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Coming to terms with chronic illness: the negotiation of autonomy in rheumatoid arthritis.

This paper examines ways in which daily life is sustained in the face of chronic illness. Using data from interviews with people with rheumatoid arthritis, we try to capture the complexity of the interdependence between individuals with chronic illness and society. The main areas focused on cover the disordered body, disruption of relationships, and management of a deviant identity. What emerges is the relativities in everyday negotiations involved as people assimilate or come to terms with the circumstances of disablement. A great deal of research by rehabilitation specialists and advocates of independent living makes use of an abstract notion of the individual and a categorical definition of independence. We suggest that through the subtle relativities individuals in fact sustain considerably more self-determination than is suggested by prevalent notions of independence. This state of affairs is more appropriately referred to as autonomy. The implications of this perspective for health care professionals are discussed.

Activities of Daily Living↗

Strategies for negotiating preemployment agreements.

Student preemployment agreements are an emerging form of employee-sponsored financial support for students. Forms of financial support for students include the preemployment agreement, sign-on bonus, employment bonus, scholarship, loan, stipend, and grant. Various professional, legal, and ethical issues are involved in the student-employer negotiation of the preemployment agreements. Students may consider financial support for education, type of practice setting, or location of future employment as primary benefits of preemployment agreements. Fieldwork facilities may identify therapist recruitment as the primary goal when offering a financial incentive to a student. Academic fieldwork coordinators may list preservation of the therapist-student relationship or adherence to the fieldwork agreement reached between the academic program and the fieldwork facility as a primary goal. In this article, guidelines for the practical use of preemployment agreements are outlined for use by students and professionals in academic and practice settings.

Employment↗

How to make salary comparisons and negotiate a raise.

For the first time, the AHRA salary survey includes factors of job responsibility related to salary level. Ms. Nielsen explains how radiology managers can use this data to determine how their compensation compares with the marketplace. She also provides helpful tips on negotiating a raise.

Data Collection↗

Negotiating and analyzing managed care contracts.

Despite some uneven performance in the 1980s, health maintenance and preferred provider organizations are here to stay. Author Keith Korenchuk believes that negotiating satisfactory managed care contracts will become increasingly important in the next decade and he offers several suggestions to reach this goal.

Contract Services↗

Evaluating antitrust risk in joint provider negotiations with payors.

Health care providers who combine to jointly negotiate contracts with third party payors risk violating the antitrust laws and incurring liability. This article describes the types of scrutiny to which joint activities are subject and outlines a number of factors that should be considered in analyzing the degree of antitrust risk involved in any joint provider arrangement.

Antitrust Laws↗

Negotiating your contract: points to consider.

The CAP offers two publications that contain basic contractual information. One was distributed in March 1983, and the other is being revised at this time to reflect recent developments. This article reviews some of the changes in contract concerns and opportunities, and serves as an interim source of information that may assist pathologists in their negotiations.

Contract Services↗

Negotiating to control care. Doctors' unions.

With medicine under siege, many physicians no longer turn up their noses at unions. The number of doctors in unions remains small, but it is growing as third parties exert more control over the practice of medicine. Fee-for-service physicians still face antitrust barriers to joining, but even the lawsuit-conscious AMA is devising ways to help them negotiate.

American Medical Association↗

Salary negotiations the smart way.

No one holds all the cards in a job interview, unless one party to the negotiations gives them to the other. To obtain the salary that you deserve, you have to do some homework to determine your market value and you have to stick to your guns during the bargaining. Taking less than you, and the prospective employer, know you're worth is a sure road to disaster.

Humans↗

Medicare program; negotiated rulemaking: coverage and administrative policies for clinical diagnostic laboratory services. Final rule.

This final rule establishes national coverage and administrative policies for clinical diagnostic laboratory services payable under Medicare Part B to promote Medicare program integrity and national uniformity, and simplify administrative requirements for clinical diagnostic laboratory services. This rule addresses public comments received on the proposed rule that was published March 10, 2000. A Negotiated Rulemaking Committee (the Committee) developed the policies as directed by section 4554(b)(1) of the Balanced Budget Act of 1997 (the BBA).

Diagnostic Techniques and Procedures↗

Conflict, negotiation and cooperation: an analysis of these parameters in international relations.

