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PubMed2004

Deaf children's use of beliefs and desires in negotiation.

Although several studies have shown that deaf children demonstrated impaired performances on false-belief tasks, the children's belief understanding appeared intact when asked to explain emotions or behavior. However, this finding does not necessarily indicate a full-fledged theory of mind. This study aimed to investigate deaf children's negotiation strategies in false-belief situations, because situations that require negotiation provide a natural context with a clear motivational aspect, which might appeal more strongly to deaf children's false-belief reasoning capacities. The purpose of this study was to compare the reactions of 11- to 12-year-old deaf and hearing children to scenarios in which a mother, who is unaware of a change in the situation, threatens to block the fulfillment of the child's desire. The results showed that deaf children more often failed to correct the mother's false beliefs. In contrast with hearing children, who frequently left their own desires implicit, deaf children kept stressing their desires as a primary argument, even though the mother could be expected to be fully aware of these desires. Moral claims were used to the same extent by both groups. In general, deaf children more often used arguments that did not provide new information for their conversation partners, including repetitions of the same argument. The results were interpreted in terms of the special needs that are required by the hampered communication between deaf and hearing people as well as in terms of the ongoing discussion regarding theory-of-mind development in deaf children.

Case-Control Studies↗

PubMed1999

Negotiating and contracting in a managed care environment: considerations for practitioners.

The world of integrated service provider networks, managed care providers, and preferred provider systems requires clinical social workers to become skilled in business negotiations, with specific attention to contracting for services. This article focuses on the components of negotiating and successfully competing for contracts to gain access to and participate in provider networks for the delivery of mental health services. The authors identify critical elements involved in contracting for services from the perspective of social work practitioners who are now working with or who plan to work with managed care organizations. This pragmatic approach recognizes the controversial nature of social workers' relationship with managed care organizations and the ethical dilemmas that affect both the quality and quantity of client services.

Contract Services↗

PubMed1998

Diagnosing developmental problems in children: parents and professionals negotiate bad news.

OBJECTIVE: To examine how parents and professionals engage in a process of negotiation over what labels to use and what developmental meaning to ascribe to those labels when imparting a diagnosis of mental disability to parents of young children. METHOD: We performed a sociolinguistic analysis of 10 feedback sessions with parents whose children had been diagnosed by a clinical team as developmentally disabled. RESULTS: Professionals shied away from explicit use of labels; they preferred to describe children's deficits with rate descriptors (e.g., "slow"). Parties to the sessions see-sawed between optimistic and pessimistic statements. That is, when parents seemed despairing, professionals would try to hold out hope; when parents were unrealistic, professionals gave more blunt statements. Parents who received the most ambiguous interpretations seemed left with diagnostic questions still unanswered; those who received more forthright information appeared better able to move on to issues of prognosis. CONCLUSIONS: Diagnoses of developmental disabilities are jointly constructed by parents and professionals. We recommend larger and more controlled studies on the relationship between negotiation and labeling in diagnostic feedback interviews and the impact of these processes on parental satisfaction and adaptation.

Child, Preschool↗

PubMed2005

Moving up: successful negotiation for the position of academic chair.

This article was written for the Academic Affairs Committee to help candidates for physical medicine and rehabilitation chair positions to effectively negotiate the new position. The article summarizes negotiation strategies provided from personal interviews and other communication via e-mail and phone with experienced physical medicine and rehabilitation chairpersons.

Academic Medical Centers↗

PubMed2006

Factors associated with self-efficacy for condom use and sexual negotiation among South african youth.

