Living and Loving Dangerously

individual

|
INTERPERSONAL : SCIENCES             

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

SOCIOLOGY : POLITICAL   

|

group

identity - choices   Memory - Cognition DEMENTIA - Early onset Inability to consent   inhibition-disinhibition  mental capacity	My liberty, my choices "What! I'm married to you? Oh!" Treatment - medication  'Secure (safe)' environment 'Holistic assessment'?
Marital/Initimate Relationships Social (our) identity Existing relational behaviours Interrelational needs Interpersonal grief Social identity/expectations Yes, but we're married ... had 40 years together ... Family bias, prejudices.. A 'new' step-parent ... Access to support:  relational - mutual vulnerability	Informed consent Assumed consent Rape, Sexual abuse, crime Capacity to give consent Consistency in decisions Lasting power of attorney - finance; health External safeguards Human rights Access to supervision - clinical & management

Prompts:

Previously post: Living and Caring Dangerously

Danny Leigh. Critic's choice - Films on release: Queen at Sea. Life&Arts, FTWeekend, 19/20 September, 2026, p.18.

https://depijp.rialtofilm.nl/en/films/queen-at-sea

So many difficult conversations. All on their own unique continuum in terms of sense-making for all concerned. 

A 'new' diagnosis at age 60; versus one at 44. Families seeking to control disclosure of the diagnosis from the patient. Clinical and family debate about this.

Finding a person locked-in the house, while their partner 'nips' to the shops. A person having their freedom to go out, on their regular walk  -despite acknowledged risks. (When they are known by people on their route - community care in action. Receiving a call from a neighbour; or the neighbour who knows where you park and can intercept you, on arrival or departure to express concerns. Or, even as you venture out for a walk with their neighbour of many a year. Categorise them as you will: [nosey, caring, concerned, public spirited, neighbourly, or (healthily) curious]?

Other discussions of grief at the loss of a person they have loved - in every way. A grief that presents new dark dimensions to what has gone before. Complicated by a state of early onset of memory loss. An ongoing disintegration of personhood and identity. An inability to consistently express thoughts, wishes, and choices. An inability to give informed consent. A loss taunted by retained physical desirability. What does love, sex, compassion mean now? What is the sum now, of love expressed over 'x' years? Hearts hollowed out, of what can be so important to a couple. Not vital to all. But for others, a source of conjoined affirmation, joy, warmth, companionship, a celebration of life and being human.

How to share that grief even amid close friends and family, who cannot cope themselves and withdraw? What of the preparedness of professions to manage such situations? What structures are in-place for team meetings, clinical supervision and inclusion in training, especially safeguarding?

From the bibliography (lower sidebar):

Hodges, B.E. (1989) The Health Career Model, IN, Hinchcliffe, S.M. (et al.) 1989 Nursing Practice and Health Care, 1st Edition only, London, Edward Arnold.

Adams, T. (1987) Dementia is a family affair. Community Outlook, Feb, 7-8.

Merritt MK, Procter N. Conceptualising the functional role of mental health consultation-liaison nurse in multi-morbidity, using Peplau's nursing theory. Contemp Nurse. 2010 Feb-Mar;34(2):158-66. doi: 10.5172/conu.2010.34.2.158. PMID: 20509800.

Murphy, K., Welford C. (2012) Agenda for the future: enhancing autonomy for older people in residential care.International Journal of Older People Nursing. 7, 75–80.

Kernohan, W. G., & Jones, P. (2023). Hodges’ Health Care Model as a Framework for Quality. Paper presented at Interprofessional work: developing oral care and the health workforce for the future, Brescia, Italy.
https://pure.ulster.ac.uk/en/publications/hodges-health-care-model-as-a-framework-for-quality

Jones, P. (2025). A Conceptual Mapping Exercise of Deprivation of Liberty Safeguards in Residential & Community Care Using Hodges' Model and Threshold Concepts. Journal of Evaluation in Clinical Practice, 31: e70085. https://doi.org/10.1111/jep.70085

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

Previously: 'capacity' : 'consent' : 'law' : 'safeguarding'

Gaps and Legacy Issues in Health and Education

 ... and across the Professions and Disciplines

I've just revised what may be table 1 of an exploratory paper. The table's role is to inform the motivation, scope and overall purpose within the introduction. The aim is to outline the gaps and legacies in health and education. Is this the combined inheritance of life chances, health and work career: gaps?

1. Theory-Practice gap

   A. Research in Practice – Translational Research;
    B. Education/Training: University – Apprenticeship (see 4.B);

2. There is no research-based conceptual framework taught and applied across health and social care systems and services.

