The interaction of ownership structure and customer satisfaction as determinants of brand equity

In this paper we study the interaction between ownership structure and customer satisfaction, and their impact on a firm's brand equity. We find that customer satisfaction has a positive direct effect on brand equity but an indirect negative one, through reductions in ownership concentration. This latter effect emerges when managers are focused mainly on satisfying customers. It gives out a warning signal that highlights the perverse effect of implementing policies focused excessively on satisfying customers at the expense of shareholders, on a firm's brand equity. We demonstrate our theoretical contention, empirically, making use of an incomplete panel data comprising 69 firms from 11 different nations for the period 2002-2005.

Consumer Satisfaction with Websites of Banks - The Moderating Effect of Consumer Technology Attractiveness

The websites are becoming the firms’ first contact interface with their clients. Hence, understanding customers’ online attitudes and behaviors have been capturing increased research attention. The extant research has pointed customers’ satisfaction with the websites as the main reason for customers’ online behaviors. This research has used mostly variables related to the characteristics of the websites as the predictors of customers’ website satisfaction. However, recent research shows that groups of individuals displaying distinctive characteristics react differently to the same context. Therefore, behavior may be considerably different among groups of customers. In this study, we develop a conceptual model of the influence of individual characteristics on the traditional website quality – website satisfaction relationship. We propose a model based on the construct of consumer technology attractiveness (CTA) to represent the genuine positive propensity of individuals toward technology. We further test the moderating effect of this construct on the commonly used predictors of customer’s website satisfaction using Hierarchical Multiple Regression. The empirical study was based on websites of banks operating in Portuguese market. The commercial banking industry is one of the Portuguese industries that better uses the Internet to establish relationships with clients. Data were collected through an online website satisfaction survey, participated by the lecturers and postgraduate students from four Portuguese Universities and Polytechnic Institutes. Our final sample comprised 276 valid questionnaires. Our study permits to conclude that the most commonly used antecedents of website overall satisfaction are still relevant for analyzing consumer’s satisfaction with the banks websites. We also conclude that CTA has a significant moderating effect on almost all customers’ website satisfaction variables used in the study. This study contributes to highlight the theoretical importance and significant influence of consumers’ personal characteristics on their online behavior. Moreover, for the practitioners, a better understanding of these individual characteristics will assist them in developing customized websites that will meet customers’ expectations. O estudo dos comportamentos dos consumidores em ambientes online tem vindo a ter um crescente interesse, uma vez que os websites estão a transformar-se num importante ponto de contacto entre as empresas e os seus clientes. A satisfação dos clientes com os websites tem sido apontada pela Literatura como o principal condicionante dos comportamentos online dos consumidores. No entanto, a investigação científica tem conseguido provar que grupos de indivíduos com características distintas reagem de forma diferente quando submetidos a contextos idênticos, o que poderá levar a diferenças significativas no comportamento online de consumidores pertencentes a diferentes grupos. Neste estudo desenvolvemos um modelo conceptual que reflecte a influência de características individuais na relação entre a qualidade e a satisfação com os websites. Propomos um modelo assente na atractividade tecnológica do consumidor (CTA), que representa a propensão genuína que os indivíduos possuem em relação à tecnologia. Testamos o efeito moderador deste conceito sobre as variáveis mais utilizadas nos estudos sobre a satisfação dos consumidores com os websites, utilizando a Regressão Múltipla Hierárquica. O estudo empírico baseou-se nos websites dos bancos que operam no mercado português, uma vez que este sector é um dos que melhor utiliza a Internet na sua relação com os clientes. Os dados foram recolhidos através de um questionário sobre satisfação com os websites, colocado online e dirigido a docentes e estudantes de programas de pós-graduações, mestrados e doutoramentos de quatro universidades e instituto politécnico portugueses, tendo resultado numa amostra final de 276 questionários validados estatisticamente. Este estudo permitiu concluir que as variáveis que são mais utilizadas como antecedentes da satisfação dos consumidores com os websites, continuam a ser igualmente válidas para a análise dos websites dos bancos. Também concluímos que a CTA tem efeitos moderadores significativos na grande maioria das variáveis utilizadas neste estudo. Assim, conseguimos realçar a importância teórica das características pessoais dos consumidores no seu comportamento online. Para os gestores, uma melhor compreensão destas características individuais permitir-lhes-á desenvolver websites customizados que irão satisfazer as expectativas dos seus clientes.

