Validação do instrumento dos indicadores observáveis da qualidade do cuidado em instituições de longa permanência para idosos

The Nursing Homes are an important alternative care in the world, but Brazil still has no valid instrument to monitor the quality these institutions. In the United States, the Observable Indicators of Nursing Home Care Quality Instrument (OIQ) is used to assess the quality of Nursing Home care using 30 indicators of structure (2 dimensions) and process (5 dimensions) related to quality person-centered care. The present study aimed at cross-culturally adapting the OIQ in order to evaluate the quality of Nursing Home care in Brazil. Conceptual and item equivalence were determined to assess the relevance and viability of OIQ in the Brazilian context, using the Content Validity Index (CVI) and a group of specialists composed of 10 participants directly involved in the object of study. Next, operational, idiomatic and semantic equivalence were carried out concurrently. This consisted of 5 phases: (1) two translations and (2) their respective back translations; (3) formal appraisal of referential and general meaning; (4) review by a second group of specialists; (5) application of the pretest at three Nursing Homes by different social entities: health professionals, sanitary surveillance regulators and potential consumers. Measurement equivalence was evaluated by the Cronbach’s alpha test to verify the internal consistency of the instrument. To measure inter-evaluator agreement, the General Agreement Index (ICG) and Kappa coefficient were used. Timely compliance and 95% Confidence Interval of indicators, dimensions and total construct were estimated. The CVI obtained high results for both relevance (95.3%) and viability (94.3%) in the Brazilian context. With respect to referential meaning, similarity was observed, ranging between 90-100% for the first back translation and 70-100% for the second. In relation to general meaning, version 1 was better, classified as “unchanged” in 80% of the items, whereas in version 2 it was only 47%. In the pretest, the OIQ was easy to understand and apply. The following outcomes were obtained: a high Cronbach’s alpha (0.93), satisfactory ICG (75%) and substantial agreement between the pairs of evaluators (health professionals, regulators from the Superintendency of Sanitary Surveillance –SUVISA-, and potential consumers), according to the Kappa coefficient (0.65). It´s possible take the operational equivalence held since it preserved the original layout in the Brazilian version from the maintenance in application mode, response options, number of items, statements and scores. The performance of nursing homes obtained approximate average scores of 87, a variation 55-111 considering a range from 30 to 150 points. The worst outcomes were related to process indicators with a mean of 2.8 per item, while structure was 3.75 on a scale of 1 to 5. The lowest score was obtained for the care dimension (mean 2). The OIQ version was deemed to be a valid and reliable instrument in the Brazilian context. It is recommended that health professionals, regulators and potential consumers adopt it to access and monitor the quality of Nursing Home care and demonstrating opportunities for improvement.

Análise estratégica das Instituições de Ensino Superior privadas da cidade do Natal

Private Higher Education Institutions are embedded in a market where competitiveness is a key factor. To remain competitive, HEIs needs to have proactive and innovative strategies, especially to understand their main customers, students, with regard to their expectations about the quality of HEI. This study is to evaluate the overall private institutions of higher education in the city of Natal / RN, as the strategies adopted to remain on the market , based on the perceived quality of students. For conduct this research, it has developed two private institutions in the city of Natal, through the application using exploratory research to guide the survey for data collection with questionnaire to apply the overview with students, being directed to senior students courses in Bussiness, Accounting and Law. This research tool addresses aspects relevant to map the dimensions: (1) teaching, perspectives related to methods and teaching tools; ( 2 ) teachers, specifies the quality attributes related to teachers; (3 ) Infrastructure, describes the environment of the HEI; ( 4 ) services , evaluates the quality processes that attach to the HEI; and ( 5 ) intangible relates aspects with student satisfaction. The results were analyzed using descriptive statistical techniques using the Statistical Package Tool for Social Sciences (SPSS). The first stage of results characterizes the descriptive analysis of the overall sample and by HEI and course, plus a build univariate analysis of the HEI and also bivariate analysis shows that correlation of the factors through Spearman correlation coefficient. The results were used to compose a matrix of importance versus performance that compare with the contents of the Ministry of Education and Culture (MEC). Finally, these comparisons allowed identification of the most important factors for the quality of the HEI and the level of performance from institutions in the development of each attributes of quality dimensions.

