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Results for “Negotiating”

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PubMed2000

Should we create a niche or fall in line? Identity negotiation and small group effectiveness.

A prospective study of 423 MBA students examined the interplay of identity negotiation and group functioning. The findings revealed that self-verification effects (through which group members brought others to see them as they saw themselves) heightened participants' feelings of connection to their groups (i.e., more identification and social integration and less emotional conflict) and improved group project grades on creative tasks (tasks that benefit from divergent perspectives). Appraisal effects (through which groups brought members to see themselves as the group saw them) facilitated group project grades on computational tasks (tasks that require deriving one correct answer). In addition, self-verification effects were more prevalent than appraisal effects. The authors discuss the implications of these findings for understanding the links among self-verification, self-categorization, and group outcomes.

Adult↗

PubMed2002

Communicating a diagnosis of developmental disability to parents: multiprofessional negotiation frameworks.

It is a hard task for professionals to give and parents to receive the bad news about a child's developmental disability. This study describes how findings about four preschool children, with difficulties suspected to lie within the autistic spectrum, were negotiated with parents by two multiprofessional groups, one in a Medical (Site M) and one in an Education setting (Site E). Each assessment was undertaken over half a day, the professionals jointly interacting with the child and family. All assessment discussions were audiotaped and each participant was interviewed after the assessment. Conversation analysis showed the activation of three major social-interaction frameworks: professionals at both sites applied a parent-friendly frame, but this was complemented by a hopeful-diagnostic-formulation frame at Site M, and a defocusing-of-bad-news frame at Site E.

Autistic Disorder↗

PubMed1995

Gender-power relations and safer sex negotiation.

This paper examines the gender-power relations in heterosexual relationships and discusses the implications for women in attempting to negotiate safer sex. Whilst acknowledging the need for examining both male and female perceptions of sexuality, the paucity of research on men's heterosexual experiences has restricted this paper to the consideration of the woman's standpoint. Reviewing the literature, the complexities of sexual relationships are explored in terms of the power imbalance which arises from the ideologies of femininity and masculinity. The implications for safer sex promotion by practice nurses working in primary health care teams are then discussed within the context of gender divisions of labour and gender role conflict.

Female↗

PubMed1996

Negotiating the role of the practice nurse in general practice.

The debate about the role of the practice nurse is not only about practice nursing per se, but raises broader issues about the organization of primary health care. Two related issues emerge as significant: the role of the practice nurse in providing primary health care; and the effective use of the practice nurse resource in the 'new' National Health Service. This paper, by drawing on material from a qualitative study, specifically examines the type of work performed by practice nurses and the factors that influence this. The responses of practice nurses, general practitioners, Family Health Service Authority (FHSA) advisers, community nurse purchasers and managers of community nursing provider units suggest that a consensus on the future development of practice nursing is unlikely. The different stakeholders emphasized different issues, reflecting their own priorities and backgrounds. Practice nurses' accounts of the future, for example, focused on professional issues. General practitioners stressed the importance of role development which met their General Medical Service responsibilities. Purchasing agencies, provider units and FHSAs adopted a wider perspective and were more concerned to develop an effective and integrated primary health care service. The tensions generated by their different interests and perspectives, and the subsequent organizational and policy initiatives that emerge, will provide the context in which the role of practice nurses will be negotiated.

Attitude of Health Personnel↗

PubMed1997

Identifying training objectives: the role of negotiation.

Current training initiatives for health care professionals tend to be based on management assumptions of need or on the wish-list demands of potential course attenders. Each approach has major disadvantages, in that neither has the capacity to simultaneously satisfy the organization's objectives, whilst maintaining the motivation and commitment of the participants. This short report discusses an alternative approach that used a valid and reliable training needs analysis instrument with nurses and managers to inform Nurse Practitioner development. The results facilitated the commissioning of relevant education courses, clarified new role boundaries and acted as an agent for negotiation and change between the two groups.

Curriculum↗

PubMed2001

Negotiating the informed-consent process in developing countries: a comparison of Swaziland and Pakistan.

Protecting the rights of research participants when conducting studies within an international context presents many challenges. The purpose of this article was to compare and contrast the process of obtaining informed consent in two very different countries - Swaziland and Pakistan. Major aspects of the informed-consent process presented included identification of gatekeepers, seeking permission from officials, negotiating with these officials and Institutional Review Board (IRB) committees in regard to the type of data to be collected, and explaining informed consent to participants in the field. Data for this article is based upon qualitative research of collaboration between nurses and healers in Swaziland and from a variety of studies completed in Pakistan. These studies demonstrate the inadequacy and complexity of applying western-based concepts of informed consent to developing countries.

Cross-Cultural Comparison↗

PubMed2004

Negotiating strategic direction for education staff development: the Southampton experience.