Treatment of skin lesions in newborn children: meeting the needs of nursing staff

Objective To understand, together with nursing staff, the care needed to treat skin lesions in newborn children hospitalized in a neonatal unit. Method Qualitative research, of the convergent care type. The data was collected through semi-structured interviews, which were conducted from November to December 2012, in the neonatal unit of a hospital in southern Brazil. The participants were four auxiliary nurses, six nursing technicians and four nurses. Results The following three categories were designated: questions about what can be used in relation to newborn children; hospitalization can cause lesions on the skin of newborn children; and knowledge about care promotes professional autonomy. Conclusion There is an urgent need for staff to know more about the treatment of skin lesions, which would provide safer care for newborn children and would also support the autonomy of professional nurses in providing that care.


Evaluating the intervening factors in patient safety: focusing on hospital nursing staff

OBJECTIVE To evaluate intervening factors in patient safety, focusing on hospital nursing staff. METHOD The study is descriptive, with qualitative approach, excerpt from a larger study with analytical nature. It was undertaken in a public hospital in Fortaleza, CE, Brazil, between January and June 2013, with semi-structured interviews to 70 nurses, using Thematic Content Analysis. RESULTS The principal intervening factors in patient safety related to hospital nursing staff were staff dimensioning and workload, professional qualification and training, team work, being contracted to the institution, turnover and lack of job security, and bad practice/disruptive behaviors. These aspects severely interfere with the establishment of a safety culture in the hospital analyzed. CONCLUSION It is necessary for managers to invest in nursing staff, so that these workers may be valued as fundamental in the promotion of patient safety, making it possible to develop competences for taking decisions with focus on the improvement of quality care.

Qualidade de Serviço numa unidade Hoteleira em São Vicente

A satisfação dos clientes é uma forma das empresas se manterem no mercado a partir da conquista dos seus parceiros comerciais, por isso o tema satisfação ganhou maior importância no contexto da administração de empresas. Dado o crescente fenómeno competitivo da indústria hoteleira, o objectivo deste estudo foi aumentar a compreensão das percepções sobre a qualidade do serviço de um hotel, da perspectiva dos seus consumidores. Além disso, este estudo também pretendeu explorar a relação entre a satisfação global e nove factores de qualidade num serviço sendo eles: “higiene e limpeza”, “decoração”, “conforto”, “funcionários”, “alimentação”, “animação”, “serviços de apoio”, “quarto”, e “relação qualidade/preço”. Esta pesquisa acedeu as percepções da qualidade do serviço no hotel através da aplicação de um questionário abrangendo uma amostra de 16 respondentes (hospedes que de livre vontade responderam ao questionário). Os dados recolhidos foram analisados em SPSS (Statistical Package for Social Sciences). Verificamos os seguintes resultados: São o conforto (primeiro lugar), a higiene e limpeza (em segundo) e os serviços de apoio (em terceiro) que mais influenciam a satisfação global no hotel. Costumer’s satisfaction is one way for companies to keep in the market by the conquest of its trading partners; hence, the theme of satisfaction gained greater importance in the context of business administration lately. Given the increasing competitive phenomenon in the touristic industry, the aim of this study was to increase the comprehension of perceptions towards hotel service quality from the hotel customer’s perspective. Besides, this study also intended to explore the relationship between the overall satisfaction and nine service quality factors, namely: “cleanness”, “decoration”, “comfort”, “staff”, and “food/beverage”, “entertainment” “support services”, “rooms and “relation quality/price”. This research assessed the ‘perceptions of service quality’ by applying a questionnaire comprising a sample of 16 guests that responded it correctly. Data collected was analyzed using SPSS - (Statistical Package for Social Sciences). The results indicated the following: comfort (in the first place), cleanness (in the second) and support services (in the third) are the factors that most influence the overall satisfaction in a hotel.

Instrument for assessing the quality of mobile emergency pre-hospital care: content validation

OBJECTIVES To validate an instrument to assess quality of mobile emergency pre-hospital care. METHOD A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K) and Content Validity Index (CVI), considering K> 0.80 and CVI ≥ 0.80. RESULTS Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes and remained in the instrument were: ambulance conservation status; physical structure; comfort in the ambulance; availability of material resources; user/staff safety; continuous learning; safety demonstrated by the team; access; welcoming; humanization; response time; costumer privacy; guidelines on care; relationship between professionals and costumers; opportunity for costumers to make complaints and multiprofessional conjunction/actuation. CONCLUSION The instrument to assess quality of care has been validated and may contribute to the evaluation of pre-hospital care in mobile emergency services.