OBJECTIVES: To use logistic regression modeling to identify factors associated with high self-efficacy for sexual negotiation and condom use in a sample of South African youth. METHODS: The Reproductive Health and HIV Research Unit (RHRU) National Youth Survey examined a nationally representative sample of 7409 sexually active South African youth aged 15 to 24 years. We used logistic regression modeling in this sample to identify factors associated with the main outcome of high self-efficacy. RESULTS: Among female respondents (n = 3890), factors associated with high self-efficacy in the adjusted model were knowing how to avoid HIV (odds ratio [OR] = 2.30, 95% confidence interval [CI]: 1.05 to 5.00), having spoken with someone other than a parent or guardian about HIV/AIDS (OR = 1.46, 95% CI: 1.01 to 2.10), and having life goals (OR = 1.28, 95% CI: 1.10 to 1.48). Not using condoms during their first sexual encounter (OR = 0.61, 95% CI: 0.50 to 0.76), a history of unwanted sex (OR = 0.66, 95% CI: 0.51 to 0.86), and believing that condom use implies distrust in one's partner (OR = 0.57, 95% CI: 0.51 to 0.86) were factors associated with low self-efficacy among female respondents. Male respondents (n = 3519) with high self-efficacy were more likely to take HIV seriously (OR = 4.03, 95% CI: 1.55 to 10.52), to believe they are not at risk for HIV (OR = 1.38, 95% CI: 1.12 to 1.70), to report that getting condoms is easy (OR = 1.85, 95% CI: 1.23 to 2.77), and to have life goals (OR = 1.30, 95% CI: 1.10 to 1.54). Not using condoms during their first sexual experience (OR = 0.51, 95% CI: 0.39 to 0.67), a history of having unwanted sex (OR = 0.47, 95% CI: 0.34 to 0.64), believing condom use is a sign of not trusting one's partner (OR = 0.63, 95% CI: 0.46 to 0.87), and refusing to be friends with HIV-infected persons (OR = 0.52, 95% CI: 0.32 to 0.85) were factors associated with low self-efficacy among male respondents in the fully adjusted model. CONCLUSIONS: We used the social cognitive model (SCM) to identify factors associated with self-efficacy for condom use and sexual negotiation. Many of these factors are modifiable and suggest potential ways to improve self-efficacy and reduce HIV sexual risk behavior in South African youth.

Adolescent↗

PubMed1998

Individuation, ego development and the quality of conflict negotiation in the family of adolescent girls.

Individuation, ego development and family negotiation of conflict were studied in 27 Norwegian families with an adolescent daughter, 16-19 years, drawn from a larger sample to represent a rectangular distribution of ego development. Individuality and Connectedness (individuation) as conceptualized and scored by Condon et al. (1984) was modified and adapted to a Norwegian material. Four factors were extracted, one related to individuality (self-assertion and separateness) and two to connectedness (clarification and acceptance). Ego development, measured by the Washington University Sentence Completion Test (Loevinger & Wessler, 1970) was related to connectedness between mother and daughter and between father and daughter, but not to individuality. Maturity of conflict negotiation was positively related to connectedness between mother and daughter and negatively to individuality between father and daughter. It was argued that for women, individuality may not be a singular goal in ego development or in individuation and that self-other differentiation of identity and interests may develop within a close relationship and not only through separation.

Adolescent↗

PubMed1994

Nurse-patient negotiation: assumption or reality?

The current socio-political philosophy in the United Kingdom promotes the belief that consumers of health care should exercise choice and express opinions about the care they receive. This view challenges the traditional paternalistic approach to health care which espoused that 'the professional knows best'. In association with general socio-political trends, nursing is undergoing radical reform. The nursing literature widely promotes the importance of a nurse-patient relationship which fosters the involvement of the patient in negotiation and decision-making regarding his care. Nurses who advocate individualized, holistic care must hold such an ideology as a central tenet to their philosophy. However, it is questionable whether this philosophy is widely expressed in the reality of clinical practice. There is also an absence of empirical evidence to support the assumption that patients wish to participate in decision-making. This paper critically reviews some of the debate centred around the concept of nurse-patient negotiation. It is suggested that the issues are complex and that there remains a need for further research which takes into account multiple factors, including the social and organization context of nursing care.

Choice Behavior↗

PubMed2006

Negotiating improved case management of childhood illness with formal and informal private practitioners in Uganda.

OBJECTIVE: In Uganda, formal and informal private practitioners (PPs) provide most case management for childhood illness. This paper describes the impact of negotiation sessions, an intervention to improve the quality of PPs' case management of childhood diarrhoea, acute respiratory infection and malaria in a rural district in Uganda. METHOD: Negotiation sessions targeted PPs working at private clinics and drug shops. The aim was to improve key practices extracted from the national Integrated Management of Childhood Illness Guidelines, and to measure the PPs' performance before and after the intervention. RESULTS: Post-intervention the quality of case management for childhood diarrhoea, acute respiratory infection and malaria was generally better, although certain practices appeared resistant to change. We discovered various types of PPs who were mostly unregistered by the district authorities. CONCLUSIONS: Results suggest the importance of maintaining ongoing monitoring and support to PPs to understand barriers to change and to encourage more practice improvement. Modifications to the intervention are needed to take it to scale and render it more sustainable. Getting local organizations and professional associations more involved could make it easier to establish and maintain contact with PPs. The government needs to simplify registration procedures and reduce associated fees to encourage PPs to register and thus be included in a large-scale intervention. Future interventions need to measure the impact on improving childhood case management at the community/household level.