The School of Medicine at the University of Southampton has identified and implemented strategic direction for education staff development. This paper reports on the processes of consultation and negotiation undertaken to ensure the success of a strategic approach and reflects on the difficulties involved. In particular, it reports on the development of a successful training programme for established teachers and course coordinators. The authors recommend adopting a transformational style of leadership for staff development and argue that focusing on student needs helps overcome tensions between the institution and individual staff members.

Curriculum↗

PubMedDate not supplied

Mexican and Mexican American women in a battered women's shelter: barriers to condom negotiation for HIV/AIDS prevention.

Anecdotal information suggests that, for Hispanic women who are involved with abusive partners, condom use request as an HIV/AIDS sexual risk-reduction behavior may expose the women to risk of both abuse and HIV/AIDS. A qualitative study explored barriers to condom negotiation for HIV/AIDS prevention among Mexican and Mexican American women in abusive relationships. A convenience sample of 14 Mexican and Mexican American women was recruited from a battered women's shelter. A demographic form, a domestic violence assessment form, and audiotaped responses to a semistructured interview guide were used to collect data. Descriptive statistics were used to describe the sample. Audiotaped interviews were transcribed verbatim and submitted to content analysis, which revealed past and present themes of physical, psychological, and sexual abuse of Mexican and Mexican American women who requested condom use by their male sexual partners. Also identified by content analysis was the influence of men's power on women's public, private, and sexual interactions.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

The negotiation of intelligibility in an aphasic dyad.

Employing conversation analysis as a research technique, this study investigates the ways that unintelligibility is accounted for and overcome within a therapeutic encounter between an individual with aphasia and dysarthria and his clinician. The results emphasize the collaborative nature of intelligibility negotiation and demonstrate how both the individual with the impairment and his clinician employ various interactional strategies and knowledge resources to turn unintelligibility into intelligibility so that the therapeutic encounter may continue.

Aphasia↗

PubMedDate not supplied

Negotiating life for the dying: hospice and the strategy of tactical socialization.

Hospice is often discussed as a social movement that is attempting to change not only the way particular patients experience dying, but the nature of death and dying for society as a whole. Participant observation research was conducted in the home care components of and a free-standing inpatient facility associated with several northeastern hospice organizations over the course of almost three years. The data are reported using negotiated order theory as a framework for understanding the hospice movement, and tactical socialization is identified as a major strategy of hospice workers for accomplishing their goals.

Attitude of Health Personnel↗

PubMedDate not supplied

Relational control in difficult physician-patient encounters: negotiating treatment for pain.

Many physicians report feelings of frustration and anger resulting from encounters with patients during which there is disagreement over the use of narcotics to treat pain. In this article, investigators report a relational control analysis of transcripts of three encounters of this type in order to explore the control dimension of these interactions. Similar analyses in the literature have reported that patients in general attempt to gain control of the interaction more often than previously thought. Results of this analysis, however, were remarkable in that nearly half of the transactions were characterized by competition for control. In addition, a descriptive analysis of the control-gaining strategies revealed physician strategies of giving instructions and orders, explicitly rejecting or disagreeing, providing reasons, and attempting to negotiate; patient strategies included explicitly rejecting or disagreeing and providing reasons. Communication skills training may enhance physicians' ability to understand their feelings of discomfort in this type of interaction as well as train them to be more effective communicators during interactions in which there is a struggle for control.

Communication↗

PubMed1997

Negotiating with administration--or how to get paid for doing hospital epidemiology.

Many hospital administrators acknowledge the value of a hospital epidemiologist. However, many hospital epidemiologists are not being paid for their work. To eliminate this inequity, hospital epidemiologists must negotiate contractual relationships successfully with their hospitals or healthcare systems. This article reviews an approach to rectifying this problem that is based on practical experience.

Epidemiology↗

PubMed1995

Innovation in clinical method: diabetes care and negotiating skills.

The development of a method to facilitate clinical negotiation with diabetic patients is described. The principles of the method incorporate patient centredness, an assessment of readiness to change and some elements of motivational interviewing. A simple low cost technology is part of the innovative method. Details of the method and its application are published before the results of a randomized controlled trial to ensure that the techniques are in the public domain before the outcome of the trial is known.

Clinical Competence↗

PubMed2005

The doctor as focus group moderator--shifting roles and negotiating positions in health research.