3. Individual – Collective (Population) Health

4. Legacies of:
     A. Integrated care (global: funding / philosophy / location / disciplines / academic …);
     B. Parity of Esteem
          i   Mind - Body – Cartesian dualism;
          ii  Funding of Health Services [mental health - general];
          iii Research funding; Policy & Education);

C. Person-Centred Care – Service-Centred Care;

D. NHS - Social care;

5. (Ill-Health-Disease, see 4.B.ii) Treatment versus Prevention first 

6. Long-term policy Vs Short-termism

7. Personal, Local, Global: Developed – Developing Health Systems & Services 

8. Determinants of Health (Schrecker and Bambra, 2025)
   
   

Any thoughts, key sources ... are most welcome, e.g. should there be a place for sustainability, self-care, the literacies and the basis of funding public, private, or charitable (mixed)? h2cmng AT yahoo.co.uk
 

Schrecker, T., Bambra, C. (2025). ‘Lethal But Legal’: The Corporate Connections (Commercial Determinants of Health). In: How Politics Makes Us Sick. Palgrave Macmillan, London. 
https://doi.org/10.1057/978-1-349-96127-6_7

Prof. George William Brown OBE, FBA (1930–2026)

"George Brown was a huge figure in sociology and social psychiatry. At a time when social science and psychiatry were so riven with conceptual differences they could not work constructively, George’s approach was collaborative, courageous and imaginative. His work addressed real-world problems and in so doing greatly enriched mental health research."

Professor Matthew Hotopf, Executive Dean, Institute of Psychiatry, Psychology & Neuroscience:
https://www.kcl.ac.uk/news/professor-george-william-brown-obe-fba-19302026

Starting in Warrington School of Nursing (Winwick Hospital) as a student mental health nurse in October 1977 you can how that curriculum and programme of study came about; and influences on Brian Hodges' early career.

 

Hodges' Health Career - Care Domains - Model

 

 An individual's 'health career' is impacted by their life chances and life events.

 

 

individual

|
INTERPERSONAL : SCIENCES             

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

SOCIOLOGY : POLITICAL   

|

group

Individual Psychology Life events PSYCHIATRY psycho-	Life events EVOLUTIONARY PSYCHIATRY
social Group Psychology Life events SOCIAL & CULTURAL  PSYCHIATRY	LIFE EVENTS  PSYCHO-POLITICAL PSYCHIATRY

See also:

Wing, J.K., & Brown, G.W. (1970). Institutionalism and Schizophrenia: A Comparative Study of Three Mental Hospitals 1960–1968. Cambridge; Cambridge University Press. 

Brown, G. & Harris, T. (1978) Social Origins of Depression. A Study of Psychiatric Disorder in Women. London: Tavistock.Google Scholar 

Brown G.W. & Harris, T. (1979) Social origins of depression: a study of psychiatric disorder in women, London: Tavistock Publications.

Brown, G. W., & Harris, T. O. (Eds.). (1989). Life events and illness. The Guilford Press.

My source: Patrick Kidd. Forum, Obituary, The Observer. 20th September, 2026, p.42.
https://observer.co.uk/profile/obituary/article/george-brown-the-former-post-office-boy-who-unlocked-the-mystery-of-depression

Previously: 'social sciences' : 'psychiatry' : 'determinants'

Living and Caring Dangerously

individual

|
INTERPERSONAL : SCIENCES             

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

SOCIOLOGY : POLITICAL   

|

group

mental health   Cognition Inability to consent  mental capacity	My liberty Locked doors Treatment - medication  'Secure (safe)' environment
Family - friends dignity, privacy, respect vulnerability Best interest decision	Lasting power of attorney - finance; health External safeguards human rights

 

My source: BBC Radio 4 'Today' 25th September 2026: From 0841

Sir Ranulph Fiennes ‘kept unlawfully in care home’ [ The Times ]

The explorer, 82, is being ‘deprived of his liberty’, according to the watchdog, and his wife Louise Millington-Cotes is refusing visitors.

Hannah Crowe. Friday, September 25 2026, 12.41am, The Times

 See also:

Living Dangerously: An Interview with Sir Ranulph Fiennes [Brighton Dome]
Wed 10th Apr 2019

From the bibliography (lower sidebar):

Hodges, B.E. (1989) The Health Career Model, IN, Hinchcliffe, S.M. (et al.) 1989 Nursing Practice and Health Care, 1st Edition only, London, Edward Arnold.

Adams, T. (1987) Dementia is a family affair. Community Outlook, Feb, 7-8.

Merritt MK, Procter N. Conceptualising the functional role of mental health consultation-liaison nurse in multi-morbidity, using Peplau's nursing theory. Contemp Nurse. 2010 Feb-Mar;34(2):158-66. doi: 10.5172/conu.2010.34.2.158. PMID: 20509800.

Murphy, K., Welford C. (2012) Agenda for the future: enhancing autonomy for older people in residential care. International Journal of Older People Nursing. 7, 75–80.

