Hiperidrose compensatória após simpatectomia toracoscópica: características, incidência e influência na satisfação do paciente

Hyperhidrosis is an idiopathic condition characterized by excessive sweating. Symptoms generally begin in childhood or early adolescence, and rarely improve with age. The excessive localized sweating generally occurs either spontaneously, or in association with stressful or emotionally charged situations. This prospective study aimed to investigate predictive factors for compensatory hyperhidrosis after thoracoscopic sympathicotomy. From 2000 to 2002, 80 patients (53 female and 27 male) underwent hyperhidrosis surgery. The patients, ranging from 12 to 56 years old, were studied and followed-up for 42.51 ±5.98 months. A satisfaction grading using a visual analogue scale -VAS (0 = not at all satisfied, and 10 = fully satisfied) was used. The surgical procedure was performed bilaterally on the second ganglion (T2) for facial hyperhidrosis, on the third and fourth ganglia (T3 and T4) for axillary hyperhidrosis, and on the third ganglion (T3) for palmar hyperhidrosis. The results showed that, 68 patients (85%) presented with compensatory sweating (CS), which was classified as mild (33.8%), moderate (33.8%) and severe (32.4%). Considering the final surgical results, 70 patients (87.5%) were satisfied with the outcome of the operation, while 10 patients (12.5%) were dissatisfied. Degrees of satisfaction varied according to sex, age, BMI and extent of denervation. Moreover, the compensatory hyperhidrosis was more severe in abdomen and back than in legs. In conclusion, although CS is a frequent adverse effect of sympathicotomy, the degree of patient satisfaction was high. Some factors were related to the occurrence and severity of CS and the most adequate patients to be submitted to this operation are young adult women whose BMI is less than 24.9

Dimensões da satisfação do paciente geriátrico com a assistência fisioterapêutica

Introdução: Os idosos constituem os maiores consumidores dos serviços de saúde, especialmente os de reabilitação, tornando imprescindível a avaliação da qualidade da assistência fisioterapêutica prestada. A satisfação do paciente tem sido considerada uma das melhores e mais eficazes formas de avaliar o cuidado e direcionar o provedor do serviço para suprir as necessidades e expectativas do paciente-cliente. O objetivo deste estudo foi investigar os principais aspectos (preditores) que contribuem para a satisfação do paciente geriátrico com o tratamento fisioterapêutico ambulatorial. Métodos: Trata-se de um estudo com enfoque epidemiológico, transversal e descritivo de cunho exploratório. Foi utilizado o instrumento de avaliação da satisfação do paciente com a fisioterapia, desenvolvido e validado para a população brasileira por Mendonça em 2007, com uma escala de satisfação do paciente composta por 23 itens. Os dados foram coletados na sala de espera de 29 clínicas de Fisioterapia da rede privada da capital do RN/Brasil e a amostra selecionada de forma não-probabilística constou de 221 pacientes com idade superior a 60 anos, que realizaram entre 5 e 60 sessões de fisioterapia onde os dados foram coletados, deveriam ser usuários de plano de saúde e ter condições cognitivas preservadas. Resultados: A análise fatorial indicou a existência de quatro fatores com autovalor maior que 1: interação pacienteterapeuta (7 itens) α = 0,901; acesso e atendimento de recepcionista e pessoal de apoio (8 itens) α = 0,888; ambiente físico e satisfação global (5 itens) α = 0,835; e conveniência (3 itens) α = 0,711. Os itens com maiores escores de satisfação completa foram os contemplados nos aspectos de interação paciente-terapeuta, especialmente o respeito e a gentileza do fisioterapeuta. As associações realizadas através do teste do Qui-quadrado e regressão logística binária entre a satisfação do paciente e as variáveis sócio-demográficas, percepção do estado de saúde e capacidade funcional demonstraram que a satisfação do paciente idoso associa significativamente com o sexo e estado civil. Os achados revelam que as mulheres mostram-se mais satisfeitas com a fisioterapia. Conclusão: Os aspectos interpessoais demonstraram ser preditores relevantes para assistência fisioterapêutica satisfatória, especialmente na população idosa que requer atenção além do suporte puramente técnico

O tratamento ortodôntico em uma perspectiva a longo prazo: avaliação da estabilidade oclusal e do grau de satisfação dos pacientes