Acute Disease↗

PubMed2000

The role of couple negotiation in unmet need for contraception and the decision to stop childbearing in Uganda.

This study uses survey and focus-group data from the 1995-96 Negotiating Reproductive Outcomes study in Uganda to describe the nature of the decision to stop childbearing and to question the simplifying assumption of consensus decision-making implicit in much demographic research on unmet need. Negotiation is characterized in four stages, from normative precedent for decision-making to communication, disagreement, and conflict resolution. Indirect forms of communication between partners predominate, contributing to the tendency of both men and women to overestimate each other's demand for additional children. Partner opposition is found to cause a statistically significant increase in unmet need reported by women and a shift in contraceptive mix favoring use of traditional methods over modern methods. For women, partner opposition may account for as much as 20 percent of unmet need in urban areas, 12 percent in rural areas, and 15 percent overall.

Adult↗

PubMed2004

Moving beyond the blame game: toward a discursive approach to negotiating conflict within couple relationships.

The concept of discourse is an important tool in negotiating conflict and facilitating conversations within therapy. This article offers a useful framework for negotiating conflict in a couple relationship by highlighting the manner in which individual's expectations are mutually emergent from particular discursive positions. Specific discursive practices and approaches that make more visible the cultural production of conflicts are presented via a case illustration. These practices provide more freedom to couples in relationships to explore conflicts with less totalizing descriptions of the other as blameworthy. In addition, a discursive analysis of conflict invites therapists to be more intentional, reflexive, and socially responsible in their work.

Adult↗

PubMed1996

Negotiating skills.

The Collins English Dictionary defines negotiation as "a discussion set up or intended to produce a "settlement or agreement." It is a skill everyone uses on a regular basis in daily life; often without realising. A plan to meet friends fo an evening meal for example involves agreeing a time and venue--this is negotiation. As it is the the process of coming to terms with the "other side" and trying to get the best deal possible it is necessary to accept the fact that a conflict of interest does exist. There is an atmosphere of uncertainty until the deal is completed and one side may gain and one may lose relative to their opening position. For this skill to be successfully applied when working with clinical management colleagues, a formal set of guidelines is necessary. In this article I highlight some of the problems which can arise and offer a systematic approach to this difficult but rewarding management activity.

Humans↗

PubMed2005

Moments in time: metacognition, trust, and outcomes in dyadic negotiations.

This research tested the relationships between turning points, cognitive and affective trust, and negotiation outcomes. After completing a simulated negotiation, participants identified turning points from videotape. Turning points were then classified as substantive (interest, offer), characterization (positive, negative), or procedural (positive, negative). Prenegotiation affective trust predicted subsequent turning points, whereas prenegotiation cognitive trust did not, suggesting that different cues influence the two types of trust. Postnegotiation cognitive trust was increased by the occurrence of interest, positive characterization, and positive procedural turning points and decreased by negative characterization turning points. Affective trust was increased by positive procedural turning points. Finally, interest turning points resulted in higher joint outcomes, whereas negative characterization turning points resulted in lower joint outcomes. We conclude that there are two paths to building trust and increasing joint gain, one through insight and one through signaling good faith intentions.

Adult↗

PubMed2003

Intercultural health care as reflective negotiated practice.

This interpretive study sought to understand how intercultural health care to immigrants can be practically conceptualized in multicultural populations. Interviews were conducted with 20 Canadian health service informants, and 12 interviews were staged during 31 months with a multicultural coordinator in an Australian teaching hospital. Transcripts of 11 previously conducted group discussions with 34 staff members from this same Australian hospital were also included. Interpretation was based on these data as well as on the literature and the author's own experience. It was concluded that intercultural health care can be practically conceptualized as reflective health worker practice. Through this practice, responsive care can be situationally negotiated between the health worker and the client in a framework of jointly considered needs. For implementation, the barriers to negotiation must be addressed.

Adult↗

PubMed2005

Naming oneself criminal: gender difference in offenders' identity negotiation.