Kernohan, W. G., & Jones, P. (2023). Hodges’ Health Care Model as a Framework for Quality. Paper presented at Interprofessional work: developing oral care and the health workforce for the future, Brescia, Italy.
https://pure.ulster.ac.uk/en/publications/hodges-health-care-model-as-a-framework-for-quality

Jones, P. (2025). A Conceptual Mapping Exercise of Deprivation of Liberty Safeguards in Residential & Community Care Using Hodges' Model and Threshold Concepts. Journal of Evaluation in Clinical Practice, 31: e70085. https://doi.org/10.1111/jep.70085

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

Previously: 'capacity' : 'law' : 'safeguarding' : 'health career'

I can't count the number of times in a nursing home, when a visit by a friend has re-ignited the flame of memory, passion and personhood; even if temporary. It was never my place to thank the friends for visiting, but they've made a difference, so crucial to acknowledge the courage on their part. Making the journey, being present and with. So difficult too, for families.

Celebrating Black History Month with the RCN NW Multicultural Group

From Allyship to Action: Building an Inclusive, Anti-Racist Future for Nursing

22 Oct 2026, 10:00 - 16:00
6 Mount Street, , Manchester, M2 5NS

Free

Book onto our celebration for Black History Month.

Join us for a full day at the Friend's Meeting House in Manchester to celebrate Black History Month!

North west members are invite to join us in celebration alongside the RCN President, who is making a special trip to Manchester to join us for part of the day.  This year we will be exploring the theme: From Allyship to Action: Building an Inclusive, Anti-Racist Future for Nursing.

The event, organised by the member-led North West Multicultural Group, will hear from speakers including:

Estephanie Dunn: Non-Executive Director of the Caribbean and African Health Network (CAHN)

Estephanie will discuss exceptionalism and how intentional and unintentional actions can negatively impact equity, inclusion and belonging in healthcare. Her session will encourage reflection on bias, challenge inequitable practices, and promote more inclusive workplaces for all.

Temitope Babajide: General Practice Nurse

Creator of both the General Practice Nurse Starter Manual and a separate nursing-themed colouring book, will share her inspiring journey in primary care. Her session will recognise and celebrate the historic and ongoing contributions of Black nurses, while showcasing the achievements, leadership and influence of Black nursing professionals in the North West and beyond.

Patricia Hughes: Associate Director RCN : Nursing Practice Nursing

Patricia will focus on equality, leadership and career progression, encouraging greater representation of Black nurses in senior and decision-making roles.

Bejoy Sebastian: RCN President

The President, will discuss the importance of allyship and the role nursing professionals play in creating anti-racist, inclusive workplaces. He will recognise and celebrate the significant contributions of Black nurses to the NHS and wider health and social care sector. The session will explore how inclusive leadership, workforce equality standards and fair career progression can help create a culture of belonging. Attendees will be encouraged to take practical action to challenge discrimination, support equality and inspire the next generation of nursing leaders.

Anandi Ramamurthy: Professor of Media and Culture, Sheffield Hallam University; Principal Investigator, Nursing Narratives: Racism and the Pandemic; Co-Editor, Anti-Racist Nursing and Midwifery: A Resource for Students, Practitioners and Activists.

The Anti-Racist Nursing and Midwifery book, the Nursing Narratives research project, and the film 'Exposed'.

There will also be a panel discussion and a poetry workshop and 'Allyship in Action' challenge workshop in the afternoon. 

Book now to avoid missing out. This event will take place in person and is open to all North West members. A sandwich lunch is provided. 

For further information regarding the aims and objectives of the NW Multicultural Group, please visit our webpage. 

Olanike Babalola

Olanike.Babalola AT reps.rcn.org.uk

"Hey Jonesy: Where's the book?"

This prompt from yesterday is far from new. There are outlines for papers on W2tQ.

Seriously though, what would a book outline look like - now?

The introduction is probably already written, it just needs to be pulled-together. But, in truth it (desperately) needs a new perspective. The question of how to update the explanation - short of running a workshop? The model's original purposes 1-4 are a statement of fact. The intro figures that invariably show how the axes 'create' the model's care, or knowledge domains? What if...? Could we also present the inverse? That would be a new slant. Does the model still 'work'? 

Details aside, here is a quick outline:

