Food handling in the domestic environment: an online questionnaire study with respondents from 24 of 26 Brazilian states / Manipulação de alimentos no ambiente doméstico: um estudo realizado com emprego de questionário online respondido por habitantes de 24 dos 26 estados brasileiros

Using an online questionnaire, this study evaluated the profile of a Brazilian population's food handling practices in the home environment. The questionnaire, containing questions about domestic behavior in terms of hygiene and food handling, was built and available through social media sites. Information about the participants' profiles, their food pre-preparation, food preparation, and food post-preparation practices, and the occurrence of foodborne diseases (FBDs) was included in the questionnaire. A total of 701 responses were obtained. The interviewees included 78.31% female participants and 21.68% male participants, with an average age of 31.2 years. Nearly all (94.3%) had a complete or incomplete higher education. In the pre-preparation stage, the participants evaluated the shelf life (97.28%) and storage temperature (44.79%) of the products while purchasing them. Regarding food handling practices, only a few participants washed the food packages before storing them (31.95%) or removed hand jewelry or other adornments when washing food (61.48%). Most participants washed their hands (91.58%) and washed vegetables (99.28%). But a group of interviewees reported washing raw meat (27.81%) before preparing it. Cutting surfaces such as plastic (50.36%) and glass (49.36%) tops were the most prevalent in the study. Most respondents did not know how long they had been using their cutting boards (67.62%) and mentioned using the same surface to handle both raw and ready-to-eat products (84.17%). As for the preparation, most interviewees declared they did not check the food temperature during preparation (86.31%), ignoring the ideal cooking temperature (88.26%). Regarding the occurrence of FBDs, 79.17% of the interviewees reported having suspicious clinical signs associated with contaminated foods and 65.59% did not seek medical help. Thus, the participants demonstrated ignorance about adequate practices for food safety in the home environment, highlighting the need to conduct health education programs within the Brazilian population.(AU)

Este estudo teve como objetivo avaliar o perfil das práticas de manipulação de alimentos no ambiente domiciliar no Brasil utilizando um questionário online. Um questionário contendo perguntas sobre comportamento doméstico em nível de higiene e manipulação de alimentos foi construído e disponibilizado por redes sociais. O questionário continha informações sobre o perfil dos participantes, suas práticas de pré-preparo, preparo e pós-preparo de alimentos e a ocorrência de doenças transmitidas por alimentos (DTA). Obteve-se 701 respostas, os entrevistados foram 78,31% do sexo feminino e 21,68% do sexo masculino, com média de idade de 31,2 anos. A maioria (94,3%) possuia ensino superior completo ou incompleto. Na etapa de pré-preparo, os participantes avaliam o prazo de validade (97,28%) e a temperatura de armazenamento (44,79%) dos produtos no momento da compra. Em relação às práticas de manipulação dos alimentos, apenas alguns participantes lavavam as embalagens dos alimentos antes de armazená-los (31,95%) ou retiravam adornos ao lavar os alimentos (61,48%). A maioria dos participantes lavam as mãos (91,58%) e os vegetais (99,28%); entretanto, um grupo de entrevistados relatou lavar carne crua (27,81%) antes de prepará-la. Superfícies de corte como tábuas de plástico (50,36%) e de vidro (49,36%) foram os mais prevalentes no estudo. A maioria dos entrevistados não sabe há quanto tempo usa as tábuas de corte (67,62%) e utilizam a mesma superfície para manusear produtos crus e prontos para o consumo (84,17%). Quanto ao preparo, a maioria dos entrevistados declarou não verificar a temperatura dos alimentos durante o preparo (86,31%), ignorando a temperatura ideal de cozimento (88,26%). Em relação à ocorrência de DVA, 79,17% dos entrevistados relataram que já apresentaram sinais clínicos suspeitos associados a alimentos contaminados e 65,59% não procuraram atendimento médico. Nesse sentido, os participantes demonstraram desconhecimento sobre as práticas adequadas para a segurança dos alimentos no ambiente domiciliar, evidenciando a necessidade de realização de programas de educação em saúde com a população brasileira.(AU)

Evaluating the impact of social deprivation on Press Ganey® Outpatient Medical Practice Survey Scores.

