Fatores que afetam a satisfação de pacientes em serviços de saúde :um estudo em setor ambulatorial de hospital

This thesis shows concepts and models related to customer satisfaction measurement, focusing in detail on patients satisfaction evaluations in a policlinic sector of a hospital located in Natal RN. To reach this aim, two hundred and fifty one patients of this hospital were interviewed. The methodology approach includes a theoretical basis through a review and study of previous research on the topic, governmental initiatives and management systems which deal with excellence and need more reports concerning customers perceptions about satisfaction. Furthermore, it was included some models of nationals index about customer satisfaction. The Norwegian model was used in this thesis. The use of this approache, together with a multiple regression analysis, led to results that shows the factors which affect patients satisfaction in a policlinic sector. They are four as following: The evaluation of physician attendance; its results; simplicity of accessibility when health services are needed; and both support and tranquility given by the hospital. The study results can support researches of a conceptual model to determinate the aspects which affect the patient s satisfaction and could be a contribution to a development of a national costumer satisfaction index

Medição de satisfação e fidelidade do cliente :um estudo com pacientes de clínica particular

This Thesis deals with a study on customer satisfaction and loyalty measurement focusing on a model of factors antecedents of customer satisfaction and loyalty. The model is based on a Satisfaction Index model adopted in Norway developed by Johnson et al.(2001) and the service quality drivers from the literature. It is surveyed a sample of 130 patients of a gynecology clinical. It is used a multiple regression analysis as the main statistical method in order to verify the factors affecting satisfaction and loyalty. The main findings are that the quality model explain 54% of the satisfaction but the whole model explain only 31% of the loyalty. Although the results are consistent with the literature in term of quality as the main driver of the satisfaction and that the satisfaction is not only one factor to explain loyalty, both the quality model to satisfaction and the factors model affecting loyalty should be improved to explain better the satisfaction and loyalty in health care service

Gestão da satisfação e fidelidade do cliente: um estudo em uma instituição de ensino superior

This Master of Science Thesis deals with the customer satisfaction and loyalty focusing on a private higher education institution in Belém city, Brazil. The literature review focuses on costumer satisfaction and loyalty concepts and theory, models of quality managing systems and methodologies of costumer satisfaction measurement. The research was a survey with a random stratified sample of 329 undergraduate students of Business Administration at the Faculdade do Pará , in the morning and the night periods. The data analysis was made through the descriptive statistics and multiple regression analysis. The main findings are that the model was satisfactory and the main factors affecting Satisfaction to the School were Best Professor Didatics (beta=0.297), Courses Contents (beta=0.280), Clerks Sympathy (beta=0.201), and Number of Students in Classroom (beta=0,187) with a adjusted R2 = 0,47. The main factors affecting School Loyalty with an adjusted R2 = 0,43 were School Image (beta=0.383), Affective Commitment (beta=0.255), and Satisfaction with Professors (beta=0,218). The findings suggest also that may be differences between the set of students and those that complain for something

Fatores que afetam a satisfação e a fidelidade do cliente: um estudo com compradores de automóveis

This thesis presents a contribution to the study customer satisfaction models, analyzing the relationship between antecedent variables satisfaction and customer loyalty, through a survey with car s buyers in Natal. The theorical survey is focused in concepts of customer satisfaction and loyalty, and in the customer satisfaction index models. For the field survey, was applied a questionnaire, based on the Norwegian Customer Satisfaction Barometer (NCSB), considered by Johnson et al. (2001), with 106 customer of concessionary Fiat, the Pontanegra Automóveis. The main results obtained by the multiple regression analysis reveal that, considering the Fiat, the satisfaction is influencing by reliance degree in the firm seriousness and by complaining handling, the loyalty is influenced by possibility of again pay the same value if was again buy a car, the satisfaction degree with a car, affective commitment relationship firm customer of the own car and the complaining handling. Considering the concessionaire, the satisfaction is influenced by reliance degree in the firm seriousness, ability degree of the concessionaire in delivery service and by complaining handling, already the loyalty is influencing by possibility of again pay the same value if was again buy a car, affective commitment relations to be concessionaire s customer, by calculate commitment in relation the economic loss of bought this car of this firm and complaining handling