This study aimed to evaluate factors associated to orthodontic treatment stability and patient satisfaction in the long-term. A total of 209 patients (88 class I and 121 class II) treated with straight wire fixed appliance were selected at least 5 years post treatment. Six hundred twenty seven dental casts were examined with the PAR Index at pretreatment (T1), end of treatment (T2), and at long-term follow up (T3, mean 8.5 years post treatment). At T3, a Dental Impact on Daily Living questionnaire was used to assess patient satisfaction with the dentition in the long-term. Friedman test and multiple regression analysis were used to evaluate changes among the time points and factors associated with stability and patient satisfaction. Predictive factors used to exam the occlusion were: PAR Index at T1 and T2, age at T1, the amount of time without retainer, length of Hawley retainer wear, length of follow-up, sex, extraction and third molar status. To assess patient satisfaction were considered: changes produced by the orthodontic treatment (PAR T2-T1), post treatment stability (PAR T3), age at the start of treatment (T1), length of treatment (T2-T1), gender, and extraction. Orthodontic treatment produced a significant improvement of 94.2% in the PAR Index (T2-T1), but this change was not associated with the level of satisfaction when the patient was questioned at T3. No significant change was observed between T2 and T3. However, when the sample was divided according to the level of finalization (PAR T2), it was observed that well-finished patients experienced some deterioration (P<.001), whereas the less well-finished ones showed some improvement (P<.05). Even with the deterioration, the well-finished patients still had a better PAR Index at T3 compared to the less well-finished ones (PAR T2- T3). Regression analysis showed that PAR Index at T1 and T2, age at T1, and length of retainer wear had a slight association with occlusal stability (R2 = 0.27). Patient satisfaction was significantly associated only with PAR Index at T3 (r2=0.125, P<.0001). We can conclude that, even thought orthodontic treatment is quite stable, not so well-finished treatments tend to show some improvement and well-finished ones deteriorate some in the long-term. Despite of that, well-finished patients still have better occlusal characteristics. Patient satisfaction is not related to the result of orthodontic treatment; nevertheless, there is a slight association with dentition in the long-term

Satisfação do paciente com a fisioterapia :tradução, adequação cultura e validação de um instrumento de medida

The measurement of patient satisfaction can provide information about the success of the care provider in reaching the values and meeting the expectations of the patient. The purpose of this study was to translate into the Portuguese language and to culturally customize to the Brazilian population the instrument to measure patient satisfaction with physical therapy elaborated by Goldstein et al. The study sample was made up of 279 patients who were undergoing physical therapy treatment at 39 different private clinics in a middle-sized town in northeastern Brazil. For the translation of the survey instrument, the back-translation technique was employed, in association with the bilingual method. The reliability and validity of the Brazilian version of the instrument were both assessed. Reliability analysis, carried out with the computation of Cronbach alpha coefficients, showed that the measures obtained with the instrument have a high degree of internal consistency. The aspects dealing with the patient therapist relationship are the most important predictors of satisfaction, followed by those dealing with courtesy, privacy, and practical aspects such as efficiency of the facility in the patient admissions process, setting up of appointments, and waiting time in waiting room. Items dealing with aspects such as location of the facility and availability of parking facilities may underestimate the reliability of the instrument. This study translated, culturally customized, and validated an instrument to measure patient satisfaction with physical therapy originally developed in English. By so doing, this study has made this instrument available to the Brazilian society, and it has rendered it a useful parameter that can be utilized in our country in the field of physical therapy

As condições de trabalho e a satisfação profissional: dimensões do profissionalismo docente no ensino médio

The dissertation is developed in the Research Base of Teacher Training and Professionalization of Universidade Federal do Rio Grande do Norte as a way to discuss the professionalization of High School teachers in Natal. It is a study linked to the research The context of teaching practice and professionalism: the case of high school teachers and sponsored by CNPq, with the objective of characterizing working conditions and job satisfaction as dimensions to the teacher professionalism in high schools. In this study we prioritized the focus on professionalization in national and international discussions, which combines the aspects of teaching in its historical, social, political and economical path, in order to reflect about its evolutional elements in the hierarchy of professions and establish a relation to high school teaching. To develop this relation we elaborated some questions that are considered relevant, such as: How does the high school teacher evaluate his/her working conditions to his/her professional practice? What level of satisfaction does the high school teacher have regarding his/her professional practice? What expectations does the high school teacher have in relation to his/her professional development? The answers to those questions were according to the high school teachers considerations shown in the questionnaire, which was structured with open and closed questions. These questions gave better adequacy to the teachers evaluations about their working place and the situations they experience in their working conditions, provoking job satisfaction and expectations for professional growth. The description of the teachers perception about working conditions, job satisfaction and expectation of professional development can explain the distinct factors that characterize these categories in the working context, although the conclusive results, in general, do not show a direct relationship between the categories studied. Some factors that teachers attribute as causes of bigger difficulties in working conditions and work activity itself are: working time, salary, professional status, school s infrastructure, and school s social context. These factors are similarly related to the degree of job satisfaction, without showing interference in the professional expectations

