Vying for a winning position: management style of the chronically ill

The process used by hospitalized chronically ill persons to defend themselves against the demands of an unpredictable and progressive disease was explored. Intensive, unstructured interviews, constant comparative analysis, and theoretical sampling were the methods used. Vying for a winning position was conceptualized as an organizing principle to describe how patients framed the challenge their disease presented and the attitudes developed to meet that challenge. The major categories of the conceptualization included (a) how patients defined and explained their illness; (b) attitudes and behaviors developed in response to, and as a result of, the uncertainty of the disease process; and (c) the manner in which hospitalization expressed patient efforts to foster control and keep ahead of the disease.