New citations - Practice Without Theory: A Philosophical Inquiry into Contemporary Nursing in South Asia

It is always welcome news when I learn of a paper (Asmat, 2024) recognising and citing Hodges' model from the nursing and wider literature. In this case an educational journal, focussed upon health and social care:

Kainat Asmat (2024). Practice Without Theory: A Philosophical Inquiry into Contemporary Nursing in South Asia: Nursing Practice without Theory. International Journal of Practice-based Learning in Health and Social Care. 12. 125-131. 10.18552/ijpblhsc.v12i2.1068. 

I have quoted at length, but it is good to have a different 'excuse' (not just extending the tail of a relevant book, or paper). ... 

'Similarly, Hodges' Health Career Model exemplifies its use as a tool for reflection during clinical assessments, care planning, and decision-making processes (Doyle & Jones, 2013). The model encourages nurses to reflect on their practice through multiple lenses, ensuring a comprehensive understanding of patient needs and care strategies. The Interpersonal domain emphasizes the relational aspects of nursing, including communication and empathy. The Sociological domain highlights the impact of societal factors and social determinants on health. The Scientific domain focuses on evidence-based practice and the integration of scientific knowledge into care. Finally, the Political domain addresses the influence of healthcare policies and organizational structures on contemporary nursing practice. In contemporary nursing practice, a nurse might use Hodges’ model to provide holistic and personalized care by considering the patient's social background, the scientific basis of their care, interpersonal dynamics, and relevant political or policy-related factors. According to Jones (2017), using conceptual models like Hodges' can greatly enhance nurses' critical thinking, fostering a reflective and engaged nursing workforce.' p.126.

'Collectively, nursing theory remains a cornerstone of contemporary nursing practice, providing an essential framework that guides clinical decision-making, promotes critical thinking, and supports reflective practice. Peter Jones, in his seminal works, underscores the critical role of theoretical models in enhancing nursing practice. His insights provide compelling evidence for the continued relevance of theory in contemporary practice. In "Humans, Information, and Science", Jones (1996a), articulates the interrelationship between human factors, informational processes, and scientific principles in healthcare. He argues that nursing, as a discipline, uniquely integrates these elements to form a comprehensive approach to patient care. This integration is fundamental in moving beyond task-oriented care towards a practice that is reflective and evidence-based. Jones emphasizes that without a theoretical foundation, contemporary nursing practice risks becoming fragmented and superficial, lacking the depth required for truly effective patient care. Similarly, in "An Overarching Theory of Health Communication",  Jones (1996b) explores the necessity of robust communication theories in healthcare. He posits that effective communication is not merely a skill but a complex process grounded in theoretical understanding. This perspective is particularly relevant to nursing, where communication is pivotal in patient interactions, interdisciplinary collaboration, and health education. Jones’ work illustrates that theoretical frameworks in communication enhance nurses' ability to engage with patients and colleagues thoughtfully and effectively, fostering better health outcomes and professional practice. Jones’ analyses reinforce the argument that nursing theory is indispensable in contemporary practice. Likewise, McEwen and Wills (2021) also highlight that nursing theory is integral to the development of nursing as a discipline. They assert that without the theoretical underpinnings, nursing risks regressing to a technical occupation devoid of critical thinking and judgment that characterize nursing professional practice. Thus, the survival and progression of nursing as a distinct profession depend on the continued integration and application of theory in contemporary nursing practice.' p.127.

In addition, the short conclusion is supportive and encouraging for ongoing efforts. As with all discovered citations thus far, I'm not sure of how Kainat Asmat located the publications on Hodges' model? A literature search - no doubt, or perhaps the blog's sidebar listing? The selection made, fits the author's purpose. 

Over the years, I've tried to indicate the scope and scale that Hodges' model can 'reach'. Especially in self-care, family, local, global and planetary health. Now, c/o Asmat (2024), Hodges' model has a much valued connection with South Asia. The required scope of Hodges' model (its inter- and transdisciplinary potential^) is also conceptual, referred to previously as holistic bandwidth. Hence the model's relevance and potential in theory and practice.

Many thanks to Kainat Asmat and the journal's editorial team.*

I will read again and return to the paper in our New Year.

Listed in the bibliography:

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. 20, 7, 631-640.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2012.01961.x/abstract

Jones, P. (1996a) Humans, Information, and Science, Journal of Advanced Nursing, 24(3),591-598. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.1996.23321.x

Jones, P. (1996b) An overarching theory of health communication? Health Informatics Journal,2,1,28-34.

Where I have now added this paper.

^Still on the agenda as a paper; as with 'revisiting' 1996a. Happy to support others in referencing, or writing more specifically about Hodges' model (a case study, mapping exercise?); especially student nurses, carers and personnel in social care and early career researchers. To which, I'd better add later career nurses, allied disciplines, nurses returning to practice (surely a UK and global policy focus?) and proof of reading (your choice of course on the paper, chapter, book...); and reflection for continuing professional development (CPD). If you're still unsure, it was a relief to put the 'pen' down, well writing is still a major challenge (and pain) here. 

*And, of course - Brian E. Hodges RIP - too.
https://hodges-model.blogspot.com/2023/08/brian-e-hodges-r-i-p.html

Book review: Nursing Knowledge: Science, Practice, and Philosophy

Searching for an up-to-date nursing theory book I wanted something different from the usual fare. The usual fare being a description of the various nursing theories, models and frameworks to date. I needed a text that would help me in two ways: firstly, deal with and critique the foundations of nursing theory; secondly, to provide some insights that would inform my own study into Hodges' model. I quickly found a book with a bonus: it is written by a philosopher.

Mark Risjord's - Nursing Knowledge: Science, Practice, and Philosophy (Wiley-Blackwell, 2010).

This is not a large book considering the literature within its potential purview at just 246 pages in total. The text is very readable both visually and in style. Even if points need to be re-read this isn't a chore. Evidence of structure and discipline runs from paragraphs to the overall division into seven parts, with the usual reference listing and index. As a nursing student of the late 70s and early 80s this book needed to reframe this subject for lifelong learning student of the 2010s. Risjord starts by examining the history - prehistory no less - of the problem. 

Key questions that have arisen in nursing and directed thought are discussed. The influence of what was happening simultaneously in the philosophy of science and culture is also related. The writing is succinct (as already suggested) on page 18 we have an explanation for the appearance of the relevance gap, how this gap endures and how it might be closed.

Central to the demographic, media and political challenges that nursing faces part II covers values. This brings in nursing's standpoint and more direct reference to cultural influences on nursing knowledge in particular feminism. This discussion is again brief, standpoints are very relevant for me. The combination of depth of analysis, brevity with a clear focus are a great achievement. A lesson in how to write, how to argue, how to communicate. You can only do this if you know your subject.

If I missed anything it is technology and information, but the book is probably all the better for this whether considered an omission or diversion. Seeing specific reference to multidisciplinary in the index and a discussion of nursing knowledge in relation to other disciplines would be helpful. Risjord's purpose for this book is however, clear from start to finish. It's there in the title. The book is no glossary, or dictionary, and yet the treatment of many concepts here, such as; axioms, borrowed theory, coherence, context, grand theory, and paradigm (a chapter)... will help reader's appreciate their definition and use. Seminal papers from the literature are identified and re-examined. Much of the book is devoted to research and methods with illustrative examples.