This qualitative research examines gender differences in offenders'ability to negotiate a positive identity once the pejorative labels of criminal, prostitute, drug dealer, and incompetent parents have been imputed onto them. In-depth semi-structured focused interviews were conducted with a purposeful information-rich sample of eight male and eight female offenders. Content analysis reveals that males were much more adept than female offenders at juggling with conventional and street norms to justify and/or resist stigmatizing labels in order to construct a favorable identity. Appeal to such personal strengths as know-how, competence, loyalty, and a code of honor allowed male offenders to challenge the boundaries between conventional and delinquent worlds. Concomitantly such an appeal gave rise to a sense of efficacy perception and an optimistic explanatory style. In contrast, even though female offenders were able to justify the labels of drug dealer, prostitute, and thief by appeal to higher loyalties and reject that of insane, all their justifications collapsed when having to negotiate the identity of incompetent mother. Female offenders' negative internal attributions and deprivation of the normative center-motherhood resulted in apathy, anomie, and lack of confidence in their ability to do something worthwhile. Rehabilitation guidelines would build female offenders' personal strengths while redirecting those exhibited by male offenders into lawful enterprises.

Adult↗

PubMed2005

Older stroke patients' negotiations within the hierarchic medical context.

A stroke can affect a person's whole being and make him or her feel helpless and insecure. In this study, the authors aimed to analyze from a gender perspective how elderly women and men responded to treatment and care after stroke in the acute care setting. They used a strategic selection procedure in this qualitative follow-up interview study, in which 7 women and 5 men aged 75 to 83 participated. Personal interviews were performed, tape-recorded, transcribed verbatim, and analyzed in accordance with grounded theory. In the hierarchic medical context, the participants used four kinds of negotiations. These negotiations were either resistant (striving for autonomy and criticizing the care) or adjustive (following the rules and building alliances) to the hierarchic structure. The authors discuss how the concepts of power from above versus power from below can be applied in the hierarchic medical context.

Aged↗

PubMedDate not supplied

Influence of abuse on condom negotiation among Mexican-American women involved in abusive relationships.

This study explored cultural and gender perspectives of abuse on condom negotiation behaviors for AIDS prevention among Mexican-American women in abusive intimate relationships. A convenience sample of 20 abused women participated in the study. Data were collected through a demographic questionnaire and audiotaped responses to a semistructured interview guide. Content analysis using QSR NUDIST was used to analyze the verbatim transcriptions of all participant interviews. The predominant category, "He always got his way," was developed in response to the content of the verbatim transcriptions. The category was further expanded to include the self-descriptive subcategories of "He beat me," "He made me feel bad," and "He forced me." Through content analysis, a relationship between abuse by male sexual partners and condom negotiation for AIDS prevention was identified. Trustworthiness of the data collection and analysis was established through methods suggested by Lincoln and Guba.

Adolescent↗

PubMed1997

Using an interactive computer game to increase skill and self-efficacy regarding safer sex negotiation: field test results.

This article describes the development, field testing, and evaluation of an interactive computer program, "Life Challenge," developed by the New York State Department of Health as a tool for enhancing adolescents' sense of self-efficacy in HIV/AIDS prevention programs. The computer kiosks were field tested in 13 sites serving high-risk adolescents. The program uses a time travel adventure game format to provide information and nonthreatening skill practice. Users record and play back their responses as they "negotiate" with their chosen partners. A proof of concept evaluation with analysis of 211 audio responses found that users took negotiating tasks seriously; statistically significant learning gains were achieved on knowledge items and in self-efficacy scores (greatest improvement for those with low baseline self-efficacy levels). Challenges and problems encountered in implementing the project are described, and the potential of using computers for skill practice and educational interventions in health education is explored.

Adolescent↗

PubMedDate not supplied

European Union bans atrazine, while the United States negotiates continued use.

Atrazine is a common agricultural herbicide with endocrine disruptor activity. There is evidence that it interferes with reproduction and development, and may cause cancer. Although the U.S. Environmental Protection Agency (EPA) approved its continued use in October 2003, that same month the European Union (EU) announced a ban of atrazine because of ubiquitous and unpreventable water contamination. The authors reviewed regulatory procedures and government documents, and report efforts by the manufacturer of atrazine, Syngenta, to influence the U.S. atrazine assessment, by submitting flawed scientific data as evidence of no harm, and by meeting repeatedly and privately with EPA to negotiate the government's regulatory approach. Many of the details of these negotiations continue to be withheld from the public, despite EPA regulations and federal open-government laws that require such decisions to be made in the open.

Atrazine↗