Part 1

Introduction and Background 

1.1 Brian E. Hodges and Post-Registration Nurse Education

1.2 Peter Jones - Primed to mind-map

1.3 Web presence: Initial website 1998-2015 - Blog 'Welcome to the QUAD' 2006 ...

1.4 Brian's original lecture notes

1.5 Looking back and forward: Models of care for the 21^st Century

1.6 Confessions: So, where is the new site / platform? 

Part 2

 The Four (Five) Care Domains 

2.1 Science

2.2 Interpersonal (& Intrapersonal)

2.3 Sociology

2.4 Political

2.5 Spiritual

Part 3

Hodges' model in Practice - Applications

3.1 Self care

3.2 Clinical

3.3 Social Care - Community 

3.4 Management

3.5 Informatics

3.6 Policy 

3.7 Education

3.8 Workforce: Local - Global 

Part 4

The Legacies (still) in Our Midst

4.1 Person-centredness

4.2 Integrated Care

4.3 Holistic Care

4.4 Parity of Esteem

4.5 The Theory-Practice Gap

4.6 Change - Transformation: When? Disease to Prevention

Part 5

It's Tomorrow Now

5.1 Health Promotion

5.2 Public (Mental) Health & Protection

5.3 Citizenship

5.4 Global Health

5.5 Planetary Health

Part 6

Research

6.1 Hodges' model as a Research Tool

6.2 Climate change

6.3 Planetary Health

6.4 Beyond the Bio-Psycho-Social Model: The Political Domain

6.5 The Literacies 

6.6 InterDisciplinary, Multi- and Transdisciplinary

6.7 Hodges' model as a Mathematical Object?

Part 7

Philosophy

 

7.1 Revisiting the Original Purposes

 

7.2 AI - The Elephant in Mind

 

7.3 Value & Values  

...?

Much to add, revise ... 'Education as Part X'. Political and Literacy too - a specific part - and with AI (in every part!)?

STOP!!

OK. It's a minefield. Even a proposal is a 'non-trivial' task.

Who's writing this? Not me! Not all of it, and for me; not AI either.

It would be marvellous to be one of several editors: one day? 

Clearly, a great project for students and early career researchers and current practitioners. 

An inoculation to help new cohorts deal with the realities, ravages and rewards of 'care' in its entirety*. 

P.S. With the start of a title right there? PJ

The Line(s)

Foresight, hindsight, sight itself and that illusory association with the line of time is a fascination for us all. No doubt, as a result of the hardwired analogue found in the lifeline and our ultimate fate. Hodges' model acknowledges all these lines; concrete and abstract. The work and health careers, an individual's education career (where accessible / permitted) now lifelong learning.

Abstract things seem tenuous, indistinct, maybe lost somewhere in theory. Concrete on the other hand, is physical, tangible. 

Hodges' model can cover paper with lines, two of them ideally. The model can then be applied in practice.

There is then an interplay between abstract and concrete; between which data, information and knowledge flows, uncertainty reduced. Scope and scale become clearer once assessment, planning, intervention and evaluation are concurrent.

This applies to all lines, if they are not destined to be covered in sand.

My source:  

End of The Line: how Saudi Arabia’s Neom dream unravelled, FTWeekend: 
https://ig.ft.com/saudi-neom-line/

 

See also: 'design' : 'architecture' : 'line'

How is your Odyssey (thus far ...)?

THE ODYSSEY

As a tool for lifelong learning Hodges' model must be capable of providing a structure through which a narrative can woven. A person's career, as in work, is another distinct example. And again the 'health career' through health, illness, physical and mental trials and tribulations is perhaps the prime example. As the example, it forms the basis of myth underpinning the world's cultures, pre- and ancient histories.

Tomorrow, is the day of "Two Odysseys". No: this is not 2001, 2010, 2061 or 3001.

One odyssey, heads off to the South West, to a place where the land ends, apparently. Memories to be made, a story to unfold.

The other, is based on a voyage: an incredible tale, an epic journey - the epic (in the west). This ODYSSEY will be found in the cinema (and not on a phone, TV, PC, laptop ...); and vitally also in an amazing book. Recounting, what was originally the oral tale of Odysseus on his fantastical 10-year journey home after the Trojan War.

Hodges' model provides a structure to weave this narrative, the twists and turns of patients, carers, students and personnel - all the narrative forms.

Image: https://www.rottentomatoes.com/m/the_odyssey_2026

See also: The Hero's Journey and Joseph Campbell

Leapspace ii - References

Of the references listed by LEAPSPACE #6 stood out:

Merritt, M.K., Procter, N. (2010) Conceptualising the functional role of mental health consultation-liaison nurse in multi-morbidity, using Peplau's nursing theory. Contemporary Nurse. https://doi.org/10.5172/conu.2010.34.2.158 

Had I missed this? When I hear (read) of new citation for Hodges' model, it is added to the blog's bibliography. So, what about this one?

I could not access the full-paper initially, but did so at:

https://lmscontent.embanet.com/MVU/NURS600/Readings/W3_Peplau.pdf

I can see that Merrit and Proctor reference the following [#16 of 1-46]:

Jones, P. (1998). Hodges’ health career – Care domains – Model, nursing – Art or science? Retrieved October 4, 2009, from http://www.pjones.demon.co.uk/holsci.html

This additional cognitive and motivational nourishment is welcome. They are spot on with '1998', the year the former website (p-jones.demon.co.uk) went live. 

Pre-2015 and indicative of (what will increasingly follow) from AI, LLMs, agentic ai - LEAPSPACE found a page on the now archived website:

https://web.archive.org/web/20150409004111/http://www.p-jones.demon.co.uk/index.htm

While a positive, perhaps (again) we should worry about regurgitation? Although on another level perhaps the definition of 'grey literature' is also being (has been) redefined?