Gestão de satisfação e fidelidade do cliente: um estudo com turistas em hotéis

This Thesis deals with a study on customer satisfaction and loyalty focusing on a model of factors antecedents of customer satisfaction and loyalty. The model is based on a Satisfaction Index model adopted in Norway developed by Johnson et al.(2001) and the service quality drivers from the literature. It is surveyed a sample of tourist in Natal. It is used a survey questionnaire applied at the airport in the departure moment of the tourist. The final sample results on 198 cases. Is is used a multiple regression analysis as the method to verify the factor affecting satisfaction and loyalty. Two models arise from the analysis. The first model concerning satisfaction results with cleaness and hygiene of the bathroom, leisure facilities, employees promptness, and price as the significant factors affecting satisfaction. The model has a R2 of 0.6430 and the also check in service, cleaness of the apartment and the hotel in general, bedroom setting have colinearity with some factors entering the model. The loyalty model results with satisfaction, affective commitment as the main factors affecting loyalty, with a R2 0.5396, and also image has collinearity with satisfaction. A small part of the sample has complained and this factor was not considered in the models. The results are consistent with the literature in term of quality as the main driver of the satisfaction and that it is not the only one factor to explain loyalty

Gestão ambiental e competitividade: um estudo sobre os fatores que afetam a decisão de compra de produtos orgânicos na cidade de Teresina-PI

The organic products represent one of the main trends of alimentary consumption in the new century. In Brazil, the answer is already well representative which it becomes the country, as a great consuming and exporting market of products of LVF type. The objective of this research was to investigate the factors capable to influence the food consumer in its purchase decision of organic products in the supermarkets of Teresina, capital of Piauí State. The methodology was exploratory and descriptive, using survey, with closed and opened questions in 542 interviewed. The questionnaire was based on projected scales to evaluate the factors that can influence the purchase decision of organic products, whose variable had been grouped in the following groups: behavior, knowledge, interest, competitiveness, importance, barrier and profile. The used statistical techniques were descriptive analysis and multiple regression analysis. The results demonstrate interest of the population in paying more for the organic product, due to better quality of life, however it lacks to one better spreading and greater sensitization to attract these consumers. Some recommendations and proposals are presented after the results, as suggestions for future research

Gestão de satisfação e fidelidade do cliente: um estudo dos fatores que afetam a satisfação e fidelidade dos compradores de automóveis

This Master s thesis presents a discussion on customer satisfaction models investigating the relations of antecedent variables service quality, price index, complaint handling, image, affective and calculative commitment, with satisfaction and loyalty. The scope of the research is the influence of service dimensions in the car buyer s satisfaction and loyalty. A sample of 91 customers was surveyed among new cars buyers of one brand in Natal city, Brazil, and the data was analyzed using multiple regression analysis. The literature review covers subjects such as customer satisfaction, management system, customer satisfaction measurement index models. The main findings suggest that satisfaction with the car brand is mainly influenced by customization of the service, time for accomplishing servicing, and the way the dealer handle complains. Regarding the dealer itself the main variable related to satisfaction is also time for accomplishing servicing. Considering customer loyalty, the customer satisfaction with the dealer explain strongly the loyalty with the brand/manufacturer. Also, the satisfaction, affective commitment and complains handling were found related to loyalty, as the stronger variables explaining the loyalty variance. One main conclusion is that service provided by dealers is one key factor influencing the customer satisfaction and loyalty in auto industry

