Avaliação da satisfação do utente na comunicação com os profissionais de saúde construção e validação de um instrumento

A satisfação do utente na comunicação com profissionais de saúde é um indicador de qualidade dos serviços ou instituições. Na literatura não encontramos instrumentos padronizados e validados, que avaliem a satisfação do utente na comunicação com os profissionais de saúde. O presente estudo tem como objetivo construir e validar um instrumento para avaliar a satisfação do utente na comunicação com os profissionais de saúde. Desenvolvemos este estudo em três ciclos. Um primeiro, revisão da literatura, para identificar dimensões e itens da comunicação interpessoal na saúde. No segundo ciclo, conduzimos um método de Delphi modificado em três rondas, com recurso à plataforma informática de questionários Survey Monkey, no qual participou um painel de 25 peritos; estabelecemos como critério mínimo de retenção para a ronda seguinte os itens que recebessem 70% do consenso por parte do painel. Após as três rondas, obtivemos um instrumento com seis dimensões comunicacionais (comunicação verbal, comunicação não verbal, empatia, respeito, resolução de problemas e material de apoio), vinte e cinco itens específicos, e mais seis dimensões genéricas, que avaliam cada uma das dimensões. No terceiro ciclo avaliamos as características psicométricas, em termos de sensibilidade, validade do construto e fidelidade, numa amostra de 348 participantes. Os resultados mostram que todas as categorias de resposta estavam representadas em todos os itens. Validade do construto- a análise fatorial identificou uma solução de seis componentes que explicam 71% da variância total. Fiabilidade - os valores da correlação item-total variam entre 0,387 e 0,722, existindo uma correlação positiva moderada a forte. O valor de alfa de Cronbach (α=0,928) indica que a consistência interna é excelente. O instrumento construído apresenta boas propriedades psicométricas. Fica assim disponível uma nova ferramenta para auxiliar na gestão e no processo de planeamento necessários ao incremento da qualidade nos serviços e instituições de saúde.

Optimization process of polyester polymer mortars modified with recycled GFRP waste aggregates – application of factorial experiment design-

Glass fibre-reinforced plastics (GFRP), nowadays commonly used in the construction, transportation and automobile sectors, have been considered inherently difficult to recycle due to both: cross-linked nature of thermoset resins, which cannot be remolded, and complex composition of the composite itself, which includes glass fibres, matrix and different types of inorganic fillers. Presently, most of the GFRP waste is landfilled leading to negative environmental impacts and supplementary added costs. With an increasing awareness of environmental matters and the subsequent desire to save resources, recycling would convert an expensive waste disposal into a profitable reusable material. There are several methods to recycle GFR thermostable materials: (a) incineration, with partial energy recovery due to the heat generated during organic part combustion; (b) thermal and/or chemical recycling, such as solvolysis, pyrolisis and similar thermal decomposition processes, with glass fibre recovering; and (c) mechanical recycling or size reduction, in which the material is subjected to a milling process in order to obtain a specific grain size that makes the material suitable as reinforcement in new formulations. This last method has important advantages over the previous ones: there is no atmospheric pollution by gas emission, a much simpler equipment is required as compared with ovens necessary for thermal recycling processes, and does not require the use of chemical solvents with subsequent environmental impacts. In this study the effect of incorporation of recycled GFRP waste materials, obtained by means of milling processes, on mechanical behavior of polyester polymer mortars was assessed. For this purpose, different contents of recycled GFRP waste materials, with distinct size gradings, were incorporated into polyester polymer mortars as sand aggregates and filler replacements. The effect of GFRP waste treatment with silane coupling agent was also assessed. Design of experiments and data treatment were accomplish by means of factorial design and analysis of variance ANOVA. The use of factorial experiment design, instead of the one factor at-a-time method is efficient at allowing the evaluation of the effects and possible interactions of the different material factors involved. Experimental results were promising toward the recyclability of GFRP waste materials as polymer mortar aggregates, without significant loss of mechanical properties with regard to non-modified polymer mortars.

Optimization of HS-SPME analytical conditions using factorial design for trihalomethanes determination in swimming pool water samples

Trihalomethanes (THMs) are widely referred and studied as disinfection by-products (DBPs). The THMs that are most commonly detected are chloroform (TCM), bromodichloromethane (BDCM), chlorodibromomethane (CDBM), and bromoform (TBM). Several studies regarding the determination of THMs in swimming pool water and air samples have been published. This paper reviews the most recent work in this field, with a special focus on water and air sampling, sample preparation and analytical determination methods. An experimental study has been developed in order to optimize the headspace solid-phasemicroextraction (HS-SPME) conditions of TCM, BDCM, CDBM and TBM from water samples using a 23 factorial design. An extraction temperature of 45 °C, for 25min, and a desorption time of 5 min were found to be the best conditions. Analysis was performed by gas chromatography with an electron capture detector (GC-ECD). The method was successfully applied to a set of 27 swimming pool water samples collected in the Oporto area (Portugal). TCM was the only THM detected with levels between 4.5 and 406.5 μg L−1. Four of the samples exceeded the guideline value for total THMs in swimming pool water (100 μgL−1) indicated by the Portuguese Health Authority.