Gestão e mapeamento de processos nas instituições públicas: um estudo de caso na Diretoria de Administração de Pessoal da Universidade Federal do Rio Grande do Norte

The new management models have led to the reorganization of institutions today. Much is made in improving the delivery of public services entities, and they have sought to adopt these new initiatives in order to improve the quality of the product or service offered to users. The modernization of the management model at the Federal University of Rio Grande do Norte (UFRN) strengthened by the accession of the institution to GesPública Program, which focuses on the management modernization leading institutions to seek ways to fit to meet the demands proposed the Program. Therefore, the Department of Personnel Administration (DAP) has structured its processes and procedures using the mapping tool processes. This research starts from the question: what were the results obtained with the implementation of the management and process mapping of PAD? It is proposed as a general objective to analyze the management and the mapping of that Board processes, identifying the possible benefits in improving the quality of the services provided to users. The specific objectives to achieve results, are pointed out: describe how you carried out the implementation of the management and process mapping in DAP and how it is working at the moment; examine the line in the relationship between the actions developed by the DAP and modern theories of this theme; identify the evolution of the sector with the measures adopted and the results obtained with the implementation of the mapping tool. In the theoretical framework, it was approached a brief history of the evolution of public administration in Brazil, GesPública program and its importance for process management in public institutions as well as the Management and Process Mapping. The context of the study was the DAP, and participants were managers of the institution in the survey. Data collection was done through the study of the institution's documents, bibliography analysis available on the topic, questionnaires and semi-structured interviews with professionals of the institution involved with the object of study, since its inception until July 2015, when it was finished the search. As a result, were listed: the motivation, importance, benefits and innovations that management and the mapping of processes brought to the institution, point out what has been improved in the service users and the tools used. We also analyze the main problems identified during the implementation of the mapping. As a suggestion, it was analyzed how these procedures can, if possible, be extended to other sectors of UFRN.

Gestão e mapeamento de processos nas instituições públicas: um estudo de caso na Diretoria de Administração de Pessoal da Universidade Federal do Rio Grande do Norte

The new management models have led to the reorganization of institutions today. Much is made in improving the delivery of public services entities, and they have sought to adopt these new initiatives in order to improve the quality of the product or service offered to users. The modernization of the management model at the Federal University of Rio Grande do Norte (UFRN) strengthened by the accession of the institution to GesPública Program, which focuses on the management modernization leading institutions to seek ways to fit to meet the demands proposed the Program. Therefore, the Department of Personnel Administration (DAP) has structured its processes and procedures using the mapping tool processes. This research starts from the question: what were the results obtained with the implementation of the management and process mapping of PAD? It is proposed as a general objective to analyze the management and the mapping of that Board processes, identifying the possible benefits in improving the quality of the services provided to users. The specific objectives to achieve results, are pointed out: describe how you carried out the implementation of the management and process mapping in DAP and how it is working at the moment; examine the line in the relationship between the actions developed by the DAP and modern theories of this theme; identify the evolution of the sector with the measures adopted and the results obtained with the implementation of the mapping tool. In the theoretical framework, it was approached a brief history of the evolution of public administration in Brazil, GesPública program and its importance for process management in public institutions as well as the Management and Process Mapping. The context of the study was the DAP, and participants were managers of the institution in the survey. Data collection was done through the study of the institution's documents, bibliography analysis available on the topic, questionnaires and semi-structured interviews with professionals of the institution involved with the object of study, since its inception until July 2015, when it was finished the search. As a result, were listed: the motivation, importance, benefits and innovations that management and the mapping of processes brought to the institution, point out what has been improved in the service users and the tools used. We also analyze the main problems identified during the implementation of the mapping. As a suggestion, it was analyzed how these procedures can, if possible, be extended to other sectors of UFRN.