Avaliação da função pulmonar em obesos mórbidos com sonolência diurna excessiva

Background: Obesity impairment to the pulmonary function related to the magnitude of adiposity and is associated with excessive daytime sleepiness (EDS) and snoring, among others symptoms of respiratory disorders related to sleep. It is possible that obese individuals with excessive daytime sleepiness may make changes in lung function on spirometry monitored during the day as a consequence of fragmented sleep or episodes of nocturnal hypoventilation that cause respiratory and changes that can persist throughout the day. The combination of these findings alone sleepiness observed by subjective scales with pulmonary function in obese patients is unknown. Objective: To assess the influence of EDS and snoring on pulmonary function in morbidly obese and distinguish between different anthropometric markers, the snoring and sleepiness which the best predictors of spirometric function and respiratory muscle strength and endurance of these patients. Methods: We evaluated 40 morbidly obese markers on the anthropometric, spirometric respiratory variables, maximal inspiratory and expiratory pressures (MIP and MEP) and maximal voluntary ventilation (MVV) and the measured excessive daytime sleepiness (the Epworth sleepiness scale) and snoring (snoring scale of Stanford). The data were treated when the differences between the groups of obese patients with and without sleepiness, whereas the anthropometric variables, respiratory and snoring. Pearson's correlation was performed, and multiple regression analysis assessed the predictors of pulmonary function. For this we used the software SPSS 15.0 for windows and p <0.05. Results: 39 obese patients were included (28 women), age 36.92+11.97y, body mass index (BMI) 49.3+5.1kg/m², waist-hip ratio (WHR) 0.96+0.07 and neck circumference (NC) 44.1+4.2 cm. Spirometric values and respiratory pressures were up 80% of predicted values, except for endurance (MVV <80%). Obese with EDS have lower tidal volume. Positive correlation was observed between BMI and EDS, EDS and NC and between snoring and BMI, and negative correlation between EDS and tidal volume (TV), and between snoring and snoring FVC and FEV1. In linear regression the best predictor of pulmonary function was snoring, followed by NC. NC has more obese with higher strength (MEP, p = 0.031) and endurance (MVV p = 0.018) respiratory muscle. Conclusion: Obese with EDS tend to have lower TV. In addition, snoring and NC can better predict pulmonary function in obese when compared with other anthropometric markers or EDS. Obese patients with higher NC tend to have greater capacity for overall strength of respiratory muscles, but may have low muscle endurance

Avaliação de lesões brancas de cáries: um estudo de prognóstico

Objective: The aim of the present study is to assess the current situation of white enamel lesions on vestibular surfaces of permanent upper incisors, diagnosed 6 years ago, without clinical intervention. Methods: A prospective study reassessed 53 students of both sexes, aged between 13 and 18 years old, all attending the public school system in Natal, Brazil. Data collection was performed by duly calibrated examiners, and a clinical chart consisting of demographic data on dental caries, oral hygiene, and gingival condition was prepared. A tactile-visual examination was conducted using a clinical mirror and periodontal probe. Data compilation and analysis were carried out using a SPSS software. In this analysis the chi-squared test was used for qualitative independent variables. To identify the net effect of treatment, multiple logistic analysis with forward stepwise model selection was performed. Results: The final sample was composed of 106 lesions in the 53 individuals, with mean age of 15.02 years, visible plaque index (VPI) of 23.34%, and gingival blood indices (GBI) of 25.92%. A statistically significant relationship (p = 0.003) was found between initial DMFS and prognosis of white enamel lesion. Conclusions: We observed that past caries experience and dental plaque were the main predictive factors for negative lesion outcomes, demonstrating the need for oral hygiene control through continuing preventive measures

Variação temporal e descrição de novas espécies de collembola (arthropoda, hexapoda) em uma área de caatinga do nordeste do Brasil

Collembola is one of the most abundant and diverse group of terrestrial arthropods, being at the base of the food chain operating in the decomposition process. They have a wide distribution in the world and can be found in practically all habitats. The knowledge of this distinctive fauna is still deficient in brazilian territory, especially in semi-arid region. The aim of this study was to investigate which climatic variables may act as predictors of species richness, abundance of individuals and compositional structure of the taxocenose of Collembola over 12 months in an area dominated by semi-arid Caatinga vegetation, northeastern Brazil and describe new species of the genus Seira found, more diverse taxon of Collembola in Brazil. Samples were collected in João Câmara, Rio Grande do Norte. Ten plots of 20 x 20 meters were established and the specimens were collected with collection effort of one hour/people using entomological aspirator. The identification and description of the species was carried out by studying the morphology and chaetotaxy. Was performed a multiple regression analysis between species richness and abundance of individuals with climatic variables. A total of 1231 individuals belonging to 15 species, 12 genera and nine families. The greatest richness and abundance of Collembola were found during the rainy season. The genus Seira was the most abundant. Rainfall explained the temporal variation in species richness and abundance of Collembola in the semi-arid region, which is consistent with the biology of these animals. The populations of Collembola showed grouped distribution. Three new species of Seira were described and illustrated and all show similarities with species already registered in the national territory