There is much to inform my studies, in particular chapter 15: Conceptual models and the fate of grand theory. Here I can conclude from Risjord that Hodges' model creates an orientation picture rather than an abstraction picture:

On this understanding, nursing models are expressions of the philosophical background to nursing research. Conceptual models orient research and practice by guiding the selection of problems or making phenomena salient. They make no theoretical pronouncements. A conceptual model can guide research and practice only in the light of some values and goals. Nursing values and goals are thus crucial components of the conceptual model on the orientation picture. They set the agenda for nursing research by articulating what is important. p.173.  

I've long considered Hodges' model to be a map. Initially, a blank map - a space within which values can be deliberated. In pedalling this particular bike since 1998 I know how tired nursing theory is. Now students don't need to get on the bike, they stand on one pedal and freewheel the short distance that represents the curricula space devoted to nursing theory (and philosophy). A packed curriculum provides the momentum for the (values) by-pass. Mark Risjord concludes with new questions about nursing theory, new maps and new directions. I've outlined other points from the text for future reference. This book will remain a companion for quite some time: a great compass.

Acknowledgement: Many thanks to Wiley-Blackwell for the review copy.

Editorial: "The Meaning of Concept Analysis" i

Nursing Science Quarterly (NSQ)

 

 

This editorial, "The Meaning of Concept Analysis" is open access and concerns an academic activity that is 'bread and butter' in nursing theory. It is well worth reading, for students too.

"The purpose of this editorial is to clarify the meanings of the term concept and analysis and to offer some guidelines that show what is appropriate for publication of concept analyses."

 

The editorial is helpful in encouraging the effort here, even as it suggests I would be wasting my time, the editor's and referees (although quarterly has a certain appeal).

 

 

The journal's role and purpose is clearly described:

"Nursing Science Quarterly is unique in that it is the only journal devoted exclusively to the enhancement of nursing knowledge. Only Nursing Science Quarterly publishes original manuscripts focusing on nursing theory development, nursing theory-based practice and quantitative and qualitative research related to existing nursing frameworks, contributed by the leading theorists, researchers and nurse executives. including nurse theory development."

I've enjoyed the freedom here, on the periphery of academia. Afraid at the same time that this 'h2cm' obsession has, will ... impact my objectivity, subjectivity - by way of attitudes, openness and view within and without of nursing, in theory, practice and management. Added to being able to carry the weight that is nursing (responsibility). The load is made-up of history, the legacies, the global academic balance (or not), the current global state of the profession, the fight for professional recognition and more. All rolled-up, and rolled-out when the challenges of the 21st century warrant it. Yes, the future is always - out there.

Concepts are key in Hodges' model, as a conceptual framework, as a series of conceptual spaces, as domains for threshold concepts and much more. I think I'm struggling now, as I always have in giving 'a' concept my critical attention, and its being in uniform. Concepts are always 'seen' as a gestalt. This may explain why I'm not an academic and definitely not a professional philosopher. The editorial notes:

"Examples of some analyses of concrete concepts that would not contribute to discipline-specific nursing knowledge and therefore are not worthy of publication include nursing overtime, nursing shortage, cultural competencies, medical diagnoses, precision health, big data, sensor technology, health economics, omics, and symptom science, among others."

I have mapped these concepts to Hodges' model below (underlined), and added in italics some associated concepts:

 

 

 INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

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

SOCIOLOGY  :   POLITICAL 

|

GROUP

psychiatric diagnosis data ethics [person-al] symptom science [here] person-centered care / health emotional/spiritual intelligence	medical diagnoses, precision health, big data sensor technology, omics, and symptom science procedure x,y,z - cost $$$
cultural competencies social prescribing health literacy public understanding of sciences	nursing overtime nursing shortage nursing crisis? data ethics [COP15] outcomes - patient safety information governance health economics

As an exercise you may like to consider the following, as relates to the care - knowledge domains of Hodges' model?

"For the discipline of nursing (which includes the extant theories and frameworks) appropriate analyses of abstract concepts that contribute to the advancement of discipline-specific knowledge include self-care, wellness, well-being, self-esteem, courage, trust, burden, comfort, resilience, betrayal, shame, and authentic presence, among others."

Along with the concern about my preoccupation with Hodges' model, every time I type reflection, reflective practice - it hurts. It feels like another form of navel gazing, and yet the need for reflection, and reflective practitioners, producing critical thinkers and reflective practitioners is recognised world-wide.

I can't help but get a sense that concept analysis is nurse's navel gazing. If I sound critical, it would be a greater problem if this was the view of others outside nursing? Maybe, this point itself, validates the production of discipline-specific knowledge for nursing? I can't escape though, the feeling that there is something limiting, narrowing, even apolitical here: (Is there a global nursing crisis)? There has been much needed conceptual work on race, justice, gender, equality [google 'concept analysis, ...']. I realise my expansive approach can - and does - fall dead from the press. If I can blame the Atlantic, then I hope that pluralism still has a role to play?

 

Parse concludes:

"Nurse researchers and emerging scholars should answer four questions before launching a concept analysis that could be worthy of publications.

1. Is the concept an abstract expression to illuminate the essences that can contribute to nursing knowledge development?

2. Is the conception critical to the advancement of discipline-specific knowledge?

3. Which extant concept analysis model is appropriate for this concept?

4. Will this concept analysis be worthy of publication in light of its level of abstraction and possible contribution to nursing science?"

In the 21st Century concept analysis will have its place, being key in philosophy, linguistics, ethics, law, artificial intelligence ... and yes, nursing too. But increasingly I think the true power of concepts (in theory, practice, management, policy) is found when they are related and conjoined.* 

More to follow ... then silence ... for a time ...

Parse RR. The Meaning of Concept Analysis. Nursing Science Quarterly. 2023;36(1):5-5. doi:10.1177/08943184221131957

*To state the obvious.

(ii) What sort of field is 'nursing'?

Mathematics without Apologies:
Portrait of a Problematic Vocation

Harris quickly differentiates between pure and applied - practical mathematics. Nursing can claim mathematical tenure in being a constant. A constantly problematic vocation for governments worldwide. Temporarily recognised for its criticality, in terms of the population's dependence on nursing by the COVID pandemic. The global nursing workforce while often a political football in its host country, is in intensive care amid demographic change and policy imperatives. 

Neither maths/mathematics, numeracy, nor arithmetic are indexed in:

Curriculum Development In Nursing Education (4th. Edition).

If present, such detail might suggest a concept-based curricula approach, but the dichotomies of qualitative-quantitative and subjective-objective work to good effect; performing as per the axes of Hodges' model. Perhaps, there are nonetheless, more similarities between mathematics and nursing than an axial first-glance might suggest?

I've noted (if not lamented) the fall in prominence of nursing theory, models of care in nurse education and practice. Within the corpus of books the phrases are still common in terms of usage:

It seems that 'models of care' are not the sole preserve of nursing and health disciplines. These models are also defined by management consultancies*, care commissioners, economists, philosophers and policy makers. Hodges' model itself can be used to argue this is a legitimate activity, desirable and to be expected. 