A hora da alfabetização: atores, ideias e instituições na construção do PAIC-CE

The objective of this thesis is to understand how a certain social condition becomes relevant enough to be regarded as an issue worthy of government action and how certain proposed initiatives prevail while others are discarded. More specifically, the goal is to discuss public policy for education and check whether the analytical models employed are significant enough to explain how the literacy issue became part of the policy agenda of the government of the State of Ceará in Brazil, and how the Literacy Program at the Right Age (PAIC) developed over time. From the empirical perspective about public policy for education in Brazil, this is a relevant case when one takes into account that, historically, the literacy policies are focused on teenagers and adults, implying a lack of specific initiatives towards children at the proper age of learning to read and write. In order to understand what drove this issue to the top of the state government agenda, this thesis is primarily based on the literature about public policy analysis, with focus on the agenda setting process and development of proposals. A hybrid approach is used, combining analytical tools from Kingdon’s Multiple Streams Model (1995), the Advocacy Coalition Framework by Sabatier and Jenkins Smith (1993) and the historical new institutionalism lens. The research method is qualitative and based on the single case study method. The data set was assembled from institutional PAIC-related documents, tachygraphy notes from sessions at Ceará’s State House of Representatives, press clippings, academic studies and interviews with key participants from several organizations. The conclusion of this thesis is that, given the complexity of the case in point, the combination of the three analytical methods is adequate and necessary to understanding the multiple drivers for this issue to have entered Ceará’s state government agenda and the design of the PAIC itself. Particularly relevant are the ideas and the policy entrepreneurs, the processes of problem recognition for the composition of a wide coalition and for the specification of alternatives, and the path dependence of the education policy in Ceará. This study adds, as a result, to a better understanding of the stages that make up the agenda setting in public policy, in particular in the field of education.

A hora da alfabetização: atores, ideias e instituições na construção do PAIC-CE

The objective of this thesis is to understand how a certain social condition becomes relevant enough to be regarded as an issue worthy of government action and how certain proposed initiatives prevail while others are discarded. More specifically, the goal is to discuss public policy for education and check whether the analytical models employed are significant enough to explain how the literacy issue became part of the policy agenda of the government of the State of Ceará in Brazil, and how the Literacy Program at the Right Age (PAIC) developed over time. From the empirical perspective about public policy for education in Brazil, this is a relevant case when one takes into account that, historically, the literacy policies are focused on teenagers and adults, implying a lack of specific initiatives towards children at the proper age of learning to read and write. In order to understand what drove this issue to the top of the state government agenda, this thesis is primarily based on the literature about public policy analysis, with focus on the agenda setting process and development of proposals. A hybrid approach is used, combining analytical tools from Kingdon’s Multiple Streams Model (1995), the Advocacy Coalition Framework by Sabatier and Jenkins Smith (1993) and the historical new institutionalism lens. The research method is qualitative and based on the single case study method. The data set was assembled from institutional PAIC-related documents, tachygraphy notes from sessions at Ceará’s State House of Representatives, press clippings, academic studies and interviews with key participants from several organizations. The conclusion of this thesis is that, given the complexity of the case in point, the combination of the three analytical methods is adequate and necessary to understanding the multiple drivers for this issue to have entered Ceará’s state government agenda and the design of the PAIC itself. Particularly relevant are the ideas and the policy entrepreneurs, the processes of problem recognition for the composition of a wide coalition and for the specification of alternatives, and the path dependence of the education policy in Ceará. This study adds, as a result, to a better understanding of the stages that make up the agenda setting in public policy, in particular in the field of education.

O olhar das instituições de previdência sobre a casa e a cidade: promoção, financiamento e avaliação de imóveis