Satisfação da equipe de enfermagem do serviço de atendimento móvel às urgências (SAMU) no ambiente de trabalho

Descriptive exploratory study, prospective with quantitative approach, performed on the Medical Regulation Central of SAMU/Natal, aiming to identify the level of professional satisfaction of the members of the nursing team working at SAMU/Natal; and verify the degree of importance attributed by the professionals to each of the components Professional Satisfaction: autonomy, interaction, professional status , work requirements, organizational rules and remuneration. The population was of 60 professionals, with data collected from january to february 2005. We used an instrument translated and validated by Lino (1999) to the portuguese language, the Professional Satisfaction Rate (PSR). The results demonstrate that there was a slight predominance of the female gender (54,9%); aged between 36 and 45 years old (60,8%); married (58,8%), 82,4% with children, 30,8% aged between 05 and 09. Regarding formation, we observed that 78,4% were nursing technicians and 21,6% nurses, formed for 11 to 15 years (17,5%). From the 11 nurses, 09 (81,8%) informed they have specialization, 29,4% of the team has been working for 11 to 15 years on the urgency area, 58.8% works for more than 02 years on SAMU, 72,6% of the team members have fixed work schedules. There was homogeneity on the work shifts: 41,2% on the day shift and 53% on the night shift. Regarding the reason to be working on SAMU, 64% chose to work in the service, and among these 76,3% predominantly perform direct care to the patients, 96,1% like and are satisfied to work in the service. Regarding the remuneration, 90,9% informed they receive 05 to 10 minimum wages; 70% of the technicians informed they receive -2 to 05 minumum wages, 50,1% informed they receive no additional benefit. The analysis of PSR through Cronbach s Alpha Coeficient resulted on the value of 0,94 and through Kendall s Tau Coeficient on 0,87, demonstrating to be a trustworthy instrument to measure the level of professional satisfaction of the SAMU nursing team, in our environment. As for the level of importance attributed to the components of professional satisfaction, we indentified that the nursing team considered the Autonomy component as the most important, followed by the component Remuneration, Interaction, Work Requirements, Work Requirements, Organizational Rules and Professional Status . Regarding the current level of professional satisfaction, we identified they were most satisfied with the Professional Status , Autonomy, Interaction, Remuneration, Work Requirements and Organizational Rules. The real professional satisfaction level, calculated through statistics, however, tells these professionals are more satisfied with Autonomy, Remuneration, Interaction, Work Requirements, professional Status and Organizational Rules. The PSR in our work was of 8,6, indicating the SAMU Natal nursing team has little satisfaction on their work environment

Clima organizacional e satisfação laboral: um estudo sobre os núcleos hospitalares de epidemiologia de Natal/RN

The Hospital Epidemiology Nucleus (NHE) is a structure that has a specific organizational climate, which influence the level of job satisfaction among professionals working in it. This is a descriptive study with a quantitative approach, aimed to identify the relationship between organizational climate in the NHE regulated in the city of Natal / RN and the job satisfaction among its professionals from the perspective of theoretical issues about Organizational Development. The research was carried out in 13 hospitals with different kinds of sponsorship, 9 public, 3 philanthropic and 1 private. Data were collected using the instrument "organization in hospitals: issues relating to climate and job satisfaction , with 33 professionals appointed and active on NHE. This study obtained an appropriate consent of the Research Ethics Committee of the Hospital of Pediatrics Professor Heriberto Ferreira Bezerra, from the Riograndense Northern League Against Cancer and the Federal University of Rio Grande do Norte. Data collected were organized and treated with simple descriptive statistics. It was observed that from 33 of surveyed people, 93% was female, had an average of 40 years old age, with activity duration between 1 and 2 years (84.9%). Furthermore, 45.5% of industry professionals were nurses. It was identified that professionals working in NHE perceive and experience its work environment as an Organization Structure in construction. It was found that with the exception of the aspects "working life", "socio-cultural" and "organizational culture , the other internal and external factors to the NHE does not have strong expression in the forming of an organizational climate conducive to the development of the sector. It was found that 70% of interviewed perceive the organizational climate as favorable for the industry's progress. Regarding the job level of satisfaction, respondents feel fairly satisfied with the organizational structure. Therefore, the results of this study are suggestive that there is some factor that is greatly contributing to a healthy organizational climate that encourages the industry team members of the NHE present behaviors that identify them as actors committed and satisfied with the work, even face of all obstacles to implementation of epidemiological surveillance. Thus, it is suggested for futures studies to seek to determine how the organizational culture, while significant internal factor, influencing the organizational climate establishment of NHE and therefore the level of job satisfaction and well-being of each members of the team