An admittedly small sample, but here in NW England student nurses I encounter struggle to recall 'a' model, or theory that has caught their attention. With discussion, they realise they have been to this abstract place before. The attention on models and theory does not appear to match the focus afforded in North America. The political background of national health systems provision, the state of development of health services and systems and education make a huge difference between nursing academia globally, even as we strive to be one-family. 

Harris writes of the quest narrative in mathematics. There are problems solvers and the theory builders in mathematics. Tenured mathematicians seek the 'golden goose'. Hodges' model is the quest here: a golden goose in cognitive form that all can possess with requisite basic literacy and explanation. While as noted in (i) mathematics is a relaxed field (Preface, p.xi), it seems nursing theory is a (largely) deserted field. Ironically, seeking person-centredness, this is where Hodges' model begins - a necessarily conceptually deserted field that offers only structure but with the prospect of unconditional positive regard.

Harris, M. (2015) Mathematics without Apologies: Portrait of a Problematic Vocation. Princeton University Press.

*Reimagining the nursing workload: Finding time to close the workforce gap. https://mck.co/43tMB7v
via @McKinsey [A post may follow.]

See also: 'commissioning'

'nursing theory'

PJ's project [ii]: Hodges' model An aide mémoire, or candidate Gärdenforsian conceptual space? Or would you like a mint?

This 'project' has in reality been ongoing through some thirty years. Although Hodges' model is by its very nature - broad and generic - I'm sure there is a specific research question here. For me this question combines nursing (theory and practice), informatics, health and public engagement. One possible question that h2cm provokes concerns whether the model can be considered a conceptual space?

Over a couple of years I've been adding to some notes which for want of another I've framed under the question above. These notes inevitably languish for a while given a full-time nursing job (plus learning Drupal, this blog, doing posters ...). Picking the text up recently though the intro material seems to have fallen into place. An introduction should cover the recurring issues, challenges - opportunities found in nursing. Although I have the secateurs in hand and the spring is warm, Hodges' model requires that education and cognitive science are also be considered in this way. Anyway, here is the current working outline:

Hodges' model: A mere aide mémoire, or candidate Gärdenforsian conceptual space?

Abstract

Part 1: Introducing Health & Social Care, Education, Hodges' model

1 Introduction
 1.1 Health and Social Care
 1.2 Recurring Issues in Health and Social Care

2 Education
 2.0 Introduction
 2.1 Education in the 21st Century
 2.2 Issues arising in Education

3 Health Care and Nursing Theory and Hodges' model
 3.0 Introduction
 3.1 Models of Nursing (Care)
  Definitions
 3.2 Hodges' Health Career - Care Domains - Model
 3.3 Information, energy?, records

Part 2: Cognitive Science & Conceptual Spaces

4 Cognitive Science and Computing
 4.0 Introduction
 4.1 Models, contexts, situations, the Project and (Darwinian) Justification
 4.2 Forms of Literacy, Requirements and Socio-Technical Perspectives
 4.3 Computation and Computer Graphics

5 Gardenfors' Conceptual Spaces

 5.0 Introduction

Drawing upon the cognitive science and computing literature the objectives of Gärdenfors’ Conceptual Spaces are made clear from the outset:

‘… is to show that a conceptual mode based on geometrical and topological representations deserves at least as much attention in cognitive science as the symbolic and associationistic approaches’ . p.2.

To what extent is h2cm a geometrical and topological representation? It appears on a simplistic level to qualify as a complex plane (Derbyshire, 2008). In this case, however, the closest we get to imaginary numbers in the negative sense are the null hypotheses of clinical research and reasoning amid uncertainty (REF). Gärdenfors continues:

‘This is a book about the geometry of thought. A theory of conceptual spaces will be developed as a particular framework for representing information on the conceptual level.’ p.2.

Hodges' model provides a framework, but as already noted it is not as yet theory based. It is based on practice, with appeals to experience and the knowledge and skills deployed in the health and social care sector. Could the h2cm framework work with Gärdenfors theory of conceptual spaces and his resulting framework for representing information? When Gärdenfors refers to his book being about the geometry of thought, here I would ask: What have nursing theorists sought? In addition to the stated motivations, surely a geometry of nursing thought? Nursing theorists seek rules and laws for a 'geometry' of care. A geometry of care is no less idealised, no less Platonic in form ultimately reflecting the values of the profession. A geometry of care would clearly be an achievement of harmony in the midst of discord and suffering. Additionally as the nursing discipline appears to some to be compromised in respect of practice, training, attitudes and professionalism.

 5.1 Representation, Explanation and Construction
 5.2 Background on key research methods
 5.3 Gärdenfors conceptual spaces - selected definitions
 5.4 Purposes, Holistic Bandwidth, Safety, Benefits and the Socio-Technical (repetition, move?)

Part 3:

6 Nursing, Care Theory and Care Domains
 6.0 Introduction
 6.1 Indicative literature review
 6.2 H2CM, Research methods and Data, Data, Data, (Data!)

Conceptual Spaces: Process, Practice and Domains - Hodges’ model

Part 4:

Coding and Classification, Ontologies, RDF, Semantic Web
Icons, glyphs, blobs
Patterns, wholes and parts
Users, Purposes and Scope of Application
Drupal and Ruby
Domains and Domain Specific Languages
Closing Discussion

(Back to this post:)
Don't ask why I am doing this. Chaos does reign here - 'Indicative literature review' in the midst...! In my defence these are notes, what's the question? Bits of the text move about, some disappears. Part 4 could become two, or three new parts, but no more than that! To what extent is there a case for M.I.N.T. a Modern Information-oriented Nursing Theory?*

Can you get there from a conceptual framework? When you get on the "conceptual framework" bus, can we simply change the destination to "conceptual space"? Has the academic bus already been and gone, or it drove right past: "Not in Service". Is this too big an ask of a bus? You need a ship to cross an ocean - even one that is illusory.

One thing I am sure of is that the model - #h2cm, this blog #W2tQ, my picking out Drupal, Ruby and the potential of visualization in the social sciences must come together in some way. One can inform the other. There is something really worth doing here. If in the end I don't get to do it well maybe others can finish the piece (the ambiguity here is intentional). Where's that illusory ship....

* M.I.N.T. sounds better than F.I.H.T. - you know cool and refreshing; but I do prefer and we really do need a Future & Information-oriented Health Theory?

Derbyshire, J. (2008). Unknown Quantity, Atlantic Books. p.12.

Gärdenfors, P. (2000). Conceptual Spaces, Cambridge.

ii Seeds in 'architecture'

There is something seductive in architecture, the imagination of ideas on paper, the promise of the cornerstone, the reality of the construction, the space it grasps and the space it bestows.

Arriving at Younés paper, the history and reference to Valéry's Eupalinos ou l'architecte, Socrates and Phaedrus had me captured. 

Healthcare is dialogue. Spoken and unspoken. Discourse. Dialectic. Perspective: One : Shared : (the) Many.

What is said, gestured, and unsaid. Valéry's dialogue sounds worthy of follow-up, appreciating Plato and this form of theatre and learning. There is a latent architect in us all. Patiency too - but not yet - let us build first. Every day and night we construct (hopefully). When necessary we know when to disassemble, de-construct, to initiate change.