The investments of Caixas and Institutos de Aposentadoria e Pensões (CAP and IAP) in homes of Natal, between the decades of 1930-60, helped to boost up the local real estate market in consolidation at the time. Inserted in the first national policy on social housing in the country, these operations have demanded the creation of a wide qualified organizational structure, which would be from the "Central Offices" of Rio de Janeiro to the decentralized units of the federal states. The professionals linked to the Local Agencies have developed, on this matter, from activities related to the design and construction of residential complexes, to the daily study of financing proposals in isolated units. As from these studies, the evaluation of shelters was essential to the effectiveness of the policy, resulting in the production of data on the market value of the properties by observing and issuing judgments upon the living quarters of different social groups. Given these considerations, the aim here is to contribute to the understanding on how to operate these real estate actions in the legitimization of boundaries about the urban space and dwellings available to workers in Natal. Therefore, the views of the city and constructions expressed by the evaluating engineers in their technical reports have been taken as the focus. Being the main primary sources of work, these reports are part of the edifices process of CAP/IAP regarding Natal, whose content is systematized in the database "Enterprises", the HCUrb Research Group. In addition, there were used local newspapers at the time and interviews with professionals as complementary sources. It was found that, in general, the evaluations have configured – in a more everyday dimension of bureaucratic routines - a vehicle, among others, circulating ideas about "home" within the social security institutions, being imbued with assumptions historically constructed about the "modern habitat". Filled in loco, the reports expose the clash between modernizing ideals in vogue and clear limitations in the city scenario at the time. Fragmented images of the town are given to read through the labels assigned to the evaluated sites – these being coated of certain "scientific" character - which both legitimated and contributed to the dynamics of appreciation/depreciation of the soil and to the socio-spatial differentiation. Contradictions were evident in the endorsement given by the technicians when financing of admittedly precarious homes for insured disadvantaged categories at the local level - such as industrial workers - while strict regulations were imposed to new construction, designed, above all, to better paid categories. By identifying raters engineers as urban agents, members of a technical-focused operating system for safety and efficiency in the real estate investments of those authorities corporatist, it is desired the usefulness of further studies on these characters, their training, professional activity and participation in the construction of discourses and practices of intervention about the city and its buildings, discussing individual and grouped interests that were left behind.

Eficiência mastigatória e qualidade das próteses totais confeccionadas pelas técnicas tradicionais e simplificada: um ensaio clínico

Traditional methods for dentures fabrication require a wide clinical and laboratory procedures; however, there is no scientific evidence that these methods can produce better results when compared with simplified methods. Aim: To evaluate the effectiveness of a simplified methods for denture fabrication, comparing it to the traditional one through masticatory efficiency and prosthesis quality. Method: A randomized controlled trial was conducted with 50 patients, 25 rehabilitated with prosthesis produced by traditional technique and 25 rehabilitated by a simplified technique. The masticatory efficiency was evaluated by colorimetric method, using chewing capsules. The quality of prosthesis was obtained using a reliable and reproducible instrument. Statistical analysis of the masticatory efficiency and quality of the prosthesis was obtained by the Mann-Whitney test. Results: 39 patients completed the study, 18 on traditional group and 21 on simplified group. There was no difference between groups for the masticatory efficiency (p = 0.835) and the quality of the prosthesis (p = 0672). The evaluation of the overall quality of the prosthesis according to oral conditions, demonstrated significant difference on the height of the mandibular ridges (p = 0.010) and mandibular muscle attachments (p = 0.039). Conclusion: Complete dentures fabricated by simplified method were considered effective from the point of view of masticatory efficiency and quality of prosthetics, with results similar to those made by the traditional method.

Eficiência mastigatória e qualidade das próteses totais confeccionadas pelas técnicas tradicionais e simplificada: um ensaio clínico

Traditional methods for dentures fabrication require a wide clinical and laboratory procedures; however, there is no scientific evidence that these methods can produce better results when compared with simplified methods. Aim: To evaluate the effectiveness of a simplified methods for denture fabrication, comparing it to the traditional one through masticatory efficiency and prosthesis quality. Method: A randomized controlled trial was conducted with 50 patients, 25 rehabilitated with prosthesis produced by traditional technique and 25 rehabilitated by a simplified technique. The masticatory efficiency was evaluated by colorimetric method, using chewing capsules. The quality of prosthesis was obtained using a reliable and reproducible instrument. Statistical analysis of the masticatory efficiency and quality of the prosthesis was obtained by the Mann-Whitney test. Results: 39 patients completed the study, 18 on traditional group and 21 on simplified group. There was no difference between groups for the masticatory efficiency (p = 0.835) and the quality of the prosthesis (p = 0672). The evaluation of the overall quality of the prosthesis according to oral conditions, demonstrated significant difference on the height of the mandibular ridges (p = 0.010) and mandibular muscle attachments (p = 0.039). Conclusion: Complete dentures fabricated by simplified method were considered effective from the point of view of masticatory efficiency and quality of prosthetics, with results similar to those made by the traditional method.

