source: https://x.com/HydeM1976/status/1718975653175796085?s=20 (and prompt)

Ahuvia, I.L., Mullarkey, M.C., Sung, J.Y., Fox, K.R. and Schleider, J.L. (2023), Evaluating a treatment selection approach for online single-session interventions for adolescent depression. J Child Psychol Psychiatr, 64: 1679-1688. https://doi.org/10.1111/jcpp.13822

https://x.com/acamh/status/1759539440605606159?s=20

Xu H, Bayless TM, Østbye T, Dupre ME. Care sequences leading to the diagnosis of Alzheimer's disease and related dementias: An analysis of electronic health records. Alzheimer's Dement. 2024; 1-10. https://doi.org/10.1002/alz.13669

https://x.com/DukeGHI/status/1759978730192306179?s=20

*https://researchmethod.net/conceptual-framework/

Is Hodges' Model anathema to 'Extant Nursing Theories' ?

 INDIVIDUAL
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 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

	Nursing Science Quarterly

"Are the extant nursing theories endangered species? Some nurse leaders think so. A cursory review of major nursing journals reveals the conspicuous absence of articles using nursing theories as guides to research and practice. These articles are often written by seasoned scholars and doctoral students in nursing, yet nursing science is absent. How can this be when PhD students are being prepared to be knowledge builders for the discipline and their teachers are the seasoned scholars?

This question took center stage in a recent international gathering of nurse researchers and theoreticians."

Parse RR. Are the Extant Nursing Theories Endangered Species? Nursing Science Quarterly. 2023;36(2):109-109. doi:10.1177/08943184221150254

 

 

Hodges' Model is a stranger in a strange land; and as usual I am writing from Wigan Pier - so vastly differing contexts and experiences acknowledged.

 

Whatever its status as a model of nursing, model of care, conceptual framework, nursing theory (level 'x'); as the editorial indicates, if the model were to have a 'home' it might be the USA with its nursing science PhD programmes. 

 

Clearly, this is not the case.

 

Unsuccessful in trying to learn of the international event mentioned, I can take encouragement from Hodges' model being 'stateless' and as such, being global, local and glocal in scope. There is succour in having an origin the model can call home here in the NW England (literal - person-centredness).

The medicalisation of nursing science may be an issue for PhD programmes in the USA, but the inter- multi- transdisciplinary potential of Hodges' model can encompass this - preserving and even assuring disciplinary identity as needed. An original purpose of the model was also curriculum design, and development.

"In all university systems it is the faculty and administrators of nursing programs who make curriculum decisions. These same faculty and administrators promulgate the use of theories from other disciplines to guide nursing research for PhD dissertations. What is wrong with this picture?"

I would suggest it is not 'big' - rich enough.

"What is the uniqueness of nursing as a discipline when medical science content has replaced the nursing theories and frameworks in PhD programs? The extant theories and frameworks concretized nursing as a unique discipline different from medicine in the 20^th century. Can nursing now be distinguished from medicine when the content of PhD programs is bereft of extant nursing theories and frameworks?"

Yes, nursing can and is being distinguished from medicine and all other disciplines: abstraction and scope of practice are key. 

So many 'literature searches' are incomplete (but I would say that).

It is actually a sad state of affairs should PhD programmes of study be the primary motivation for the development of nursing science. This is the 21st Century.

Nursing should be defined by the needs of national and global populations and associated national and global policy - especially ongoing gaps in those needs.