There is a positive in the author's acknowledgement of Hodges' model on several counts, being associated with:

• Highlighting the need for inclusion of mental health/illness (parity of esteem);
• Peplau's seminal work;
• A search to link mental health with other specialities (emergency, liaison, burns);
• Recognition of the inverse (psychological care within medicine); 
• The fact of being listed with Phil Barker (Tidal Model). 

Negatively, on the archived homepage (above) many links to content may not work:

The (rather short but referenced) page Merrit and Proctor list is available here:

https://web.archive.org/web/20111018204743/http://www.p-jones.demon.co.uk/holsci.html

I will insert this paper in the bibliographical listing; and revisit this.

Leapspace? Why not ...?

Referred to a paper in an email: https://doi.org/10.1016/j.jclinepi.2026.112401.

- I noticed an invitation to try Leapspace. 

So I leapt (with much editing - for formatting here). ...

 

Copilot steps

Creating a plan to respond to your query

Performing search for foundational documents
Performing keyword search
Using data from Scopus
("Hodges' model" OR "Hodges model" OR "Hodges' health career model" OR "health career model" OR "care domains model") AND (nursing OR healthcare OR "health care" OR education) AND (domain* OR component* OR framework OR concept* OR definition*)

Performing natural language search
Using data from Scopus
What are the conceptual definitions, domains, and components of Hodges' model in nursing and healthcare education?

Performing keyword search
Using data from Full text
("Hodges' model" OR "Hodges model" OR "care domains") AND (diagram* OR figure* OR visual* OR schema) AND (teach* OR education OR curriculum OR learning) AND (critique OR adaptation* OR application*) AND (method* OR framework OR discussion)

Performing natural language search
Using data from Full text
How is Hodges' model represented, taught, and adapted in nursing or healthcare education, including diagrams and critiques?

Performing keyword search
Using data from Scopus
("Hodges' model" OR "Hodges model" OR "care domains framework") AND (application* OR use OR implementation OR practice) AND (critique* OR limitation* OR adaptation* OR evaluation*) AND (nursing OR healthcare OR "health care")

Performing natural language search
Using data from Scopus
What applications and critiques of Hodges' care domains framework have been reported in nursing and healthcare practice?

Done

Generated by LeapSpace, Thu Jul 09 2026

Hodges' health career - care domains - model

Hodges’ Health Career – Care Domains – Model is a generic, practice-based conceptual framework for health and social care that organizes thinking into four knowledge/care domains: science, political, sociology, and interpersonal. It is presented as broadly applicable across healthcare contexts and is used to structure reflection, critical thinking, and care planning. [1] [2] [3]

Core domains

Domain	What it covers	How it is used
Science	Cause and effect, evidence, costs, benefits, and trade-offs	Helps frame the “hard” evidence side of care and service decisions. [1]
Political	Policy, systems, and structural influences on care	Helps connect care to wider health and social policy contexts. [1] [4]
Sociology	Social context, culture, stigma, and relationships	Helps explain how social factors shape health and illness experiences. [1] [5]
Interpersonal	Therapeutic relationships, patient/carer engagement, and human interaction	Supports person-centred and relational practice. [1] [2] [6]

What the model is for

• It is described as universal in structure and adaptable to many healthcare settings, including informatics, dementia/palliative care, forensic mental health, and oral health. [2] [3] [4] [7] [8]

• It helps practitioners map concepts into domains, build a mind-map-like structure, and support reflective practice and critical thinking. [3] [9]

• In forensic mental health nursing, it is proposed as a way to guide assessment, decision-making, and recovery-oriented practice. [2]

Bottom line

Hodges’ model is best understood as a four-domain lens for integrating clinical evidence, policy, social context, and relationships into one framework for care and reflection. Its main value is not in prescribing a single care process, but in helping users think more holistically and systematically about health problems and care systems. [1] [2] [3]

Confidence level: High — multiple sources consistently describe the model’s four domains, generic structure, and broad healthcare applications.

References

1. Fox, Siobhán, FitzGerald, Carol, Harrison Dening, Karen, (...), Timmons, Suzanne (2017) Better palliative care for people with a dementia: summary of interdisciplinary workshop highlighting current gaps and recommendations for future research. BMC Palliative Care. https://doi.org/10.1186/s12904-017-0221-0

2. Doyle, M., Jones, P. (2013) Hodges' Health Career Model and its role and potential application in forensic mental health nursing. Journal of Psychiatric and Mental Health Nursing. https://doi.org/10.1111/j.1365-2850.2012.01961.x

3. Jones, P., Wirnitzer, K. (2022) Hodges' model: The Sustainable Development Goals and public health - Universal health coverage demands a universal framework. BMJ Nutrition, Prevention and Health. https://doi.org/10.1136/bmjnph-2021-000254

4. Bettiol, S., Jones, P., Onyedikachi, H.A., Kernohan, W.G. (2026) Bridging Gaps in Oral Health Frameworks: Mapping With Hodges' Health Career - Care Domains - Model. Journal of Public Health Dentistry. https://doi.org/10.1111/jphd.70034

