Tuesday, January 12, 2010

'situated' in Hodges' model #1

I'm not exactly sure how many times I've cut and pasted the paragraphs that introduce Hodges' model as person-centered and situated. Quite a few!

Thanks to the HIFA-2015 list I realised last week that there is no tag for 'situated' on W2tQ. Well, this post corrects that omission, but what does situated mean in Hodges' model?

Here is a definition c/o Google:
  • situated/s'ɪtʃueɪtɪd/
    Synonyms:
    • If something is situated in a particular place or position, it is in that place or position. ADJ adv ADJ v-link ADJ prep
      ...
Related phrases
  • If you situate something such as an idea or fact in a particular context, you relate it to that context, especially in order to understand it better.
    ...
Hodges' model is based on the belief that health and social care are multicontextual. Without wishing to substitute one term for another context and situation are inter-related and bear closer examination here on W2tQ.

Hodges' model prompts the user to consider that the person (-at-the-center) of care is simultaneously residing within four primary situations or contexts (five - if we include the spiritual aspects). Veterans and new recruits appreciate from the dizzy heights of the model, how quickly we find complexity in the multiple contexts that exist in health and social care. The many perspectives and views that must be taken into account to achieve safe, integrated and holistic care. Together with the above there are other definitions of relevance to scholars, champions and users of Hodges' model:
located: situated in a particular spot or position; "valuable centrally located urban land"; "strategically placed artillery"; "a house set on a ...
wordnetweb.princeton.edu/perl/webwn

In artificial intelligence and cognitive science, the term situated refers to an agent which is embedded in an environment. ...
en.wikipedia.org/wiki/Situated

Located in a specific place; Supplied with money or means
en.wiktionary.org/wiki/situated
The first definition about location is important as Hodges' model puts the person at the center. It is from there that the care domains are considered in turn and revisited as required. Hodges' model provides a locus around which care activities can be placed. Usually we view self-centeredness in a pejorative way. When you think about it though this is precisely what is needed to achieve person-centered care. In this case we need something that constantly re-centers - reorientates the subject(s) and agent(s) of care.

The second definition which looks to A.I. for inspiration is relevant as the concept of embodiment, embeddedness already has academic form* as a means to explore self-centeredness. Not only is the individual embedded in a (the) situation, but the carer (formal - informal) must also reside there and share to an extent the experience, if empathy, rapport and communication are to arise.

That final definition can be utilised due to the inclusion of means. People have skills, strengths and coping strategies and this sense of situated rings very true at present, with the emphasis on recovery, staying well, relapse prevention and adjusting to what may be permanent change. People also need knowledge as a means to maximise their health and well-being, which takes me back where I started with Health Information for All by 2015.

So, amid all the complexity, over-arching infrastructures, policies,
debate (and definitions!) it is refreshing that as I revel in the
scope of Hodges' model - two axes, four domains,
its holistic bandwidth... I can find the
word 'situated' planted
firmly
at the model's
center.


* Ref:
Paley, J. (2004) Clinical cognition and embodiment, International Journal of Nursing Studies, Volume 41, Issue 1, Pages 1-13.

Image source - with thanks: Ariel Bravy - http://www.arielbravy.com/photoblog/
http://www.arielbravy.com/photoblog/images/20060719214447_glenn%20x%20millenium%20park.jpg