Burnout and associated factors in employees of a Swiss teaching hospital

Background Working in a teaching hospital is a highly stressful occupation, which can lead to burnout. The consequences of burnout in health professionals can be very serious, both for themselves and patients. The aim of this cross-sectional study was to assess the extent of burnout and associated factors in hospital employees. Methods In the Fall of 2007, all employees of a Swiss teaching hospital were invited to complete a job satisfaction survey. It included the work-related burnout scale (scored 0-100) of the Copenhagen Burnout Inventory (CBI-French version), measuring the degree of physical and psychological fatigue and exhaustion perceived as related to the person's work; a high degree of burnout was defined as a score _50. Logistic regression analyses were used to determine factors associated with a high degree of burnout. Results A total of 4575 individuals returned the questionnaire (response rate 54%). Of them, 1503 (33%) had a high degree of burnout. The rate of burnout was higher among women (34.3% versus 30.5%, P = 0.012) and respondents younger than 40 years (37.7% versus 28.6%, P < 0.001). Executives were less prone to burnout than employees (27.1% versus 33.9%, P < 0.0019). Rates of burnout differed by profession: nurses and physicians had higher rates than administrative and logistic staff (42.8% and 37.4% versus 25.6% and 20.9%, respectively P < 0.001). Burnout was inversely associated with job satisfaction. In multivariate analysis, factors associated with burnout were overall dissatisfaction (OR 3.23; 95% CI 2.66-3.91), dissatisfaction with workload (OR 2.09; 95% CI 1.74-2.51) and work-life balance (OR 2.25; 95% CI 1.83-2.77), being a woman (OR 1.56; 95% CI 1.28-1.90), working fulltime (OR 1.41; 95% CI 1.08-1.85) and working as a nurse, a physician or in the psychosocial sector. Conclusions One-third of respondents, mostly nurses and physicians, experienced burnout and had lower levels of job satisfaction. The factors associated with burnout may help to tailor programmes aiming at reducing burnout at both the individual and organizational level within the hospital.

Pleasure-suffering indicators of nursing work in a hemodialysis nursing service

OBJECTIVE To measure the pleasure and suffering indicators at work and relate them to the socio-demographic and employment characteristics of the nursing staff in a hemodialysis center in southern Brazil. METHOD Quantitative research, with 46 workers. We used a self-completed form with demographic and labor data and the Pleasure and Suffering Indicators at Work Scale (PSIWS). We conducted a bivariate and correlation descriptive analysis with significance levels of 5% using the Epi-Info® and PredictiveAnalytics Software programs. RESULTS Freedom of Speech was considered critical; other factors were evaluated as satisfactory. The results revealed a possible association between sociodemographic characteristics and work, and pleasure and suffering indicators. There was a correlation between the factors evaluated. CONCLUSION Despite the satisfactory evaluation, suffering is present in the studied context, expressed mainly by a lack of Freedom of Speech, with the need for interventions to prevent injury to the health of workers.

Nursing staff sizing in the emergency room of a university hospital

OBJECTIVE To verify the adequacy of the professional nursing staff in the emergency room of a university hospital and to evaluate the association between categories of risk classification triage with the Fugulin Patient Classification System. METHOD The classification of patients admitted into the emergency room was performed for 30 consecutive days through the methodology proposed by Gaidzinski for calculating nursing requirements. RESULTS The calculation determines the need for three registered nurses and four non-registered nursing for each six hour shift. However, only one registered nurse and four non-registered nurse were available per shift. There was no correlation between triage risk classification and classification of care by the Fugulin Patient Classification System. CONCLUSION A deficit in professional staff was identified in the emergency room. The specificity of this unit made it difficult to measure. To find the best strategy to do so, further studies should be performed.