BACKGROUND: Social deprivation has been shown to affect access to health care services, and influences outcomes for a variety of physical and psychological conditions. However, the impact on patient satisfaction remains less clear. The objective of this study was to determine if social deprivation is an independent predictor of patient satisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey (PGOMPS). METHODS: We retrospectively reviewed unique new adult patient (≥ 18 years of age) seen at a tertiary academic hospital and rural/urban outreach hospitals/clinics between January 2014 and December 2017. Satisfaction was defined a priori as achieving a score above the 33rd percentile. The 2015 Area Deprivation Index (ADI) was used to determine social deprivation (lower score signifies less social deprivation). Univariate and multivariable binary logistic regression were used to determine the impact of ADI on PGOMPS total and provider sub-scores while controlling for variables previously shown to impact scores (wait time, patient age, sex, race, specialty type, provider type, and insurance status). RESULTS: Univariate analysis of PGOMPS total scores revealed a 4% decrease in odds of patient satisfaction per decile increase in ADI (p < 0.001). Patients within the most deprived quartile were significantly less likely to report satisfaction compared to the least deprived quartile (OR 0.79, p < 0.001). Multivariable analysis revealed that the odds of achieving satisfaction decreased 2% for each decile increase in ADI on the Total Score (p < 0.001), independent of other variables previously shown to impact scores. For PGOMPS Provider Sub-Score, univariate analysis showed that patients in the lowest ADI quartile were significantly less likely be satisfied, as compared to the least deprived quartile (OR 0.77; 95% CI 0.70-0.86; p < 0.001). A 5% decrease in a patient being satisfied was observed for each decile increase in ADI (OR 0.95; 95% CI 0.94-0.96; p < 0.001). CONCLUSIONS: Social deprivation was an independent predictor of outpatient visit dissatisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey. These results necessitate consideration when developing health care delivery policies that serve to minimize inequalities between patients of differing socioeconomic groups.

Identification of quality gaps in healthcare services using the SERVQUAL instrument and importance-performance analysis in medical intensive care: a prospective study at a medical center in Taiwan.

BACKGROUND: Assessing patients' expectations and perceptions of health service delivery is challenging. To understand the service quality in intensive care units (ICUs), we investigated the expected and perceived service quality of ICU care. METHODS: We conducted this study at an ICU of a university-affiliated medical center in Taiwan from April to September 2019. Admitted patients or their family members responded to a questionnaire survey adopted from the SERVQUAL instrument consisting of 22 items in five dimensions. The questionnaire was provided on ICU admission for expectation and before ICU discharge for perception. We analyzed the quality gaps between the surveys and applied important-performance analysis (IPA). RESULTS: A total of 117 patients were included (62.4% males, average age: 65.9 years, average length of stay: 10.1 days, and 76.9% survival to ICU discharge). The overall weighted mean scores for the surveys were similar (4.57 ± 0.81 and 4.58 ± 0.52, respectively). The 'tangibles' dimension had a higher perception than expectation (3.99 ± 0.55 and 4.31 ± 0.63 for expectation and perception, respectively, p < 0.001). IPA showed that most of the items in 'reliability,' 'responsiveness' and 'assurance' were located in the quadrant of high expectation and high perception, whereas most of the items in 'tangibles' and 'empathy' were located in the quadrant of low expectation and low perception. One item (item 1 for 'tangibles') was found in the quadrant of high expectation and low perception. CONCLUSIONS: The SERVQUAL approach and IPA might provide useful information regarding the feedback by patients and their families for ICU service quality. In most aspects, the performance of the ICU satisfactorily matched the needs perceived by the patients and their families.