Reading Younés I can readily relate the paper to nursing, Hodges' model, and healthcare generally. The paper's three main questions concern (of course) architectural theory:

1. the causal relation between building and theory;
2. the necessary mental conditions that precede theory;
3. a definition of theory in its scope, discourse, and nature.
   

There are many points of note (reading my yellow highlighter) here. 

'Reflection precedes realization, but theory does not necessarily precede practice'. p.234.

'Theory however, is a systemic elaboration that operates based on definitions and concepts, in the sense that definitions build concepts, and concepts in turn build a theory, but not the reverse of the sequence.'

'Theory, then, comes 'late', only because it is the synthesis of a content that was already present'. It is constructed after a prolonged reflection over many experiences, based on common, comparative, or contrasting sets of criteria.

Younés focus is specific the development of theory in architecture, but as he writes: 'there is some element of reflection which can be termed the building's efficient cause' p.234. I wonder about Nursing Theory and the nurse's theory based on the person - in-person: reflection of care, assessed, planned, delivered, evaluated and recorded. There are nurses still preoccupied with Q.1, even if the (primary) focus is within academia(?).

Q.2 seems an invitation for philosophy (as per the journal's title!). Being non-judgemental, if not starting to build nursing Theory, then especially for the nurse co-constructing, co-designing a theory of care with the patient/family. Hodges' model is not just a series of set squares, facilitating design; it is an empty set. Never completely empty, due to the structure. A structure that contradicts. A structure paradoxical as it constrains and releases, records and forgets.

Q.3? Did someone call - continuity? Yes, (and how!) we can carry on from Q.2. Scope - yes. See the space? Listen to all the dimensions. Reduced to those that count, in discourse and nature, by nature.

Person-centred? New patient. RESET. Re-build - but remember humanistically.

See also:

Seeds in 'architecture' i

Seeds in 'architecture' iii

Younés, Samir. “Constructing Architectural Theory.” Philosophy 78, no. 304 (2003): 233–53. http://www.jstor.org/stable/3752046.

 

Because we are (still) living in a post-Project 2000 World ...

Hodges' model #h2cm is history ...

Ack. Walsh, M. (1991). Models in clinical nursing: The way forward. London: Bailliere Tindall.

"The emphasis of Project 2000 on community care also has implications for curriculum design, since the way nursing is taught must at least in part be applicable to the non-hospital situation. p.144.

"The power and autonomy of nursing have been under continual attack since 1985 with the Griffiths Report and the introduction of general management." p.148.

"Models act as broad organizing concepts, as philosophies or frameworks of care, and in that sense operate at the large-scale or macro-theory level." p.149.

"Models, therefore, are essential in defining nursing. Only by saying that 'This is nursing' and that only a trained qualified nurse can do whatever nursing consists of will be able to hang on to the domain of nursing. Once that is lost an army of low-paid health care assistants (HCAs) acting as 'basic carers' and 'physician's assistants' can be employed to take over."  p.150.

Figure 1 (p.155)
Sorry about the image quality (will try again)
but hopefully the meaning is conveyed.

" ... we can say that at the macro level of theory different models place differing emphases on areas of the patient for the nurse to explore. Each model also has its own unique philosophy of care. At the micro level, nursing theory remains an independent body of knowledge, applicable under any model of nursing, but which may be implemented in different ways, subject to the approach of that model."
p.150.

"British nursing has been talking for too long about models; it is time to see whether they can be made to work!" p.152.

See Figure 1 - "Perhaps nursing models may be best thought of as subjective views of nursing which by virtue of widespread discussion become generally accepted by nurses, leading to a series of coherent frameworks which have consistent value systems applicable to the delivery of care." p.154.

"The Sir Humphreys of the nursing world are quick to point out that nobody has shown that implementing a model of nursing has improved nursing care. This is true, although nobody has shown that a model makes care any worse either!" p.153.

... it is now and the future too ... [PJ]

Walsh, M. (1991). Models in clinical nursing: The way forward. London: Bailliere Tindall.

Context:

https://www.google.com/search?client=firefox-b-d&q=nursing+project+2000

https://en.wikipedia.org/wiki/Humphrey_Appleby

Pre-Publication Discount: Nursing and Clinical Informatics - Socio-Technical Approaches

Take Advantage of the Pre-Publication Discount by Ordering this Book Today!


Nursing and Clinical Informatics: Socio-Technical Approaches

Edited By: Bettina Staudinger, University for Health Sciences, Medical Informatics and Technology, Austria; Victoria Höß, University for Health Sciences, Medical Informatics and Technology, Austria; Herwig Ostermann, University for Health Sciences, Medical Informatics and Technology, Austria


Description:
The field of nursing informatics is one of the fastest growing areas of medical informatics. As the industry grows, so does the need for obtaining the most recent, up-to-date research in this significant field of study.

Nursing and Clinical Informatics: Socio-Technical Approaches gives a general overview of the current state of nursing informatics paying particular attention to its social, socio-technical, and political aspects to further research and development projects. A unique international comparative work, this book covers the core areas of nursing informatics with a technical and functional respect and portrays them in their proper context.

Table of Contents:

Chapter I: A Treatise on Rural Public Health Nursing

Wanda Sneed, Tarleton State University, USA The objective of this chapter is to promote public health nursing and community health nursing’s role in the new care delivery patterns, with predictive and preventative care models for populations. This entry will broaden the range of information available for informaticists, as their role expands in the new healthcare arena. Articulation with nursing informatics and the “quality chasm” crossings in U. S. healthcare will assist the informaticists with search and retrieval activities. All players in the healthcare arena will continue to be involved, but probably with a more rational policy-making role.

Chapter II: Assessment in a Computer-Based Nursing Documentation

Elfriede Fitz, University for Health Sciences, Austria
Daniela Deufert, University for Health Sciences, Austria
Johannes, Hilbe, University for Health Sciences, Austria
Christa Them, University for Health Sciences, Austria Experience in nursing practice shows that there are still problems with assessment in computer-based nursing documentation. In addition to nursing documentation, an assessment instrument that captures the needs for care must also be integrated. This chapter describes different Nursing Assessment Instruments and the advantages of Computer-Based Nursing Process Documentation by using quality criteria for assessment instruments such as validity, sensitivity, specificity, reliability, practicability, and the appropriateness of the instrument. Quality criteria for computer-based systems are basically software ergonomic aspects and therefore not part of this study. Each country should choose for itself those specific assessment instruments that capture the needs for care of their clients. The data presented make it possible that facilities are compared (also in regard of reliable cost estimates).

Chapter III: Clinical Decision Support Systems in Nursing

Dawn Dowding, University of York, UK
Rebecca Randell, City University, UK
Natasha Mitchell, University of York, UK
Rebecca Foster, School of Health Sciences at the University of Southampton, UK
Valerie Lattimer, School of Health Sciences at the University of Southampton, UK
Carl Thompson, University of York, UK Increasingly, new and extended roles and responsibilities for nurses are being supported through the introduction of clinical decision support systems (CDSS). This chapter provides an overview of research on nurses’ use of CDSS, considers the impact of CDSS on nurse decision making and patient outcomes, and explores the socio-technical factors that impact the use of CDSS. The chapter presents the results of a multi-site case study that explored how CDSS are used by nurses in practice in a range of contexts. The study reveals that how a system is used and may vary considerably from the original intentions of the system designer.

