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Negotiating a successful affiliation agreement between a hospital and a university, Part II.

Part I in the January/February 1984 issue of HOSPITAL TOPICS discussed how such an affiliation can help solve the DRG problem and improve the cost benefit of your capital and operating programs. Part 1 also included an up-to-date list of references on all phases of the subject. Part II takes up the interests of the University, the Hospital Board, the Physician, the Patient, the Third Party Payor and the costs of the affiliation. It will detail entering into a memorandum of agreement between the Hospital and University and the text of such an agreement is given.

Hospitals, Community↗
PubMed1994

Negotiating sexual relationships after testing HIV-positive.

Drawing on in-depth interviews with 60 people with HIV disease and 40 of their caregivers, this article reports on the effects of HIV seropositivity on sexual interaction and relationship formation. Using a sample representing gay and heterosexual, black and white, and male and female respondents, we focus on how people in the syndrome account for, cope with, and work through problems associated with HIV. While disengagement from sexuality is common, at least initially, many respondents successfully readjusted the mutual understandings of ongoing relationships or went on to develop new ones, often with seronegative people. Further, we compare the experiences of those already in relationships when they test HIV-positive to those seeking new relationships and discuss problems of disclosure and safer sex, with notes on the responses and perceptions of HIV-negative sexual partners.

Female↗
PubMed2005

Negotiating risk: how women working in massage parlours preserve their sexual and psychological health.

The small exploratory study was conducted in a heavily populated urban area in the Midlands region of England. Through semistructured interviews with women working in massage parlours, we investigated the health risks inherent in the work and the strategies adopted by the women to overcome these, as well as examining circumstances where theses strategies could be compromised. The effects of working in the sex industry on women's relationships and lives outside also emerged as the research progressed. We found that, in addition to preserving their sexual health, women's main concern was with the separation of home and work.

Adult↗
PubMed1998

Negotiating behavior change with HIV-positive adolescent girls.

A demonstrative case of an HIV-positive adolescent girl is presented in order to illustrate the stages of adaptation that HIV-positive youth undergo. Also discussed is the process by which this individual changes her behavior and the integral role and contributions the service provider can make in the behavior-change process for HIV-positive youth. Finally, this case illustrates some of the unique issues encountered by HIV-positive young women and how those issues can be incorporated into a comprehensive, coordinated, and continuous system of care.

Adaptation, Psychological↗
PubMed1998

Sexual coercion, domestic violence, and negotiating condom use among low-income African American women.

Coercion to engage in unwanted sex places women at risk for human immunodeficiency virus (HIV) infection. A survey of 125 women living in low-income housing developments in Fulton County, Georgia, showed that 53 (42%) women had engaged in unwanted sex because a male partner threatened to use force or used force to obtain sexual access. Women who had been sexually coerced were more likely to have used marijuana and crack cocaine and to have abused alcohol. Coerced women were more likely to have been physically abused by a domestic partner. These women were also more likely to perceive that requesting male partners to use condoms would create a potentially violent situation. These results suggest that women experience an interactive constellation of social problems that create risks for HIV infection and, therefore, that efforts to prevent HIV infection among women will require multifaceted intervention strategies to reach both men and women at risk.

Adult↗
PubMed1986

Patient requests in family practice: a focal point for clinical negotiations.

A growing body of literature has stressed the importance of eliciting the patient's views on the management of health and illness. In particular, it is recognized that patients frequently enter into clinical encounters with specific requests for services, that is ideas about how they hope to be helped. The present investigation examined the following two questions: what kinds of requests do adult patients coming to a family practice center have prior to seeing the doctor; and will factor analysis of a 25-item patient request questionnaire provide evidence of the basic or most common dimensions of patient requests in this population? Two newly-developed instruments were administered to a sample of 144 adult patients before their visit to the doctor. Factor analysis yielded five major request factors--'medical information', 'psychosocial assistance', 'therapeutic listening', 'general health advice', and 'biomedical treatment'--partially replicating the findings of an earlier pilot study. The clinical implications of eliciting patient requests in the light of current behavioural and social science research into the doctor-patient relationship are discussed. Future research directions are also outlined.

Adolescent↗