Fatores da satisfação e fidelidade do cliente: um estudo no varejo de supermercado

This thesis deals with the factors affecting customer satisfaction and loyalty in the supermarket sector. It is adapted a model proposed by Johnson et al. (2001) and included the brand construct as a loyalty of construct antecedent. It is conducted a survey with a sample of 290 customers of a supermarket in Natal city, Brazil, and descriptive and multiple regression statistical analysis. The main findings are that the proposed model is confirmed with quality being the main factor affecting satisfaction, but also in this case the place marketing construct playing a key role on satisfaction. The loyalty model is also supported by this research with the brand construct appearing important for a segment of the customers. This study support the conclusion that customer satisfaction is not the sole or main factor to explain loyalty

Fatores da qualidade e satisfação na compra pela internet e sua influência na fidelidade dos consumidores

A presente pesquisa objetivou estudar as relações entre os fatores intervenientes para a satisfação no processo de compras baseadas na Internet e sua influência na fidelidade online (e-loyalty), na visão dos consumidores de varejo virtual. Para tanto, foi utilizado como instrumento de coleta de dados um questionário baseado em fatores de qualidade e fidelidade oriundos dos serviços convencionais, que foi adaptado para a realidade dos serviços digitais. A pesquisa caracteriza-se como exploratória, de natureza quantiqualitativa. A análise quantitativa descreveu e testou a relação de variáveis de qualidade do site e de preço dos produtos do site com as variáveis de satisfação. Neste caso, foram utilizadas técnicas estatísticas como distribuição de freqüência, médias e desvio-padrão e correlação de postos de Spearman. Já na abordagem qualitativa, foi empregada a análise de conteúdo para uma questão aberta relacionada com a identificação dos fatores que levam a fidelidade digital. A pesquisa de campo foi feita com uma amostra de 44 alunos de pós-graduação em nível de Especialização da Universidade Federal do Rio Grande do Norte. Os resultados da análise quantitativa evidenciaram que a qualidade está ligada à satisfação dos clientes em vários fatores, mas o preço não influencia muito na satisfação. Na análise qualitativa, a segurança do website e os preços oferecidos são fatores que potencialmente fidelizam os clientes digitais, segundo a perspectiva dos entrevistados. O fator segurança e confiança no website foi considerado o mais crítico para a fidelidade dos clientes que compram pela Internet

Fatores da satisfação do cidadão com a gestão pública: um estudo sobre o orçamento participativo municipal

This thesis deals with the quality dimensions and factors affecting citizens satisfaction in the participatory budgeting process in a major city of Brazil. Participatory budgeting was introduced as a usual practice in many Brazilian cities since the 1990s. It is adapted a model proposed by Johnson et al. (2001) of customer satisfaction and loyalty antecedent factors with constructs related to governance also included, to evaluate the quality perception and satisfaction rates by citizens representatives in the participatory budgeting process. It is conducted a survey with a sample of 84 citizens representatives of the seven city regions of Natal, the capital of a Northeastern State of Brazil. It is applied descriptive and multiple regression statistical analysis. The main findings related to quality and governance constructs are that the quality factors are the main factors affecting satisfaction but also the tax construct is significative to satisfaction. More regarding it was found that for different perspective of the satisfaction there are different set of factors affecting it

Fatores da satisfação, fidelidade e recomendação em serviço de saúde: estudo em setor ambulatorial de hospital

This thesis deals with the factors affecting customer satisfaction, loyalty and recommendation in the health care sector. It is adapted a model proposed by Johnson et al. (2001) of quality and loyalty antecedent factors and it is conducted a survey with a sample of 109 customers of a hospital on the ambulatory in Natal city, a capital of a Northeastern State of Brazil. It is carried descriptive and multiple regression statistical analysis. The main findings related to satisfaction are that quality factors of doctor professionalism, clerical staff efficiency, consultancy room comfort, time to provide the medical consultancy but also hospital localization are the most significant factors affecting satisfaction. Regarding personal full loyalty, satisfaction with the hospital and affective commitment are the main factors yet for partial loyalty image and calculate commitment play the main role. For recommendation satisfaction, image and brand are the main factors. The overall model used fairly explains the satisfaction, loyalty and recommendation outcomes with varying factors regarding each final purpose, e.g. loyalty or recommendation