Implementing the intermed in a post-acute care rehabilitation clinic for traumatic injuries: Obstacles and benefits

In 2003, the INTERMED, an instrument to assess biopsycho- social case complexity and to direct care, was introduced in daily clinical practice in the .Clinique romande de réadaptation suvaCare., a national rehabilitation hospital for traumatic injuries, located in the French speaking part of Switzerland. The introduction of the INTERMED was easy to realize and no major obstacles hampered its systematic implementation. Up to now, about 2,000 patients have been evaluated with the INTERMED and are followed for different outcomes. The INTERMED improved not only patients. assessment by including relevant psychosocial aspects of the clinical situation, it also favoured interdisciplinary communication, enhanced work satisfaction of the nursing staff and allowed early identification and adaptation of treatment for the injured patient showing a high degree of case complexity. Upon follow up, patients with a high degree of case-complexity showed a less favourable outcome, i.e. more health care utilization and lower rates of return to work. In conclusion, the systematic implementation of the INTERMED enabled the reorganization of medical rehabilitation, anchored it in a bio-psycho-social framework, improving interdisciplinary communication and collaboration and ameliorated treatment outcome.

Job satisfaction and life satisfaction: Analysis of a reciprocal model with social demographic moderators

The general objective of the study was to empirically test a reciprocal model of job satisfaction and life satisfaction while controlling for some social demographic variables. 827 employees working in 34 car dealerships in Northern Quebec (56% responses rate) were surveyed. The multiple item questionnaires were analysed using correlation analysis, chi square and ANOVAs. Results show interesting patterns emerging for the relationships between job and life satisfaction of which 49.2% of all individuals have spillover, 43.5% compensation, and 7.3% segmentation type of relationships. Results, nonetheless, are far richer and the model becomes much more refined when social demographic indicators are taken into account. Globally, social demographic variables demonstrate some effects on each satisfaction individually but also on the interrelation (nature of the relations) between life and work satisfaction.

Patients's satisfaction concerning postoperative analgesia after caesarean section: a comparison of 4 alternative analgesic regimen

Introduction: Different routes of postoperative analgesia may be used after cesarean section: systemic, spinal or epidural [1]. Although the efficacy of these alternative analgesic regimen has already been studied [2, 3], very few studies have compared patients' satisfaction between them. Methodology: After ethical committee acceptation, 100 ASA 1 patients scheduled for an elective cesarean section were randomized in 4 groups. After a standardized spinal anesthesia (hyperbaric bupivacaine 10 mg and fentanyl 20 μg), each group had a different postoperative analgesic regimen: - Group 1: oral paracetamol 4x1 g/24 h, oral ibuprofene 3x600 mg/24 h and subcutaneous morphine on need (0.1 mg/kg 6x/24 h) - Group 2: intrathecal morphine (100 μg) and then same as Group 1 - Group 3: oral paracetamol 4x1 g/24 h, oral ibuprofene 3x600 mg/24 h and PCEA with fentanyl 5 μg/ml epidural solution - Group 4: oral paracetamol 4x1g/24 h, oral ibuprofene 3x600 mg/ 24 h and PCEA with bupivacaine 0.1% and fentanyl 2 μg/ml epidural solution After 48 hours, a specific satisfaction questionnaire was given to all patients which permitted to obtain 2 different scores concerning postoperative analgesia: a global satisfaction score (0-10) and a detailed satisfaction score (5 questions scored 0-10 with a summative score of 0-50). Both scores, expressed as mean ± SD, were compared between the 4 groups with a Kruskall-Wallis test and between each group with a Mann-Whitney test. A P-value <0.05 was considered significant. Results: Satisfaction scores Gr. 1 (n = 25) Gr. 2 (n = 25) Gr. 3 (n = 25) Gr. 4 (n = 25) P-value global (0-10) 8.2 ± 1.2 9.0 ± 1.0 7.8 ± 2.1 6.5 ± 2.5 0.0006 detailed (0-50) 40 ± 6 43 ± 5 38 ± 6 34 ± 8 0.0002 Conclusion: Satisfaction scores were significantly better in patients who received a systemic postoperative analgesia only (Groups 1 and 2) compared to patients who received systemic and epidural postoperative analgesia (Groups 3 and 4). The best scores were achieved with the combination of intrathecal morphine and multimodal systemic analgesia (Group 2) which allowed early ambulation without significant pain. Patients treated with postoperative epidural analgesia with combined local anesthetics and opioids (Group 4) obtained the worse scores (more restrictive nursing with less mobility, frequent asymmetrical block with insufficient analgesia on one side and motor block on the other)