BACKGROUND: Any research is inextricably entwined with the researcher's positions adopted while collecting data. This represents an important challenge to focus group moderators whose positions within the group influence data collection. This situation is particularly important in health research where moderators are doctors. OBJECTIVES: This study explores the moderator's social interaction with the group, in particular the moderator's position and how it affects data collection, the research process and knowledge production. METHODS: A qualitative study exploring group dynamics and the moderator's positions in focus group discussions, in particular the interaction between the moderator's position and her role as a doctor. RESULTS: The social construction and negotiation of the doctor's position depended both on the participants' view of the moderator and on the moderator's situational response. The moderator dealt with the participants' expectations and alternated between different positions: those she chose for herself and those chosen for her by the participants. Adoption of an active strategy outlining the moderator's position clarified the framework of data collection. CONCLUSIONS: Doctors using focus groups as research tool to gain insight into people's ideas about illness must be conscious about how their medical background influences their positions during data collection. The focus group moderator must balance between letting participants discuss the topics without being disturbed and actively intervening in the discussion to clarify the process. The researcher has to set the boundaries and guidelines as to how the research is conducted.

Female↗

PubMed2004

Negotiating care: ties between aging mothers and their caregiving daughters.

OBJECTIVE: Using a feminist social constructionist perspective, we illuminate how aging mothers and their caregiving daughters negotiate issues of connection, autonomy, and conflict. METHODS: We conducted a qualitative analysis of videotaped interactions between 31 White mother-daughter pairs. RESULT: We found that the mothers and daughters mostly (a) were attentive and responsive, (b) preserved mothers' autonomy, and (c) minimized open conflict and tension. Subtle behavioral cues visible on the videotapes also exposed underlying emotional tension in these relationships. These cues alerted us to important variation in relationship quality among the pairs. Three patterns of relating emerged: (a) symmetrically connected, (b) asymmetrically connected, and (c) symmetrically constrained. DISCUSSION: Our exploratory study suggests that a balance between autonomy and connection is fundamental to the success of these mother-daughter caregiving relationships. Not only is it important for frail mothers to be responsive to their caregiving daughter's needs, but also it is important for daughters to support the autonomy and independence of their mothers. Our study also highlights the importance of attentiveness in these relationships. Even when mothers, because of illness and frailty, were less capable of attending to their daughters' lives, daughters in connected pairs interacted with their mothers in attentive ways. In constrained pairs, neither intergenerational partner was attentive.

Adult Children↗

PubMed2003

Association of negotiation strategies with consistent use of male condoms by women receiving an HIV prevention intervention in Zimbabwe.

One of the fundamental aspects of HIV counselling for women is condom negotiation strategy development. The present research sought to identify condom request strategies used by Zimbabwean women and to determine which were most effective in persuading male partners to use condoms. Of six types of strategies used by women after a prevention intervention, one was significantly associated with consistent condom use 2 months later. Implications for the development of counselling and testing protocols are discussed.

Condoms↗

PubMed2005

Negotiated safety relationships and sexual behavior among a diverse sample of HIV-negative men who have sex with men.

OBJECTIVE: To examine the prevalence of negotiated safety (NS) in a diverse sample of HIV-negative men who have sex with men (MSM), characteristics of MSM practicing NS, and adherence to NS. METHODS: This was a cross-sectional survey of San Francisco MSM recruited from venues and community organizations. NS relationships were defined as those in which HIV-negative men were in seroconcordant primary relationships for >/=6 months, had unprotected anal intercourse (UA) together, and had rules prohibiting UA with others. Adherence to NS was determined from self-reported sexual behavior in the prior 3 months. Presence of an agreement with NS partners to disclose rule breaking was also determined. RESULTS: Of 340 HIV-negative participants, 76 (22%) reported a current seroconcordant primary relationship for >/=6 months. Of these 76 men, 38 (50%) had NS relationships, 30 (39%) had no UA with primary partners, and 8 (11%) had UA with primary partners without rules prohibiting UA with others. In multivariate analysis, NS was more common than no UA with primary partners in younger men. Among 38 NS men, 29% violated their NS-defining rule in the prior 3 months, including 18% who reported UA with others, and 18% reported a sexually transmitted infection (STI) in the prior year. Only 61% of NS men adhered fully to rules and agreed to disclose rule breaking. CONCLUSIONS: Although NS was commonly practiced among HIV-negative men in seroconcordant relationships, some men violated NS-defining rules, placing themselves and potentially their primary partners at risk for HIV infection. Prevention efforts regarding NS should emphasize the importance of agreement adherence, disclosure of rule breaking, and routine STI testing.

Adolescent↗

PubMedDate not supplied

Nurse case management: negotiating care together within a developing relationship.

UNLABELLED: TOPIC/PROBLEM: The purpose of this study was to explicate the process of nurse case management involving clients afflicted with chronic mental illness. METHOD: Grounded theory was the method of choice. Interviews were conducted with nurses in inpatient, transitional, and community settings in four cities in southern Ontario, Canada. FINDINGS: Negotiating care together within a developing relationship emerged as the basic social process. "Building a trusting relationship" was identified as the foundation of case management. CONCLUSIONS: Salient differences were found between the three settings, yet the basic social process was consistent across settings. This underscores the therapeutic relationship as the basis for nurse psychiatric case management.

Adult↗