5. Jones, P. (2008) Exploring serres' atlas, Hodges' knowledge domains and the fusion of informatics and cultural horizons. Social Information Technology: Connecting Society and Cultural Issues. https://doi.org/10.4018/978-1-59904-774-4.ch007

6. Merritt, M.K., Procter, N. (2010) Conceptualising the functional role of mental health consultation-liaison nurse in multi-morbidity, using Peplau's nursing theory. Contemporary Nurse. https://doi.org/10.5172/conu.2010.34.2.158

7. Jones, P. (2009) Socio-technical structures, 4Ps and hodges' model. Nursing and Clinical Informatics: Socio-Technical Approaches. https://doi.org/10.4018/978-1-60566-234-3.ch011

8. Jones, P. (2011) Socio-technical structures, 4Ps and hodges' model. Clinical Technologies: Concepts, Methodologies, Tools and Applications. https://doi.org/10.4018/978-1-60960-561-2.ch215

9. 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. https://doi.org/10.1111/jep.70252

Follow-up Suggestions 

What are the key components of Hodges' health career care domains model?

How does Hodges' model apply to interdisciplinary health care practices?

What are the implications of Hodges' health career care domains model for patient-centered care?

ii Thoughts re. Ecosia's AI Chat 'answer'

The previous post has been updated, to the prompt is added:

 'Please provide sources and references.

[If you are new here, and too Hodges' model please see the bibliography in the sidebar.] 

A 'human' reading (still) makes me wonder if the 'answer' is what I want to hear (as a user)? Is it worrying that the first provides a 'Conclusion' the latest does not. The table is helpful as I believe that Hodges' model has a role across research (and political!) -isms through methodologies and methods. The model can also encompass ('eat'!) aspects of scale, or level.

The reply still gives me quadraphonic joy (if read out-loud). Not only are the domains recognised, but the LLM/agent ai takes the intrapersonal / interpersonal in its stride (from the blog?). Subjects related to each of the domains are given in brackets. 

There is of course a bias (several) in the prompt, as the care domains were never intended to be comparable. It is positive that each domain is seen as having its own specific scope and function. Over twenty years notes were started on a paper on Hodges' model and its role/function in helping to define 'scope of practice'. Significantly, in the UK the rise of associate positions across disciplines has provoked much debate, vitriol (on X and union and lobbying) and soul searching in certain professional groups. Given the increasing importance of the global health and social care workforce this trend is reflected globally. A situation set to be extended with uncertainties and tensions exacerbated by artificial intelligence in practice.

Before 'explaining' the asymmetries (in points 1-4) it seems the domains are complementary (for all their differences), and provide a holistic underpinning for the model as a whole (my reading).

1. Scope and Focus 

Interesting, how the science and sociology domains are described as broad. Perhaps I am underestimating the depth/density of sociology, after all folk theory is found there? Unfortunately, we can also add a myriad of conspiracy theories? Sociology can also lay claim to quite a few constructions of its own. Including aesthetics as a bridge to architecture and design(?).

On 'X', Hodges' model has been described negatively as inviting / fostering generalism. So, this is a bad thing? Is it not strange then that your Advanced Nurse Practitioner, Consultant doctors (all specialities) and students cross-curricula can all use Hodges' model? The fact that my own responses were never engaged has helped train my thought. Here the relevance of the model to students and continued professional development is made through generalizable knowledge.

The response to the political domain is supportive, acknowledging resource allocation and the distinction between individual and collective (see for example):

S. Bettiol, P. Jones, H. A. Onyedikachi, and W. G. Kernohan, (2026) Bridging Gaps in Oral Health Frameworks: Mapping With Hodges' Health Career - Care Domains - Model, Journal of Public Health Dentistry. 1–14, https://doi.org/10.1111/jphd.70034.  

I've seen tweets today regards IQ reductions in younger people. This is one reason for support of the top-left mental domain being designated as 'Intrapersonal – Interpersonal'. Our interpersonal skills and awareness are surely dependent upon our achieving a given level of inner mental life? Encouraging to see how subjectivity and objectivity is assigned too. Although, I think I'm in an echo chamber!

2. Epistemological Differences

In arguing for a model of health and social care that goes beyond:

• medical model;
• bio-medical model;
• bio-psycho-social model.

Reading 1-2 from the perspective of the Intrapersonal – Interpersonal domain you see how limiting this is, if an individual in a mental health/illness/mental capacity context can only point to sciences and sociological domains. Indeed, they may be relying guardians and advocates as they are unable to does this and raise the political matter of their rights. Without the POLITICAL domain (or as a result of it - neglect, structural racism) there is no law enshrining independent advocacy...

3. Practical Application in Care

To care is to act. Think about triage and emergency response.

Now in the 21st century 'care' must include self-care, health and social care, and (delayed or not you decide?) planetary care.