Formação profissional do cuidador de idosos em instituições de longa permanência

The old caretaker's work seeks to minimize suffering and morbidity resulting from physical, cognitive and emotional limitations of these individuals, being a practice permeated by the uniqueness of the subjects involved, therefore, a process in constant construction. In this notion, the caregiver's role is crucial to assist the elderly in everyday life, aiming at improving their quality of life. This study has descriptive and analytical character with quantitative and qualitative approach aimed to investigate the professional training of active caregivers in long-term stay institutions for the Elderly (ILPIs) in Natal/RN in the year 2014. For this, semi-structured interviews were conducted with 63 caregivers employed in nine ILPIs, representing 75% of the professionals performing activities in these institutions. The interviews captured data on the socioeconomic profile, the perception about the profession and training of caregivers. Data were analyzed by observation of absolute and relative measures of central tendency of the numeric variables frequencies. It was found that most caregivers had poor socioeconomic status and had no specific training course to practice caregiver role. However, among those who carried out courses, most reported that the content covered during the training gave security to perform the practice, although they have shown a contradiction when referred to the need to build capacity. The perception of care is mainly related to love and care for the other while the choice of profession is associated with care practice itself. The results also indicate the presence of a low level of formal training for the exercise of the occupation, also revealing the weaknesses ranging from the absence of a core curriculum that can guide the formation, compounded by the low educational professionals in focus.

A GESTÃO DA COMUNICAÇÃO MERCADOLÓGICA EM INSTITUIÇÕES DE ENSINO SUPERIOR CONFESSIONAIS – O CASO UMESP

A partir do governo do Presidente Fernando Henrique Cardoso (1995-2003), houve incentivo para abertura de novas Instituições privadas de ensino superior no Brasil. Os alunos tornam-se clientes e começam a escolher a melhor opção de instituição de ensino superior (IES) que atenda às suas necessidades. O objetivo desta dissertação é compreender limites e policiamentos no desenvolvimento da comunicação mercadológica de IES confessionais na captação de novos alunos. A pesquisa desenvolvida foi a partir de um estudo exploratório descritivo, por meio de revisão bibliográfica e pesquisa qualitativa com entrevistas com executivos de comunicação da UMESP. Os principais resultados apontam para uma maior restrição no desenvolvimento da comunicação mercadológica da IES em estudo (UMESP), notadamente na vigilância sobre a veracidade e alcance do texto publicitário

COMUNICAÇÃO E MARKETING NA EDUCAÇÃO SUPERIOR: uma análise dos conteúdos comunicacionais online de instituições de ensino privadas

O presente contexto mercadológico da educação superior, onde a concorrência é cada vez mais acirrada, tem levado as instituições de ensino a estabelecer um processo de gestão de comunicação e marketing mais estratégico e competitivo, buscando alcançar uma posição diferenciada em relação à concorrência, a fim de conquistar seus públicos de interesse. Este trabalho contemplou a aplicação dos objetivos de comunicação no mercado de ensino superior, analisando as formas pelas quais as instituições vêm estabelecendo os processos comunicacionais com seus públicos-alvo, estando direcionado para as Universidades privadas brasileiras. A pesquisa se apóia em: revisão bibliográfica, entrevistas em profundidade com gestores de comunicação e marketing do setor pesquisado e análise de conteúdo de peças de comunicação em mídia online. Inicialmente foi elaborado um relato acerca do contexto atual do mercado de ensino superior no Brasil: sua evolução e caracterização. Em seguida, definiu-se marketing aplicado ao segmento de educação superior: conceitos e o papel designado a ele. Posteriormente relacionou-se comunicação mercadológica com o serviço de educação superior e sua aplicabilidade neste setor. Depois, foram realizadas entrevistas em profundidade - semiestruturadas, com gestores de comunicação e marketing de duas instituições, localizadas na cidade de São Paulo (Insper e Universidade São Judas Tadeu) com posicionamentos antagônicos e classificações distintas quanto à sua imagem para o mercado -, com a finalidade de conhecer suas visões e opiniões sobre o mercado e as ações de comunicação de marketing que vêm adotando. Finalmente, foi elaborada análise de contéudo, comparando anúncios (peças publicitárias) em mídia online das duas IES estudadas. Todos os procedimentos da análise de contéudo foram estabelecidos e categorizados com base nos objetivos de comunicação definidos por Yanaze (2011).