Communicating with patients about breakdowns in care: a national randomised vignette-based survey.

BACKGROUND: Many patients are reluctant to speak up about breakdowns in care, resulting in missed opportunities to respond to individual patients and improve the system. Effective approaches to encouraging patients to speak up and responding when they do are needed. OBJECTIVE: To identify factors which influence speaking up, and to examine the impact of apology when problems occur. DESIGN: Randomised experiment using a vignette-based questionnaire describing 3 care breakdowns (slow response to call bell, rude aide, unanswered questions). The role of the person inquiring about concerns (doctor, nurse, patient care specialist), extent of the prompt (invitation to patient to share concerns) and level of apology were varied. SETTING: National online survey. PARTICIPANTS: 1188 adults aged ≥35 years were sampled from an online panel representative of the entire US population, created and maintained by GfK, an international survey research organisation; 65.5% response rate. MAIN OUTCOMES AND MEASURES: Affective responses to care breakdowns, intent to speak up, willingness to recommend the hospital. RESULTS: Twice as many participants receiving an in-depth prompt about care breakdowns would (probably/definitely) recommend the hospital compared with those receiving no prompt (18.4% vs 8.8% respectively (p=0.0067)). Almost three times as many participants receiving a full apology would (probably/definitely) recommend the hospital compared with those receiving no apology (34.1% vs 13.6% respectively ((p<0.0001)). Feeling upset was a strong determinant of greater intent to speak up, but a substantial number of upset participants would not 'definitely' speak up. A more extensive prompt did not result in greater likelihood of speaking up. The inquirer's role influenced speaking up for two of the three breakdowns (rudeness and slow response). CONCLUSIONS: Asking about possible care breakdowns in detail, and offering a full apology when breakdowns are reported substantially increases patients' willingness to recommend the hospital.

Evaluation de la culture de sécurité en Etablissement d'Hébergement pour Personnes Agées Dépendantes (EHPAD): adaptation française du questionnaire Nursing Home Survey on Patient Safety Culture.

The objective was to translate into French the American questionnaire "Nursing Home Survey on Patient Safety Culture" and to test the feasibility of its use in a sample of nursing homes. The questionnaire was translated by a multidisciplinary group of six experts and tested on a sample of people working in nursing homes. The questionnaire was then administered in five nursing homes. A first version of the French NHSPSC is proposed in this article. Despite similarities between items and ceiling effect for one item, the choices made were conservative to allow international comparisons. The administration of the questionnaire in five nursing homes confirmed the feasibility of the approach, with a participation of more than 50 per cent. This work made a French version of the NHSPSC available and confirmed that it is a feasible method for evaluating safety culture in nursing homes.

Survey Instruments to Assess Patient Experiences With Access and Coordination Across Health Care Settings: Available and Needed Measures.

BACKGROUND: Improving access can increase the providers a patient sees, and cause coordination challenges. For initiatives that increase care across health care settings, measuring patient experiences with access and care coordination will be crucial. OBJECTIVES: Map existing survey measures of patient experiences with access and care coordination expected to be relevant to patients accessing care across settings. Preliminarily examine whether aspects of access and care coordination important to patients are represented by existing measures. RESEARCH DESIGN: Structured literature review of domains and existing survey measures related to access and care coordination across settings. Survey measures, and preliminary themes from semistructured interviews of 10 patients offered VA-purchased Community Care, were mapped to identified domains. RESULTS: We identified 31 existing survey instruments with 279 items representing 6 access and 5 care coordination domains relevant to cross-system care. Domains frequently assessed by existing measures included follow-up coordination, primary care access, cross-setting coordination, and continuity. Preliminary issues identified in interviews, but not commonly assessed by existing measures included: (1) acceptability of distance to care site given patient's clinical situation; (2) burden on patients to access and coordinate care and billing; (3) provider familiarity with Veteran culture and VA processes. CONCLUSIONS: Existing survey instruments assess many aspects of patient experiences with access and care coordination in cross-system care. Systems assessing cross-system care should consider whether patient surveys accurately reflect the level of patients' concerns with burden to access and coordinate care, and adequately reflect the impact of clinical severity and cultural familiarity on patient preferences.