Variação temporal e descrição de novas espécies de collembola (arthropoda, hexapoda) em uma área de caatinga do nordeste do Brasil

Collembola is one of the most abundant and diverse group of terrestrial arthropods, being at the base of the food chain operating in the decomposition process. They have a wide distribution in the world and can be found in practically all habitats. The knowledge of this distinctive fauna is still deficient in brazilian territory, especially in semi-arid region. The aim of this study was to investigate which climatic variables may act as predictors of species richness, abundance of individuals and compositional structure of the taxocenose of Collembola over 12 months in an area dominated by semi-arid Caatinga vegetation, northeastern Brazil and describe new species of the genus Seira found, more diverse taxon of Collembola in Brazil. Samples were collected in João Câmara, Rio Grande do Norte. Ten plots of 20 x 20 meters were established and the specimens were collected with collection effort of one hour/people using entomological aspirator. The identification and description of the species was carried out by studying the morphology and chaetotaxy. Was performed a multiple regression analysis between species richness and abundance of individuals with climatic variables. A total of 1231 individuals belonging to 15 species, 12 genera and nine families. The greatest richness and abundance of Collembola were found during the rainy season. The genus Seira was the most abundant. Rainfall explained the temporal variation in species richness and abundance of Collembola in the semi-arid region, which is consistent with the biology of these animals. The populations of Collembola showed grouped distribution. Three new species of Seira were described and illustrated and all show similarities with species already registered in the national territory

Influência dos intermediários de distribuição de produtos turísticos no processo de decisão do meio de hospedagem pelo consumidor

This study examines the complex hotel buyer decision process in front of the tourism distribution channels. Its objective is to describe the influence level of the tourism marketing intermediaries, mainly the travel agents and tour operators, over the hotel decision process by the buyer-tourist. The data collection process was done trough a survey with three hundred brazilian tourists hosted in nineteen hotels of Natal, capital of Rio Grande do Norte, Brazil. The data analysis was done using some multivariate statistic techniques as correlation analysis, multiple regression analysis, factor analysis and multiple discriminant analysis. The research characterizes the hotel services consumers profile and his trip, and identifying the distribution channels used by them. Furthermore, the research verifies the intermediaries influence exercised over hotel buyer decision process, looking for identify causality relations between the influence level and the buyer profile. Verifies that information about hotels available on internet reduces the probability that this influence can be practiced; however it was possible identifying those consumers considers this information complementary and non-substitutes than the information from intermediaries. The characteristics of the data do not allow indentifying the factors that constraint the intermediaries influence neither identifying discriminant functions of the specific distribution channel choice by consumers. The study concludes that consumers don t agree in have been influenced by intermediaries or don t know if they have, still considering important to consult them and internet doesn t substitute their function as information source

Fatores que influenciam a intenção de compra online: aplicação de um modelo adaptado de aceitação da tecnologia para o comércio eletrônico

This research aims to understand the factors that influence intention to online purchase of consumers, and to identify between these factors those that influence the users and the nonusers of electronic commerce. Thus, it is an applied, exploratory and descriptive research, developed in a quantitative model. Data collection was done through a questionnaire administered to a sample of 194 graduate students from the Centre for Applied Social Sciences of UFRN and data analysis was performed using descriptive statistics, confirmatory factorial analysis and simple and multiple linear regression analysis. The results of descriptive statistics revealed that respondents in general and users of electronic commerce have positive perceptions of ease of use, usefulness and social influence about buying online, and intend to make purchases on Internet over the next six months. As for the non-users of electronic commerce, they do not trust the Internet to transact business, have negative perceptions of risk and social influence over purchasing online, and does not intend to make purchases on Internet over the next six months. Through confirmatory factorial analysis six factors were set up: behavioral intention, perceived ease of use, perceived usefulness, perceived risk, trust and social influence. Through multiple regression analysis, was observed that all these factors influence online purchase intentions of respondents in general, that only the social influence does not influence the intention to continue buying on the Internet from users of electronic commerce, and that only trust and social influence affect the intention to purchase online from non-users of electronic commerce. Through simple regression analysis, was found that trust influences perceptions of ease of use, usefulness and risk of respondents in general and users of electronic commerce, and that trust does not influence the perceptions of risk of non-users of electronic commerce. Finally, it was also found that the perceived ease of use influences perceived usefulness of the three groups. Given this scenario, it was concluded that it is extremely important that organizations that work with online sales know the factors that influence consumers purchasing intentions in order to gain space in their market