Chapter IV: Culturally Sensitive Healthcare for Newcomer Immigrants

Jerono Rotich, North Carolina Agricultural & Technical State University, USA This chapter will give an overview of the healthcare-related challenges that most newcomer immigrants and refugees encounter as they acculturate into their new environments in Western countries. It will highlight practical tips that can: a) enhance the caregiver and patient relationships across cultures and across continents; b) enhance culturally sensitive healthcare services; and c) help to create culturally inviting healthcare environments. It is also evident that, although these newcomers enrich their new nations with their diverse backgrounds, language, and cultural differences, each continues to pose formidable obstacles to their health, healthcare providers, and the health system in general. While the patients and providers realize the effects of immigration on the quality and access to healthcare, they seem to be overwhelmed by the barriers.

Chapter V: Mobile Technology in a Developing Context: Impacts and Directions for Nursing

Pammla Petrucka, University of Saskatchewan, Canada
Sandra Bassendowski, University of Saskatchewan, Canada
Thomas F. James, Apogia Networks, Ltd. , Canada
Hazel Roberts, Government of St. Kitts-Nevis, Ministry of Health, Canada
June Anonson, University of Saskatchewan, Canada This chapter presents the imperatives of mobile technologies in the healthcare. It presents the contextual overview in development of the diffusion, penetration, and uptake of health-related mobile technologies. A consideration of the roles and responsibilities of the diaspora in the embracing of information and communication technologies is emphasized. Key examples of mobile technologies in development to increase understanding and demonstrate promising practices in this emergent field are given.

Chapter VI: Nursing Documentation in a Mature EHR System

Kenric W. Hammond, VA Puget Sound Health Care System, USA
Charlene R. Weir, University of Utah, USA
Efthimis Efthimiadis, University of Washington Information School, USA Computerized patient care documentation (CPD) is a vital part of a Patient Care Information System (PCIS). Studying CPD in a well-established PCIS is useful because problems of system adoption and start-up do not interfere with observations. Factors interfering with optimal nursing use of CPD are particularly challenging and of great concern, given today’s shortage of nursing manpower. The chapter describes problems and advantages of CPD usage identified by nurses in a series of research interviews. It is shown that explicit consideration of nursing workflow constraints and communication processes is necessary for development of effective nursing documentation systems. Some findings point to a PCIS reconfiguration strategy that is feasible in the short term. Other findings suggest the value of considering mobile and team-oriented technologies in future versions of the PCIS.

Chapter VII: Nurses and Telehealth: Current Practice and Future Trends

Sisira Edirippulige, University of Queensland, Australia
Anthony C. Smith, University of Queensland, Australia
Mark Bensink, University of Queensland, Australia
Nigel Armfield, University of Queensland, Australia
Richard Wootton, University of Queensland, Australia Home telehealth, the use of information and communication technologies to deliver and support healthcare directly to the home, is emerging as an important application for nurses. This chapter provides an overview of home telehealth and how it may be applied to the practical challenges nurses face everyday. We provide a summary of the evidence available to support its use in specific areas and a guide for those thinking of implementing telehealth in their own practice. The future of home telehealth lies in carefully considered and designed research, ongoing education, and training and a multidisciplinary approach.

Chapter VIII: Successful Online Teaching and Learning Strategies

Mary D. Oriol, Loyola University New Orleans, USA
Gail Tumulty, Loyola University New Orleans, USA This chapter presents a theoretical framework and research base for the successful transition of an established Master of Science in Nursing program from that of traditional classroom delivery to one that is Web-based with no geographic limitations to students. The application of socio-technical systems theory to facilitate creation of a positive learning environment for future nurse leaders is described. Use of social processes and application of technology to optimize learning is explained and the latest research on content presentation and student engagement in an e-learning environment are presented. The chapter gives an understanding of the competencies necessary for students and faculty to be successful in online education.

Chapter IX: Shaping Funding Policy for Nursing Services

Virginia Plummer, Monash University, Australia Concerning nursing resource allocation health service executives have different views about whether systems based on ratios or those based on patient dependency are more accurate. This chapter reports on a statistical analysis of almost 2 million hours of nursing data provided by 22 acute care public and private hospitals in Australia, New Zealand and Thailand. To evaluate both ways an informatics system was used which has the capacity to simultaneously measure nurse patient ratios and nursing workloads by a dependency method of nursing hours per patient day. The results showed that it predicts actual direct nursing care requirements with greater accuracy than ratios for all hospital and patient types, facilitating better allocation of nursing resources and demonstrating that the cost of nursing care would be less for hospitals using that system than for ratios.

Chapter X: Simulations to Assess Medication Administration Systems

Elizabeth M. Borycki, University of Victoria, Canada
Andre W. Kushniruk, University of Victoria, Canada
Shigeki Kuwata, Tottori University Hospital, Japan
Hiromi Watanabe, Tottori University Hospital, Japan A range of new technologies/information systems are being implemented in clinical settings in order to reduce errors associated with the medication administration process. Simulation methods can be used to assess the impact of integrating new technology/information systems into the nurses’ work environment prior to full-scale implementation of a health technology/information system. Simulations as an evaluative tool emerged from a direct need to assess unintended and intended consequences of health information systems upon nurses’ work before systems are fully implemented. Nurse information use of simulations to assess and test health technologies/information systems will allow nurses to determine the impact of a new software and/or hardware upon aspects of nurses’ work before its implementation to allow for appropriate system modifications.

Chapter XI: Socio-Technical Structures, 4Ps and Hodges' model

Peter Jones, NHS Community Mental Health Nursing Older Adults, UK This chapter explores the potential of a conceptual framework – Hodges’ model – both as a socio-technical structure and means to explore such structures of relevance to nursing informatics theory and practice. The model can be applied universally by virtue of its structure and the content which it can encompass. In apprehending this chapter, readers will be able to draw, describe, and explain the scope of Hodges’ model within contemporary healthcare contexts and the wider global issues presented by the 21st century that influence and shape nursing informatics. Critically, the reader will also gain insight into how socio-technical structures can facilitate cross fertilization of clinical and informatics theory and practice; drawing attention to information as a concept that provides a bridge between socio-technical, clinical, and informatics disciplines. The paper will review the socio-technical literature and venture definitions of socio-technical structures related to Hodges’ model and advocate the need for sociopolitical-technical structures. This chapter also proposes the 4Ps as a tool to facilitate reflection upon and the construction of socio-technical structures. The adoption and significance of the hyphenated form as per “socio-technical” will also be explained.

Chapter XII: Strategies for Creating Virtual Learning Communities

Beth Perry Mahler, Athabasca University, Canada
Margaret Edwards, Athabasca University, Canada Teaching nursing online requires teachers to purposefully use strategies that facilitate the development of virtual learning communities. This chapter proposes answers to the question, “How can educators effectively teach the very social discipline of nursing in virtual classrooms?” Specific online teaching strategies including Photovoice, Virtual Reflective Centers, and Conceptual Quilting are explored. The social and socio-technical implications of teaching nursing online are considered. A final section in the chapter describes how these developments in online nursing education are changing the social and pedagogical perspectives of distance learning. Research questions that arise from this exploration are presented.