Estratégias na Implementação da norma ISO 9001 em IPSS (Instituições Particulares de Solidariedade Social)

A qualidade está na base do sucesso no mundo empresarial, sendo um fator de competitividade e de diferenciação entre organizações. No contexto das Instituições Particulares de Solidariedade Social, a aposta na qualidade é também uma realidade. No entanto, estas instituições enfrentam diversas dificuldades no processo de implementação do sistema de gestão da qualidade (SGQ) ISO 9001. De entre estas, destaca-se o difícil acesso à metodologia, crenças impostas, culturas resistentes à mudança, desconhecimentos e receios, que resultam em custos avultados para as organizações, dado o recurso frequente a empresas de consultoria. Como tal, o presente trabalho de investigação pretende salientar as principais dificuldades no processo de implementação da norma ISO9001:2008 em IPSS e dar o seu contributo para a clarificação da polémica que envolve a certificação desta norma, mediante a criação de um kit, com todas as ferramentas necessárias à implementação da norma. Por conseguinte, e para dar resposta ao objetivo proposto, procedeu-se numa primeira instância à realização de inquéritos a 29 organizações certificadas pelas normas ISO 9001:2008 e/ou EQUASS (European Quality in Social Services), de forma a apreender as principais dificuldades no processo de implementação da norma nas várias IPSS. Esta análise permitiu concluir que, os principais fatores que dificultaram a implementação do sistema de gestão da qualidade, segundo a norma ISO 9001:2008, são essencialmente a falta de tempo e/ou disponibilidade, assim como a dificuldade de interpretação da norma. Como tal, as organizações necessitam de ferramentas de auxílio que as apoiem e esclareçam no processo de implementação do sistema da qualidade. Neste sentido, elaborou-se o kit de implementação “Qualifica”. Este é constituído por um manual e um CD interativo com documentos, formações e ferramentas para a implementação do sistema, cujo objetivo é esclarecer, encaminhar, orientar e simplificar todo o processo de implementação da norma e utilizando uma linguagem simples e acessível. Para finalizar, a viabilidade do KIT “Qualifica” foi devidamente validada através da sua aplicação numa IPSS não certificada. Após a revisão do sistema implementado na IPSS em estudo, conclui-se que o KIT "Qualifica" ofereceu todas as bases e todos os recursos necessários para o bom entendimento, encaminhamento e implementação da norma, provando a sua potencialidade como ferramenta auxiliar fundamental que qualquer organização poderá no futuro utilizar.

Avaliação de Desempenho Organizacional: Análise Comparativa dos Modelos Teóricos e Pesquisa de Aplicação nas Instituições de Ensino Superior da Região Metropolitana de São Paulo

As Instituições de Ensino Superior (IES) brasileiras têm passado por grandes desafios devido ao aumento da concorrência. Paralelamente, no campo da Administração, um tema que tem sido estudado de forma recorrente são os modelos de avaliação organizacional. Nesse contexto, foi realizada uma pesquisa com o objetivo de identificar e comparar os principais métodos e indicadores de avaliação de desempenho organizacional desenvolvidos na literatura e sua forma de utilização nas IES da Região Metropolitana de São Paulo – RMSP. Com base em análise sistematizada da bibliografia consultada foram identificados 19 modelos de avaliação de desempenho, resumindo-se suas principais características, pontos fortes e fracos. Realizou-se, adicionalmente, uma análise comparativa destes modelos com base na consideração de 18 aspectos classificados em 5 grupos: clientes e mercado; econômico-financeiros; gestão e organização; recursos humanos; e sociedade em geral. Por meio de «survey» junto aos gestores de 14 significativas IES foram identificados seus formatos e indicadores de avaliação de desempenho organizacional constatando-se que a maioria realiza avaliação de desempenho por meio de modelos, sendo o «The Balanced Scorecard» o mais utilizado. Entre os 19 indicadores de desempenho pesquisados, os quatro utilizados com mais frequência e também considerados de maior importância pelas IES são os relacionados: à demanda por ensino; aos clientes, ou alunos; à qualidade e eficiência dos processos; e a aspectos econômico-financeiros. É possível levantar a hipótese de que a importância dos dois primeiros deve-se ao fato de serem relevantes direcionadores de receita, a do terceiro, ser direcionador de custo, e a do quarto, ser a síntese dos resultados.