iii Picking up sticks: when axes matter
It is one thing for us to break the stick, but quite another from a concept's perspective. They are accustomed to the dynamics at work, when as search terms they are exploded, or not. And, not just any concept but one that can be unique. Consider the concept, and how or where it finds itself [ in Hodges' or another model ]? Let us use the intra-INTERPERSONAL domain, as an example, and ask:
- Is 'mood' fixed by the I-axis alone?
- Does the humanistic axis have a role in where in the doomain the user of Hodges' model places 'mood'?
- Acknowledging person-centredness, if the patient/client had a view, to what extent would this agree (with annonymity assured) with the professional's judgement, or a relatives / guardian?
- What is as a result, 'mood' has become 'very low mood'? (To continue in this vein , invites complication, but we will continue.)
- Introducing the 'Other' whatever their role and relationship, pushes us to the humanistic, but whether this is achieved in a person-centred manner (triage excluded) is a matter of opinion and judgement (evaluation).
If mood is fixed by the I-axis then if we determine the issue is 'low mood' are we introducing a combined quantitative and qualitative dimension, a continuum, at the selected point in the interpersonal domain? Writing previously about threshold concepts, I wondered, and proposed compound threshold concepts. There is a progression from the patient's subjective self-assessment, to in all likelihood of an objective measure being introduced, so spanning two domains. Definition of 'compound' aside; there is a compound structure at work.
What points 1-5 above reveal is triangulation. When it is argued that Hodges' model facilitates navigation as per my presentation on 21st April, this is a strategy from mixed-methods research in practice. Many years ago, Hodges' model was described as a 'cognitive periplus', reflecting the way ancient mariners initially charted the coastlines creating the first map, as per their culture and dispora. In the west more recently the value of social approaches and activities, especially in mental health. Care navigation is a role. Literally sign-posting to individually suited (which must be stressed) activities, resources, and agencies. So, in Hodges' model what are our three triangulation points? They are:
- Axial;
- Intra- InterDomain;
- Person-centred.
Perhaps, we can describe 1-2 as conceptual anchors at least when dealing with a concept, while #3 is more about approach, values and philosophy. So, there is something of a 'cheat' going on, because each one is compound:
1. Axial: The axial is comprised of four points. The axes create a Cartesian plane (figure). And, as far as a patient is concerned, they mark off a point on the respective Individual and Humanistic-Sciences parts of the axes. This form of triangulation point can claim a general conceptual precision (language) in the applied terminal labels; but what happens in-between can be patently fuzzy. A mix of what may be objective and subjective.
2. Intra- Interdomain: This may be the most imprecise triangulation point. It appears the axes of Hodges' model are composite (figure). They have two-sides as a boundary. To be pedantic, in our example, one plays to the interpersonal domain, the other the sciences.
[The relationship between the axis and the domains in Hodges' model, is far from unique; but I wonder if there is something else here?]
2. Person-Centred: There is a paradoxical nature to person-centred(ness). It is also nebulous in nature, and yet in care it is definitive in practice (safety, purposes, values, professionalism, competency, ...). It forms locus which can also be classed as a traingulation point, at the centre of the model. This is the point around which Hodges' model is built. This captures the individual's (life, care) context and situation, all influenced by their life chances as consequent health - and other - careers. Salience and our attention^ is key. Is it possible to frame our purpose(s)?
^A focus for [N] autumn.
Marrakech, Le Jardin Secret. 24th April. 1000-1830.
orcid.org/0000-0002-0192-8965