This necessitates a change of mindset at an individual and collective level. Consider the literacies that (again) young people must master to be effective, productive and happy citizens tomorrow?

So the following is a gift (in my eyes): 

"This means the intrapersonal-interpersonal domain is not just another 'content area' but a lens through which all other domains are experienced and integrated."

4. Hierarchy of Integration

'While the domains are conceptually equal in Hodges’ model' ..

This is interesting in itself.

[There does seem a emphasis upon the Intrapersonal – Interpersonal domain in this answer?]

This is quite a step, as the idea of a nexus and integration are picked up; and pointing to what are the determinants of health:

'For example:

• A scientific understanding of depression (e.g., serotonin levels) must be interpreted through the intrapersonal experience of the individual.
• A sociological analysis of healthcare disparities must be understood through the political structures that enable or inhibit change.
• A political decision about resource allocation must be filtered through intrapersonal values and priorities.'

I'm pleased I did this, as long as I'm not being trapped in an epistemological cocoon: otherwise known as a circle. Apart from a few occasions, I have not used AI/LLMs, perhaps it is time to explore more? I'd like to preserve my naivety, especially were maths is concerned. I'm not sure of what baggage I may pick up and lack the knowledge to interpret?

Previous post:  https://hodges-model.blogspot.com/2026/06/h2cm-domains-symmetry.html

[Updated] AI Chat: Are the domains of Hodges' model comparable?

In drafting a future post: 'The Sciences: points, lines, angles and perspectives on domains', I thought I would ask Ecosia's AI Chat a related question, here is the (quick) prompt and reply:

PROMPT: 
In Hodges' model there are four care, or knowledge domains. The four domains are the sciences, sociology, political, and intrapersonal – interpersonal domain. In terms of potential content are these domains comparable, or is there an essential asymmetry? Please provide sources and references.

(I have saved the prompt for future reference and refinement.)

RESPONSE: [updated 21st June 2026]

Hodges’ model (also known as the Health Career Model or h2cm) is a conceptual framework that organizes knowledge and care into four quadrants, each representing a distinct domain of human experience and knowledge. These domains are:

1. Sciences (empirical, biological, and physical sciences)
2. Sociology (social structures, relationships, and community)
3. Political (power, policy, governance, and resource allocation)
4. Intrapersonal – Interpersonal (psychological, emotional, and relational aspects of the self and others)

Are the Four Domains Comparable or Asymmetrical?

The four domains in Hodges’ model are not strictly symmetrical in terms of their content, scope, or application. While they are presented as equal in structure (each occupying one quadrant of the model), their potential content, theoretical foundations, and practical implications can vary significantly. Here’s why:

1. Differences in Scope and Focus

• Sciences (Quadrant 1):
  This quadrant focuses on empirical, measurable, and biological aspects of health and care, such as anatomy, physiology, and pathophysiology. Its content is often highly specialized, technical, and evidence-based, rooted in natural sciences like biology and chemistry.

  • Example: The role of hormones in stress response or the pathophysiology of diabetes.

• Sociology (Quadrant 2):
  This quadrant addresses social structures, culture, and community dynamics. Its content is broader and more interpretive, drawing from sociology, anthropology, and social psychology.

  • Example: The impact of socioeconomic status on health outcomes or the role of family support in recovery.

• Political (Quadrant 3):
  This quadrant examines power, policy, governance, and resource distribution. Its content is highly contextual and often contested, influenced by political science, economics, and public policy.

  • Example: The effect of healthcare policies on access to services or the role of advocacy in shaping health priorities.

• Intrapersonal – Interpersonal (Quadrant 4):
  This quadrant focuses on individual psychology, emotions, and relationships. Its content is highly subjective and variable, drawing from psychology, psychotherapy, and ethics.

  • Example: A patient’s personal beliefs about illness or the dynamics of a therapeutic relationship.

2. Differences in Methodology

• Sciences and Political domains often rely on quantitative methods (e.g., experiments, statistical analysis, policy evaluations).
• Sociology and Intrapersonal domains frequently use qualitative methods (e.g., interviews, case studies, ethnography).
• This methodological diversity can create asymmetry in how knowledge is generated, validated, and applied.

3. Differences in Practical Application

• Sciences and Political domains  are often system-level and influence macro-level decisions (e.g., clinical guidelines, healthcare policies).
• Sociology and Intrapersonal domains are more individual- or community-level, focusing on personalized care, cultural competence, and therapeutic relationships.
• This can lead to asymmetry in impact, where some domains (e.g., Political) shape broad systems, while others (e.g., Intrapersonal) focus on direct human experience.

4. Theoretical Foundations

• The Sciences and Political domains are grounded in positivist and structuralist theories, emphasizing objectivity and external reality.
• The Sociology and Intrapersonal domains are influenced by interpretivist and constructivist theories, emphasizing subjectivity and lived experience.
• This theoretical diversity can create asymmetry in how knowledge is perceived and valued in different contexts.