Diagnóstico ecotoxicológico dos efluentes lançados no complexo estuarino do Jundiaí/Potengi, Natal/RN

Untreated effluents that reach surface water affect the aquatic life and humans. This study aimed to evaluate the wastewater s toxicity (municipal, industrial and shrimp pond effluents) released in the Estuarine Complex of Jundiaí- Potengi, Natal/RN, through chronic quantitative e qualitative toxicity tests using the test organism Mysidopsis Juniae, CRUSTACEA, MYSIDACEA (Silva, 1979). For this, a new methodology for viewing chronic effects on organisms of M. juniae was used (only renewal), based on another existing methodology to another testorganism very similar to M. Juniae, the M. Bahia (daily renewal).Toxicity tests 7 days duration were used for detecting effects on the survival and fecundity in M. juniae. Lethal Concentration 50% (LC50%) was determined by the Trimmed Spearman-Karber; Inhibition Concentration 50% (IC50%) in fecundity was determined by Linear Interpolation. ANOVA (One Way) tests (p = 0.05) were used to determinate the No Observed Effect Concentration (NOEC) and Low Observed Effect Concentration (LOEC). Effluents flows were measured and the toxic load of the effluents was estimated. Multivariate analysis - Principal Component Analysis (PCA) and Correspondence Analysis (CA) - identified the physic-chemical parameters better explain the patterns of toxicity found in survival and fecundity of M. juniae. We verified the feasibility of applying the only renewal system in chronic tests with M. Juniae. Most efluentes proved toxic on the survival and fecundity of M. Juniae, except for some shrimp pond effluents. The most toxic effluent was ETE Lagoa Aerada (LC50, 6.24%; IC50, 4.82%), ETE Quintas (LC50, 5.85%), Giselda Trigueiro Hospital (LC50, 2.05%), CLAN (LC50, 2.14%) and COTEMINAS (LC50, IC50 and 38.51%, 6.94%). The greatest toxic load was originated from ETE inefficient high flow effluents, textile effluents and CLAN. The organic load was related to the toxic effects of wastewater and hospital effluents in survival of M. Juniae, as well as heavy metals, total residual chlorine and phenols. In industrial effluents was found relationship between toxicity and organic load, phenols, oils and greases and benzene. The effects on fertility were related, in turn, with chlorine and heavy metals. Toxicity tests using other organisms of different trophic levels, as well as analysis of sediment toxicity are recommended to confirm the patterns found with M. Juniae. However, the results indicate the necessity for implementation and improvement of sewage treatment systems affluent to the Potengi s estuary

Comunidades zooplanctônicas como bioindicadoras da qualidade da água de quatro reservatórios da região semi-árida do Rio Grande do Norte

The response of zooplankton assemblages to variations in the water quality of four man-made lakes, caused by eutrophication and siltation, was investigated by means of canonical correspondence analysis. Monte Carlo simulations using the CCA eingenvalues as test statistics revealed that changes in zooplankton species composition along the environmental gradients of trophic state and abiogenic turbidity were highly significant. The species Brachionus calyciflorus, Thermocyclops sp. and Argyrodiaptomus sp. were good indicators of eutrophic conditions while the species Brachionus dolabratus, Keratella tropica and Hexarthra sp. were good indicators of high turbidity due to suspended sediments. The rotifer genus Brachionus was the most species-rich taxon, comprising five species which were associated with different environmental conditions. Therefore, we tested whether this genus alone could potentially be a better biological indicator of these environmental gradients than the entire zooplankton assemblages or any other random set of five species. The ordination results show that the five Brachionus species alone did not explain better the observed pattern of environmental variation than most random sets of five species. Therefore, this genus could not be selected as a target taxon for more intensive environmental monitoring as has been previously suggested by Attayde and Bozelli (1998). Overall, our results show that changes in the water quality of man-made lakes in a tropical semi-arid region have significant effects on the structure of zooplankton assemblages that can potentially affect the functioning of these ecosystems