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

Avaliação do conhecimento e de habilidades clínicas em saúde sexual e reprodutiva na graduação de medicina

No Brasil, a despeito das conquistas obtidas a partir da implantação do Sistema Único de Saúde e dos avanços legais e institucionais na atenção a diversos problemas relacionados ao gênero, a incorporação de temas relacionados aos direitos humanos, sexuais e reprodutivos no contexto da formação profissional em saúde permanece deficiente. Este trabalho teve como objetivos avaliar a inserção da temática saúde sexual e reprodutiva no currículo do curso de graduação em Medicina, por meio do emprego de avaliações de conteúdo cognitivo, procedimental e atitudinal. Trata-se de estudo de intervenção educacional envolvendo alunos do internato do curso de Medicina da UFRN. Foram utilizados os seguintes métodos avaliativos: prova escrita, exame clínico objetivo estruturado (OSCE) e Mini-CEX. Como variáveis explicativas foram consideradas o sexo, idade e participação prévia no componente curricular optativo Saúde Reprodutiva . A avaliação do processo constou da aplicação de questionários de satisfação e entrevistas acerca dos métodos avaliativos utilizados. Considerando os três métodos avaliativos empregados, 183 estudantes participaram do estudo, com média de idade de 24,5 ± 2,2 anos, sendo 52,5% do sexo masculino e 47,5% do sexo feminino. No contexto geral, observamos concordância entre os desempenhos dos estudantes nas avaliações de conteúdo cognitivo, procedimental e atitudinal. A participação dos estudantes no componente curricular eletivo Saúde Reprodutiva mostrou-se associada com melhor desempenho em algumas dimensões da avaliação cognitiva e na avaliação com o Mini-CEX, em relação às competências de anamnese, profissionalismo e qualidades humanísticas, relação médico paciente e desempenho global. A análise da fidedignidade entre os avaliadores na avaliação com o método OSCE mostrou-se adequada (alfa de Cronbach superior a 70%) em relação ao desempenho global e aos aspectos técnicos das competências avaliadas, observando-se baixa confiabilidade na avaliação da comunicação médico-paciente. O presente trabalho constitui-se numa experiência educacional inovadora e pioneira no âmbito da educação médica brasileira no que tange à inserção da temática de saúde sexual e reprodutiva na graduação, sugerindo-se um impacto positivo da iniciativa na formação do médico generalista na UFRN. A avaliação de conhecimentos, habilidades e atitudes em saúde sexual e reprodutiva na graduação de Medicina mostrou-se factível, com alta concordância entre os diferentes métodos empregados. Os métodos OSCE e Mini-CEX podem ser aplicados ao contexto da saúde sexual e reprodutiva, possibilitando a avaliação de competências clínicas relevantes para a formação do médico generalista e que habitualmente não são contempladas nas avaliações rotineiramente realizadas na graduação

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

A weight loss protocol and owners participation in the treatment of canine obesity

O sucesso de um programa de perda de peso para animais de estimação depende da colaboração do proprietário. A adesão deste é fundamental para a correta instituição do manejo alimentar do paciente. Este trabalho teve por objetivo comparar a efetividade de um programa de perda de peso em dois grupos de cães, um mantido sob condições experimentais e outro com seus proprietários. Empregou-se a mesma ração hipocalórica para todos os animais. A quantidade fornecida foi restrita a 60% da necessidade energética de manutenção estimada para o peso corporal meta, definido como o peso autal reduzido em 15%. Os animais foram acompanhados durante 90 dias. Por meio de um questionário padronizado, estudou-se a percepção dos proprietários quanto à obesidade e seu tratamento. Verificou-se que o protocolo e a dieta empregados foram eficazes. Os animais controle apresentaram uma perda de peso média de 1,39% por semana. Os cães de proprietário perderam, em média, 0,75% do peso vivo por semana, resultado estatisticamente menor (P<0,05), o que sugere uma indisponibilidade dos mesmos em cumprir rigorosamente o tratamento. Mesmo com esta perda de peso modesta, foi perceptível a satisfação dos proprietários com os resultados obtidos. O uso de questionários demonstrou ser uma ferramenta importante na investigação das causas e no acompanhamento do tratamento da obesidade canina.

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 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

Seis sigma :uma proposta para implementação da metodologia em pequenas e médias empresas

The Six Sigma methodology consists of a program guided to the continuous improvement of enterprise processes, which aims at customer satisfaction, as well as increasing financial and operational profits. Considering that more than 99% of the Brazilian companies have up to five hundred employees, this study investigates how Six Sigma can be applied in small or medium size companies. This study was conducted based on literature review and application of the ideas in a medium size newspaper company, which manufactures newspapers that circulate daily in the state of Rio Grande do Norte. The results of the research point to the viability of use of the methodology in this market segment, as well as suggest a method that can be used in similar companies