Chapter XIII: The Impact of Technology in Organizational Communication

Roberta Cuel, University of Trento, Italy
Roberta Ferrario, Laboratory for Applied Ontology (ISTC-CNR), Italy In this chapter a case study is presented, in which the ethnomethodological approach is used to analyze the impact of the implementation of an information system, called Sispes, on organizational communication processes in the residence for elderly Giovanelli (Italy). Sispes is a Web-based platform which sustains communication processes and knowledge management according to a customized workflow management system. Adopting structuration theories in the analysis of the case study, and taking inspiration from the philosophical tradition, especially in epistemology and in the analytic philosophy of law, an innovative perspective is adopted, which specifically acknowledges the role played by the communication processes in shaping both the attitudes of the involved actors and the social reality in which they are immersed. According to this perspective, three types of communication processes are presented, namely the normative, descriptive and constructive approach. These latter are then applied to a concrete case study.

Chapter XIV: The Roles of a Nurse in Telemedical Consultations

Boris A. Kobrinsky, Moscow Research Institute for Paediatrics and Children’s Surgery, Russia
Nikolay V. Matveev, Moscow Research Institute for Paediatrics and Children’s Surgery, Russia Telemedicine, or distant medical consultations using communication via electronic networks, is gradually becoming a standard of medical care delivery in distant areas worldwide, including both the most developed and the developing countries. For instance, in 2007 telemedical centres existed in 55% of the Russian regions (on average, about 4 centres in each region). In most of the cases, nurses are actively involved into organization of various types of distant consultation. Main types of telemedical services include: (1) emergency consultations of patients by telephone (2) telemedical consultations using videoconferences or store-and-forward systems and (3) home telecare systems. Possible roles of nurses in different types of telemedical consultations are discussed.

Chapter XV: The Role of EBM and Nursing Informatics in Rural Australia

Daniel Carbone, University of Melbourne, Australia The purpose of this chapter is to discuss broadly the need for enhanced evidence-based medicine (EBM) by nurses in the context of rural Australia and the role that nursing informatics and an informed strategy could facilitate in making such need a feasible reality. First, the introduction highlights current time gaps between health discoveries and eventual practice and the potential for information technology to positively affect this gap. Then, the need for nurses to take an active role in evidence-based medicine in rural settings is argued. The link between information literacy and evidence medicine is consequently presented and gaps in knowledge regarding nursing informatics training are highlighted. Concluding with the argument that to achieve evidence-based research and eventual use, there needs to be a purposeful health informatics learning strategy that recognises the role of computer and information literacy.

Chapter XVI: Use of Handheld Computers in Nursing Education

Maureen Farrell, University of Ballarat, and RMIT University, Australia The use of mobile technologies in nursing education is rapidly increasing. Handheld computers are the most frequently used of these technologies as they can provide students with information for point of care clinical reference, such as diagnostics, medical terminology, and drug references. Integrating the management and processing of information into clinical practice is an effective learning approach for students and reflects a changing paradigm in nursing education. Traditionally, nursing programs have the tendency to separate the acquisition of academic knowledge from clinical practice, and the process of integrating academic information into the decision-making processes in the clinical area has been difficult for student nurses. This chapter will provide an overview of the use of handheld computers in nursing and medical education, including a brief synopsis of current use in clinical practice. It will discuss the advantages and disadvantages of their use, barriers to implementation and future directions.

Chapter XVII: Using Information Technology in Nursing Education

Elizabeth Rogerson,University of Dundee, UK
Linda Martindale, University of Maryland School of Nursing, USA
Carolyn Waltz, University of Maryland School of Nursing, USA This chapter addresses issues relating to nursing informatics as used and applied in nursing education. This includes the use of information technology (IT) in delivering nursing education, as well as the teaching of IT and informatics skills to prepare nurses for practice. Drivers associated with the development and use of IT in nursing education are discussed, as well as current use of IT in nursing education and practice, including both mainstream and emerging technologies. Lastly some key issues for the future are identified. Internationalism is regarded as a consistent theme in IT development and occurs as a recurring thread throughout this chapter.

Fragmentation in Nursing ...

Jarrin, Olga F., "An Integral Philosophy and Definition of Nursing: Implications for a Unifying Meta-Theory of Nursing" (2006). School of Nursing Scholarly Works. 46.
https://opencommons.uconn.edu/son_articles/46

 - begins (page 2):

"From the frame of reference of mainstream thinking, a major issue in
nursing is our failure to achieve unity. ... From a feminist perspective,
the real issue involves divisiveness and fragmentation that sustains
oppressive relations in an industrialized, patriarchal medical system.
Remaining divided from one another serves the interests of the
dominant group. Rather than benefiting us, fragmentation in nursing
serves to confuse us, to keep our minds and hearts focused on the
dominant system for solutions that never materialize."

~ Peggy L. Chinn¹

 

"Fragmentation within the profession of nursing is still a pressing concern fueled by differences in educational preparation, specialization, disparities in working conditions, divergent worldviews, and, where I hope this paper will make a difference, a lack of a basic nursing theory that is easily understood. The following pages will lay the philosophical and theoretical foundation for a unifying meta-theory of nursing, which retains all the diversity of nursing while providing common ground for communication, both within our profession, and for better articulation of our work to other professions and the general public. The contemporary philosophical and epistemological grounding of nursing in systems theory is challenged, but not rejected, in this new vision for unification and growth of nursing as a discipline and a profession."

Previously on W2tQ:

https://hodges-model.blogspot.com/search?q=wilber

Publication list - Peter Jones

Previously, I used to maintain a publications list, one that runs from the year 'dot' (ego eh!). The bibliography in the blog's sidebar serves this purpose, also being (much) enriched by other papers that use/cite Hodges' model. 

I decided to revisit the exercise. Successful at interview late in 2019, for a part-time (variable hours) tutoring role, no teaching opportunities followed as COVID intervened.

Invited now to f/w an updated CV and covering letter, I realise that apart from several recent papers I did not include a 'comprehensive' list - as I'm sure is the custom in academe; no doubt listings with many more entries. Here's the list:

Publications by Peter Jones (#1-4 software; #37 website; #40 this blog)