Ways in which political conflicts may be stimulated, reduced, enhanced, and managed are discussed. Human political space and time concepts are explained, while distinct ways of perceiving, exploring, and affecting the world are developed in detail. Everyday communication as opposed to political communication is described, as are their dimensions, effectors, and/or the events that they effect. The thesis is suggested that political communication demands a special morality and a special understanding of interaction at a political level. A taste of the range and delicacy of the interlacing flow of conflict, negotiation and cooperation is given and the final contention is that j order to be a true and competent leader of an effective modern state these delicate tools must be immediately evocable.

Communication↗

Negotiating a severance agreement.

A severance agreement is a valuable and negotiable benefit for the nurse executive in transition. Knowing which clauses to request and which to avoid helps the nurse executive provide for a secure job transition.

Humans↗

Describing parent-child interaction during exploration: situation definitions and negotiations.

A coding scheme based on Wertsch's (1983) extension of Vygotsky's ideas about adult-child interaction in the zone of proximal development was used to analyze parent-child interaction during exploration. Sixty children, 3 to 6 years old, were videotaped while exploring novel objects in 15-min sessions with their mothers and fathers. Clusters of verbal and nonverbal behavior were used to code how participants defined the situation in each 15-s interval of each session in terms of one of nine categories. When parent-child mismatches occurred, the participants' negotiations of an intersubjective definition were coded, and child and parent questions were coded for complexity, complexity and appropriateness of response, and function. Results indicated that parent and child definitions matched almost 80% of the time, usually around exploration by the child with attention of or collaboration by the adult. Fathers tended to be more didactic than mothers.

Attention↗

[Application of the negotiated process method to primary health care for women].

Since 1984 the University of Illinois School of Public Health in Chicago has been offering the course "Women's Health: A Primary Health Care Method." The objectives of the course are to develop a model to meet the health needs of urban women in industrialized countries and to teach post-graduate students from various health-related programs to work as members of interdisciplinary teams with groups of women in communities. This activity involves the use of the negotiated process method, the purpose of which is to train students and the community group to work together and separately on solutions to identified health problems. During the course given in 1985 this method was applied to analyzing the problem of battered women in a Latin American community. Although the results were satisfactory, other similar experiments should be conducted to determine its usefulness more precisely.

Community Health Services↗

A strategic approach for negotiating with hospital stakeholders.

Executives should consciously formulate negotiation strategies which are linked to the broader strategic posture of the hospital. This approach provides a diagnostic and action-oriented framework for (1) determining and focusing on desired outcomes and (2) anticipating actions stakeholders are likely to take.

Cooperative Behavior↗

The negotiating machinery of the Danish Nurses Organization.

The author presents the successful negotiating machinery and the possibilities of the Danish Nurses Organization in the actual economic and political situation in Denmark. This paper was presented at the ICN SEW Resource Group meeting in Geneva.

Collective Bargaining↗

Observing troubled children's interpersonal negotiation strategies: implications of and for a developmental model.

29-year-old boys, both selected from a pool of children with socioemotional and interpersonal difficulties, were observed unobtrusively in 35 weekly hour-long pair therapy sessions over the course of 2 school years. A transcript/narrative analysis technique was used to identify all interpersonal negotiation strategies each child used within each session. Strategies were classified using a coding system that simultaneously ordered them according to 4 developmental levels (0, impulsive-physical; 1, unilateral-coercive; 2, reciprocal-influential; and 3, collaborative-mutual) and 2 interpersonal orientations (self- and other-transforming). Using individual strategies as the basic unit of analysis, strategies in each weekly session were charted according to level and orientation and were summed to show total distributions and trends over time. Results indicated that the predominant level of strategy used by both children was unilateral (level 1) followed for each child by reciprocal (level 2), impulsive (level 0), and then collaborative (level 3) strategies. Across time a trend toward increased use of reciprocal strategies was suggested, although there was wide oscillation in the percentage and absolute use of strategies coded at each level from 1 weekly session to the next. Different patterns of strategy use were identified for each child. With respect to the pattern of use of orientations (self- and other-transforming) over time, each subject began the interaction with strategies rigidly adherig to 1 particular orientation. However, while 1 subject was consistently rigid in orientation over the 35 weeks, the other demonstrated a movement with time to a more balanced usage of strategies across orientations. Results of this study were discussed with respect to their implications for using developmental methods and models for clinical purposes.

Affective Symptoms↗

Child health. Negotiating care roles.

This paper examines the use of research findings related to the negotiation of care roles between paediatric nurses and the parents of children in hospital. The implications for future practice are discussed.

Child↗