Constructing the uncertainty of due dates.

By its nature, the date that a baby is predicted to be born, or the due date, is uncertain. How women construct the uncertainty of their due dates may have implications for when and how women give birth. In the United States as many as 15% of births occur before 39 weeks because of elective inductions or cesarean sections, putting these babies at risk for increased medical problems after birth and later in life. This qualitative study employs a grounded theory approach to understand the decisions women make on how and when to give birth. Thirty-three women who were pregnant or had given birth within the past 2 years participated in key informant or small-group interviews. The results suggest that women interpret the uncertainty of their due dates as a reason to wait for birth and as a reason to start the process early; however, information about a baby's brain development in the final weeks of pregnancy may persuade women to remain pregnant longer. The uncertainties of due dates are analyzed using Babrow's problematic integration, which distinguishes between epistemological and ontological uncertainty. The results point to a third type of uncertainty, axiological uncertainty. Axiological uncertainty is rooted in the values and ethics of outcomes.

Advice-giving and the management of uncertainty for cancer survivors.

This study examines advice and uncertainty management, in the context of cancer survivorship, with specific emphasis on the relative influence of target receptiveness, advice content, and advice optimism on uncertainty-management processes, coping processes, and advice evaluation. Cancer survivors (N = 184) completed a questionnaire (online or paper) reporting on informal advice received after diagnosis. Results indicated that target receptiveness and advice optimism were positively related to coping processes and advice evaluation. Target receptiveness was positively related to uncertainty management. Appropriateness of advice was significantly related to problem-solving utility, and absence of limitations was significantly related to emotional awareness. Limitations of the study are offered, and implications for future research are advanced in the area of cancer survivorship.

Factors which influence physicians to join labor unions.

As members of a fiercely independent and individualistic profession, physicians have historically resisted the lure of organizing into collectives and have steadfastly maintained their autonomy. With the advent of managed care, the conditions of work have been altered and many of the assumptions guiding unions and collective bargaining have taken on renewed interest. Proponents of organizing physicians argue that unions can act as representative agents for health care providers to negotiate effectively with managed care organizations (MCO), insurance companies and government for conditions of work to help make their practice of medicine better for patients. Many physicians who previously rejected the notion of unions have reconsidered their entrenched positions and are beginning to weigh the costs and benefits associated with union membership.

Predictors of communication quality: the patient, provider, and nurse call center triad.

The purpose of this study was to examine characteristics of communication quality in a managed care context in which a nurse call center was used as the patient point of entry to the health system. The study sought to determine the level of communication quality among patients, health care providers, and nurses in the call center. Having measured the timeliness, accuracy, usefulness, and quantity of communication variables, a reasonable picture of communication quality emerged. The study explored patient differences in their perception of communication quality due to socioeconomic status, needs, experience, age, and various other factors. Likewise, providers who differ in training, specialty, and experience should have different perceptions and expectations of communication through nurse call center interaction.