1. 1982 CAPA: COMPUTER AIDED PATIENT ASSESSMENT, Sinclair ZX81, advertised in Nursing Mirror (see below) provided on audio cassette tape.
2. 1983 THE NURSING PROCESS – Computer Aided Learning program, BBC Micro, published by Open Software Limited (OSL)
3. 1984 HAEM. Blood Groups Computer Aided Learning program, BBC Micro – (OSL). (see below)
4. c.1989 SHADES OF GREY, Computer Aided Learning program, BBC Micro. Simulation of nuclear weapons, Based on Fanchi, J. Local effects of nuclear weapons, BYTE, Volume 11. Issue 13. Dec., pp. 143–155. Computer Aided Learning program, BBC Micro, published by Open Software Limited. (see below).
5. Jones, P. (1986) Computing in Nursing NEWS. Computerised Patient Assessment. Nursing Times. 85: 5. Sep 3-9;82(36):63-5. PMID: 3532039 (Describes 'CAPA', a BBC microcomputer program for student nurses.)
6. Jones P. 1988 Thunderbirds are Go? (Impact of technology in society, disasters, macro-engineering). Popular Computing Weekly.
7. Jones, P. 1989 Modems are Cheap, it's the phone bills that hurt. Popular Computing Weekly.
8. Jones, P. (1989) Computers in Nursing NEWS. Creating a Program. Nursing Times. Feb 1-7;85(5):66-8. PMID: 2648342 (Describes 'HAEM', a BBC microcomputer program for student nurses on blood and blood groups.)
9. Jones, P. (1989) Information Technology is Good For You! (Effects of information technology) IT in Nursing, BCS-Nurs. Specialist Group. 1,1
10. Jones, P. (1990) Creating a Community Mental Health IS (Creation of a community mental health resource centre - a multidisciplinary research project). IT in Nursing and Paper at BCS NSG Conference. 2,4
11. Jones, P., Beckingham, D. (1991) The Ins and Outs of a small mental health Information System. Healthcare Computing 91 Conference Paper.
12. Jones, P. (1992) Nursing: All in the mind and machine? (Models of nursing and computing). British Computer Society -Nursing Specialist Group Conference Paper
13. Jones, P., Beckingham, D. (1992) Community Mental Health: IT in the Buffer Zone. Healthcare Computing 92 Conference (Poster).
14. Jones, P. (1993) Computerised Models of Nursing. (Data types in nursing - opportunities and problems). Healthcare Computing 93 Conference Paper.
15. Jones, P. (1993) Using a Semantic Network to Represent Nursing Terminology (project for B.A. (Joint Hons. Computing / Philosophy). Supervisor J Kirby - Medical Informatics Group. University of Manchester). BCS-NSG Conference Paper.
16. Jones, P. (1993) Nursing: All in the mind (and machine?). IT in Nursing, 5,4.
17. Jones, P. (1994) An Enthusiast's View of CAL. (Problems in production of CAL - Simulation effects of Nuclear Weapons - conversion of GWBASIC to BBC BASIC from BYTE - with original author's permission - J Fanchi). IT in Nursing. 6,2.
18. Jones, P. (1994) IT with Records in Mind (Mental Health CPA and Record types - idealised, cognitive, CBR, Distributed), IT in Nursing. 6,4.
19. Jones, P. (1996) Humans, Information, and Science, Journal of Advanced Nursing, 24(3),591-598.
20. Jones, P. (1996) An overarching theory of health communication? Health Informatics Journal,2,1,28-34.
21. Jones, P. (1996) Nursing Technology and Elephants - Part 1: Technology as a beast of burden. IT in Nursing. 8,1,4-6.
22. Jones, P. (1996) Nursing Technology and Elephants - Part 2: Technology as a serpent. IT in Nursing. 8,2,5-7.
23. Jones, P. (1996) Nursing Technology and Elephants - Part 3: Technology rope to save humanity and health care, IT in Nursing. 8,3,5-7.
24. Jones, P. (1997) Providing Mental Health Care: Getting A Purchase On Information. IT in Nursing. 9,3.
25. Jones, P. (1997) IT: The ubiquitous Research Tool (The use of IT in research - to access; transform; transcribe and disseminate information). IT in Nursing. 9,4.
26. Jones, P. (1999) Visualization in Nursing: Workshop report, IT in Nursing, 11.1.
27. Jones, P. (1999) It's time to master the latest tools and Hodges' Health Career Model, IT in Nursing, 11.2.
28. Jones, P. (2004) Viewpoint: Can informatics and holistic multidisciplinary care be harmonised? British Journal of Healthcare Computing & Information Management, 21, 6, 17-18.
29. Jones, P. (2004) The Four Care Domains: Situations Worthy of Research. Conference: Building & Bridging Community Networks: Knowledge, Innovation & Diversity through Communication, Brighton, UK.
30. 2005. Bursary Award Poster: Introduction and Scope of H2CM. HC2005: Harrogate. With thanks to the BCS Health Informatics Forum and my manager(s).
31. 2005. Mental health and geography: questions and issues for a mental health trust organised using Hodges' four care domains GEOMED 2005. Cambridge – Poster.
32. Jones, P. (2008) Exploring Serres’ Atlas, Hodges’ Knowledge Domains and the Fusion of Informatics and Cultural Horizons, IN Kidd, T., Chen, I. (Eds.) Social Information Technology Connecting Society and Cultural Issues, Idea Group Publishing, Inc. Chap. 7, pp. 96-109.
33. Jones, P. (2009) Socio-Technical Structures, the Scope of Informatics and Hodges’ model, IN, Staudinger, R., Ostermann, H., Bettina Staudinger, B. (Eds.), Handbook of Research in Nursing Informatics and Socio-Technical Structures, Idea Group Publishing, Inc. Chap. 11, pp. 160-174.
34. Jones, P. (2012). Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model. The Journal Of Community Informatics. 8(3). Retrieved from https://openjournals.uwaterloo.ca/index.php/JoCI/article/view/3034
35. 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. 20, 7, 631-640. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2012.01961.x/abstract
36. Jones P. (2014) Using a conceptual framework to explore the dimensions of recovery and their relationship to service user choice and self-determination. International Journal of Person Centered Medicine. Vol 3, No 4, (2013) pp.305-311.
37. 1998-2015 Website devoted to Hodges' model p-jones.demon.co.uk Now on web.archive.org:  https://web.archive.org/web/19990501185433/http://www.p-jones.demon.co.uk/index.htm
38. Jones P. Exploring the relationship of threshold concepts and Hodges’ model of care from the individual to populations and global health. Rev Cuid. 2017; 8(3): 1697-720. http://dx.doi.org/10.15649/cuidarte.v8i3.464
39. Jones P, Wirnitzer K. Hodges’ model: the Sustainable Development Goals and public health – universal health coverage demands a universal framework. BMJ Nutrition, Prevention & Health 2022;0:e000254. doi:10.1136/bmjnph-2021-000254
40. 2006- Ongoing This blog - Welcome to the QUAD.

Ngrams: E-portfolios, nursing theory, models of nursing...: Do the lines run true?

For the latest module I'm looking at e-portfolios in nursing education and possibly wider afield. In the FT Weekend Life & Arts there is an extract -

Capitalism’s secret love affair with bureaucracy

- from David Graeber’s book: The Utopia of Rules: On Technology, Stupidity, and the Secret Joys of Bureaucracy published this week on March 12. It includes a graph from Google Books Ngram a word count through time of 'bureaucracy'. I'd read about Ngrams and tried them quite some time ago, but never used them. Now's my chance.

The graph below began with e-portfolio and eportfolio. I tried nursing e-portfolio... but these were not found. With conceptual framework the scale was disrupted. Adding models of nursing and nursing theory provided a frame that also nicely encompasses, at least in this rendering, conceptual space and threshold concepts.

At the risk of asking too much of the graph if not the source, we might be disappointed that models of nursing is not running concurrent with e-portfolio and reassured that nursing theory has waned but is 'still up there'. This is to forget though that the count for e-portfolio here is general not nursing specific.

Ngrams are another tool and a dynamic one no doubt, when the API is utilised, the data downloaded and words are re-examined over time. In answer to the title's question, I do not believe the lines do run true but this is about nursing and e-portfolios.

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

 INDIVIDUAL
|

 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.