Fatores de satisfação de empregados: um estudo com docentes de instituição de educação tecnológica

This Master of Science Thesis deals with investigating the factors affecting employees satisfaction studying the case of teachers on a technological education institution. It is surveyed teachers in a sample of size 42 out of 316. It is used a form that deploys a model of satisfaction antecedents factors comprised of work system, professional development, teaching activity, physical environment, pay, and problems management. The sample was found representative (χ2 test) based on genre, tenure, degrees, and age. The model for satisfaction with the institution presented a adjusted r2 > 0,80 and the main factors affecting it was found to be work system, professional development, and teaching activity. For the satisfaction with the career, the model results with a r2 > 0,70 and as main factors professional development, teaching activitiy and pay. The variables contribuition for the students education and use of suggestions were ones of the main variables appearing in the models. The results suggest an improvement in the model regarding the previous models used by Silva (2003) and Cruz Filho (2007) regarding model explicability of teacher satisfaction

Fatores que afetam a satisfação e a fidelidade do consumidor: um estudo com usuários de calçado esportivo (tênis), na Região Sul da cidade de Natal

This paper aims to investigate the factors that influence the satisfaction and fidelity of tennis´s users with the region southern city of Natal, capital of Rio Grande do Norte as the area of analyzing , using the national satisfaction index models as a tool to study. In this study was used the questionnaire as a tool for collecting data based on the new Norwegian customer satisfaction barometer model proposed by Johnson et. al. (2001). The data collection took place during the months of May and June 2008, when 450 tennis´s users were interviewed. The main results obtained by multiple regression analysis and logistic regression showed that the users' satisfaction with the tennis´s brand is influenced by the quality, comfort, material used in the manufacture and price, while fidelity is potentized by the image of the brand and the satisfaction degree with the user's tennis and with the brand of tennis. In relation to user satisfaction with the tennis, that satisfaction is influenced by the quality, comfort, weight and the material used, while fidelity is potentized by the satisfaction with the tennis´s brand, with the possibility of paying the same amount again and the emotional commitment. As the processing of claims there was no direct influence on satisfaction and consumers fidelity due to the low number complaints

Gestão da satisfação e fidelidade do cliente : um estudo dos fatores que influenciam na satisfação e fidelidade dos clientes corporativos de telefonia celular

The competition in the telecommunications industry has grown in Brazil since the privatization, forcing companies that are active in the market to a growing commitment to quality products and services in order to survive. In this context, this work aims to understand the main factors that influence the degree of satisfaction exists in respect of a mobile operator with its corporate customers. The research covered theoretical concepts and analytical models of quality management system and models of indices related to the measurement of customer satisfaction. For the field research was carried out in a practical application of the main approaches based on this thesis by a case study in corporate segment, through a questionnaire applied to 10 consultants and 40 corporate customers of that company. Comparing the results of research with the consultants and corporate clients there is the concern of respondents to the indicators that comprise the constructs of customer satisfaction, commitment calculated, the price index and the handling of complaints, denoting the dissatisfaction of the general assessment for corporate customers with the carrier, against its current expectations. It is concluded that the mobile operator of the telecommunications industry have a big challenge, after ten years of privatization and consequently the period of rapid expansion of customer base and with the depleted, retain corporate customers as highly strategic, thus avoiding that migrate to other companies. We emphasize the need for further research and analysis of different approaches through research and using the same models to specifically evaluate and measure customer satisfaction of mobile enterprise, to adjust the model to the national market. Finally, we suggest the creation of an effective customer loyalty program with a strategy of relationship and specific to the corporate sector of mobile telephony

Fatores da satisfação e fidelidade de clientes na hotelaria: um estudo sobre a percepção dos gestores de hotéis

This Master of Science Thesis deals with the perception of hotels managers about the factors affecting the loyalty and satisfaction of its customers. It is surveyed a group of managers attending a hotel industry meeting and the results of their responses are compared with three surveys on tourist satisfaction and loyalty factors in Natal, Brazil, including international, national and regional tourist. The main findings suggest a divergence on the managers perception and the customer significant factors affecting satisfaction surveyed, but a certain convergence on the factors affecting loyalty. The research suggest a need for a customer satisfaction and loyalty measurement system in order to contribute for the alignment of managers perception and its customers evaluations