Is There an Essential Asymmetry?

Yes, there is an essential asymmetry in the potential content of the four domains. While the model presents them as equal in structure, their content, methods, applications, and theoretical foundations are not interchangeable. The domains complement each other but serve different purposes in understanding and delivering care.

Sources and References

1. Conceptual Overview of Hodges’ Model:

   • Hodges’ Model: A Cognitive Periplus for - WikiEducator (PDF)
   • Hodges’ Model: Welcome to the QUAD
   • Hodges’ Health Care Model as a Framework for Quality

2. Theoretical Foundations:

   • Hodges’ Health Career Model and its role and potential application
   • Hodges’ model: the Sustainable Development Goals and public health

3. Discussions on Asymmetry and Complementarity:

   • The model’s holistic intent is emphasized in Hodges’ Health Care Model as a Framework for Quality, but its quadrants are not identical in content or application.
   • The differences in methodology and scope are discussed in Hodges’ Health Career Model and its role and potential application.

Summary Table: Asymmetry in Hodges’ Model Domains

Domain	Content Focus	Methodology	Theoretical Foundation	Level of Application
Sciences	Biological, empirical data	Quantitative	Positivist	Macro (systems, clinical)
Sociology	Social structures, community	Qualitative/Quantitative	Interpretivist, Structuralist	Meso (groups, communities)
Political	Power, policy, governance	Quantitative/Qualitative	Structuralist, Critical Theory	Macro (systems, policy)
Intrapersonal-Interpersonal	Psychology, emotions, relationships	Qualitative	Constructivist, Humanistic	Micro (individual, relational)

PROMPT: 
In Hodges' model there are four care, or knowledge domains. The four domains are the sciences, sociology, political, and intrapersonal – interpersonal domain. In terms of potential content are these domains comparable, or is there an essential asymmetry?

 

In Hodges’ model, the four care (or knowledge) domains are:

1. Sciences (biological, physiological)
2. Sociology (social, cultural, environmental)
3. Political (legal, policy, organizational)
4. Intrapersonal – Interpersonal (psychological, emotional, relational)

These domains are not strictly comparable in terms of content, scope, or function. Instead, they represent complementary perspectives that together form a holistic framework for understanding human health, well-being, and care. Here’s why there is an essential asymmetry between them:

1. Scope and Focus

• Sciences and Sociology are broad, well-established academic disciplines with extensive theoretical and empirical foundations. They provide generalizable knowledge about biological processes and social systems.
• Political is more narrowly focused on power structures, governance, and resource allocation. While critical for systemic change, it is less about individual experience and more about collective frameworks.
• Intrapersonal – Interpersonal is deeply personal and subjective, focusing on individual psychology, emotions, and relationships. It is less about universal laws and more about unique, context-dependent experiences.

This makes the intrapersonal-interpersonal domain inherently asymmetrical compared to the others, as it deals with subjectivity and variability rather than objective or structural phenomena.

2. Epistemological Differences

• Sciences, Sociology, and Political domains rely on external observation, measurement, and analysis. They are rooted in positivist or structuralist traditions, where knowledge is often generalized.
• Intrapersonal – Interpersonal is rooted in interpretivist and phenomenological traditions, where knowledge is co-created through subjective experience and dialogue. It resists universal generalization.

This creates a fundamental asymmetry in how knowledge is produced and validated across the domains.

3. Practical Application in Care

• The Sciences, Sociology, and Political domains provide frameworks for action (e.g., medical treatments, social policies, legal rights). They are instrumental in shaping systems and interventions.
• The Intrapersonal – Interpersonal domain is transformative—it shapes how individuals perceive, interpret, and respond to care. It is the domain where meaning is made and agency is exercised.

This means the intrapersonal-interpersonal domain is not just another “content area” but a lens through which all other domains are experienced and integrated.

4. Hierarchy of Integration

While the domains are conceptually equal in Hodges’ model, in practice, the intrapersonal-interpersonal domain often acts as the nexus where the other domains intersect. For example:

• A scientific understanding of depression (e.g., serotonin levels) must be interpreted through the intrapersonal experience of the individual.
• A sociological analysis of healthcare disparities must be understood through the political structures that enable or inhibit change.
• A political decision about resource allocation must be filtered through intrapersonal values and priorities.

This integrative role makes the intrapersonal-interpersonal domain asymmetrical in function, even if not in formal status.

Conclusion: Essential Asymmetry

The four domains are not comparable in content or function. Instead:

• The Sciences, Sociology, and Political domains provide structural and systemic knowledge.
• The Intrapersonal – Interpersonal domain provides subjective and relational knowledge, which is essential for meaning-making and agency.

The asymmetry arises from the epistemological and practical differences between objective/systemic knowledge and subjective/experiential knowledge. Hodges’ model emphasizes that all domains are necessary, but they operate in fundamentally different ways.