Notes (IV) for a 2010 introduction to the Health Career Model

... Influences past, present and future

The above [development, definitions] can be explained more coherently by reflecting on events and influences at the time when Brian Hodges first created the model commuting between Manchester and his home in Sheffield in the NW England. We can compare and contrast the situation from 1983-84 and so highlight:

• models of nursing
• the nursing process
• individualised care (through the nursing process)
• mind mapping

Models of nursing and nursing theory are still there on nursing curricula. Students still write the essays in their first year (as I learned this week), but their importance on many nursing courses - be that foundation, the adult, paediatric, learning disability or mental health branches; or post-graduate is diminished. This does not mean to the extent that they are no longer worthy of Masters dissertations and Doctorates, but the academic agenda and theoretical emphasi*, found in the curricula, practice and management have however moved on. The nursing process is now transparent, it is embedded into theory and practice in the form of paper (the nursing Kardex) and electronic record formats. What is interesting is that individualised, or personalised care remains a challenge to achieve and measure. The final item listed above - mind mapping - is in many respects coincidental, but was concurrent and of great importance for Hodges' model, informatics and the social sciences. For decades before Hodges' model was created the potential of diagrammatic forms and representation as an educational and learning tool was recognised and championed in several quarters notably in the 1970s by Buzan and others.

So, in 2010 we can identify needs - both old and new - to account for #:

• person-centred care
• public engagement
• preventive health programs (NHS = 'ill NHS')
• public health and public mental health (in which mental health is still 'lost')
• global health and nursing's role in achieving the aspirations of health for all (bridging other divides - local - global: glocal)
• information technology - various schools of informatics
• self-care
• demographic trends
• economics and care delivery / commissioning models
• information and visual literacy

In addition to knowledge, in light of the above, we can also add information as a key concept to help explain Hodges' model. The website in updates after 1998 attempted to introduce information as a concept that can conjoin Hodges' model, health and social care (nursing) and informatics (in particular the socio-technical). Of the original purposes the statement concerning bridging the theory - practice gap is too general to inform this introduction. ...

* emphasi = neologism: it just sounds right?
# At the same time - is that possible?

(Notes V to follow)

[These are notes. If you have any thoughts, views on a new introduction to the model please get in touch:
h2cmng @ yahoo.co.uk What do you feel needs to be explained? Which audience should be addressed in the first instance? What assumptions can be made? ....? Many thanks PJ ]

Notes I intro for 2010

Notes II intro for 2010

Notes III intro for 2010

Nursing theory - conceptual spaces: Where's my T-shirt?

Tripp-Reimer's 1996 paper The Dimensional Structure of Nursing Interventions has been sitting in my dsw - 'do something with' - pile for ages. Now reading Gardenfors I came across multidimensional scaling and realised that Tripp-Reimer et al. have also been there done that. They have been wearing the T-shirt for well over a decade.

Their paper begins with the evolution of nursing’s substantive structures and the emergence through the late 1960s to the early 1980s of a plethora of conceptual models (including - but not mentioned Hodges’ model). According to Tripp-Reimer these models while clearly possessed of nursing credentials, they were not always produced as combined research and practice tools. They argue that this failure may have contributed to the rise of the metaparadigm of nursing, with the effect that:

‘At best, the metaparadigm myth provided a rationale and mechanism for the discipline to displace (transcend) the conceptual models.’ p.11.

Ah! So that would account for why Hodges' model (and other global conceptual frameworks) have languished in the lay-bye!

‘Currently, nursing conceptual models have limited utility beyond their historical importance. That utility is derived from the structures they can provide for nursing education programs. Analogously, they also provide a framework that is useful for beginning nurses, assisting them in cognitively framing a clinical situation. These models provide a map, stimulating the new nurse in a clinically familiar space.’ p.15.

The paper goes on to contrast the way these models are used a-consciously by experts. I would suggest that there is a problem in nursing theory; or if not so severe as to be deemed a 'problem' then a tension at least. Educationalists (theorists) will rightly justify the case for nursing to be defined and boundaries set; otherwise, curricula will not support delivery of the desired learning experience, would lack focus and integrity in terms of evaluation of content and professional credibility. Socio-politically professional groups need a sense of (group) identity. The intention to develop models – theories in order to delineate nursing and establish professional identity is, however, at odds with the practice objectives of holistic and (interdisciplinary) integrated health and social care. Nurses need conceptual models and spaces that extend - from the outset - beyond the clinical situation.

It is the unfamiliar spaces (patient, carer, community... occupied) that we must seek or at least be able to account for in assessment, planning, interventions, evaluation (research) and information governance. Clinical situations should certainly be familiar within the bounds (latitude) of the curricula and including the match between what is taught and practical experience (practicum).

Health and social care, education and policy are constantly changing. Amid the rapid pace of T-shirt slogan turnover tools such as Hodges’ model retain their relevance for experts and beginners alike.

Tripp-Reimer, T., Woodworth, G., McCloskey, J.C., Bulechek, G. (1996). The dimensional structure of nursing interventions. Nursing Research; 45(1):pp.10-17.

T-shirt image source Copyright © 2001 - 2008 The CELDirect Group

ICN Congress in Australia 2013: a symposium - you, me and another nursing colleague?

I posted previously about the aspiration of visiting Australia and presenting at the International Council of Nursing 25th Quadrennial Congress next May.


Instead of opting for a 15 minute concurrent session I am wondering about the possibility of collaborating with two other speakers to prepare a symposium session of 80 minutes. Copied below is a *draft* abstract that could be adapted to include and reflect other speaker’s motivations and interests. The word limit is 250 including title and author details. It would be marvellous not only to present h2cm at the ICN, but sharing the challenge to produce a presentation that is coherent and informs nursing theory and practice today and tomorrow.

The deadline for abstracts is 14th September so if this is going to happen it needs to be very soon; otherwise I will submit an abstract for a 15 minute session.

If you are interested please get in touch. There may be points I have missed, for example I plan on staying for three weeks. If you have a place I can stay with a teaching opportunity I'd be very grateful for your support and the teaching/learning opportunity. Please spread the word...

I know this approach is unorthodox, but this is 2012. If this does not happen next year there may be other opportunities. Thanks for listening...

Draft abstract:

A global health care model for the challenges of twenty-first century care and self-efficacy

You?, me & presenter three?

Nursing is a discipline and profession with global aspirations in terms of supporting health for all. Professional recognition of nursing has in part been gained through the development of nursing theory and models of nursing. This presentation argues the need for a global, generic conceptual framework that has relevance for all nurses and citizens. While there is a marked variation - often for good reason - in nursing curricula having a common framework can provide a foundational standard, a conceptual basis for nursing that can serve as a common currency for dialogue.

Hodges' model, a conceptual framework created in the mid 1980s is the focus. This symposium is presented in three parts. Firstly, the characteristics of the model including its structure, content and original purposes are explained. Secondly, the model is demonstrated by mapping the themes of this congress. This exercise utilises the model’s knowledge domains, namely sciences, sociology, politics, interpersonal and spiritual. Finally, a critique is provided. As I seek to listen to patients, why should you listen? What does a 1980s model of nursing offer to professionals in the 20th century? Where do the values of nursing reside in what is yet another model of care, and how can this model affirm the positive aspects of nursing, global health care, well-being and self efficacy? What directions are there for further research? Additional resources will be signposted.

Image source: http://www.ausbird.com/