Evaluating CollaboRATE in a clinical setting: analysis of mode effects on scores, response rates and costs of data collection.

BACKGROUND: Shared decision-making (SDM) has become a policy priority, yet its implementation is not routinely assessed. To address this gap we tested the delivery of CollaboRATE, a 3-item patient reported experience measure of SDM, via multiple survey modes. OBJECTIVE: To assess CollaboRATE response rates and respondent characteristics across different modes of administration, impact of mode and patient characteristics on SDM performance and cost of administration per response in a real-world primary care practice. DESIGN: Observational study design, with repeated assessment of SDM performance using CollaboRATE in a primary care clinic over 15 months of data collection. Different modes of administration were introduced sequentially including paper, patient portal, interactive voice response (IVR) call, text message and tablet computer. PARTICIPANTS: Consecutive patients ≥18 years, or parents/guardians of patients <18 years, visiting participating primary care clinicians. MAIN MEASURES: CollaboRATE assesses three core SDM tasks: (1) explanation about health issues, (2) elicitation of patient preferences and (3) integration of patient preferences into decisions. Responses to each item range from 0 (no effort was made) to 9 (every effort was made). CollaboRATE scores are calculated as the proportion of participants who report a score of nine on each of the three CollaboRATE questions. KEY RESULTS: Scores were sensitive to mode effects: the paper mode had the highest average score (81%) and IVR had the lowest (61%). However, relative clinician performance rankings were stable across the different data collection modes used. Tablet computers administered by research staff had the highest response rate (41%), although this approach was costly. Clinic staff giving paper surveys to patients as they left the clinic had the lowest response rate (12%). CONCLUSIONS: CollaboRATE can be introduced using multiple modes of survey delivery while producing consistent clinician rankings. This may allow routine assessment and benchmarking of clinician and clinic SDM performance.

Assessment of Universal Healthcare Coverage in a District of North India: A Rapid Cross-Sectional Survey Using Tablet Computers.

OBJECTIVE: A rapid survey was carried out in Shaheed Bhagat Singh Nagar District of Punjab state in India to ascertain health seeking behavior and out-of-pocket health expenditures. METHODS: Using multistage cluster sampling design, 1,008 households (28 clusters x 36 households in each cluster) were selected proportionately from urban and rural areas. Households were selected through a house-to-house survey during April and May 2014 whose members had (a) experienced illness in the past 30 days, (b) had illness lasting longer than 30 days, (c) were hospitalized in the past 365 days, or (d) had women who were currently pregnant or experienced childbirth in the past two years. In these selected households, trained investigators, using a tablet computer-based structured questionnaire, enquired about the socio-demographics, nature of illness, source of healthcare, and healthcare and household expenditure. The data was transmitted daily to a central server using wireless communication network. Mean healthcare expenditures were computed for various health conditions. Catastrophic healthcare expenditure was defined as more than 10% of the total annual household expenditure on healthcare. Chi square test for trend was used to compare catastrophic expenditures on hospitalization between households classified into expenditure quartiles. RESULTS: The mean monthly household expenditure was 15,029 Indian Rupees (USD 188.2). Nearly 14.2% of the household expenditure was on healthcare. Fever, respiratory tract diseases, gastrointestinal diseases were the common acute illnesses, while heart disease, diabetes mellitus, and respiratory diseases were the more common chronic diseases. Hospitalizations were mainly due to cardiovascular diseases, gastrointestinal problems, and accidents. Only 17%, 18%, 20% and 31% of the healthcare for acute illnesses, chronic illnesses, hospitalizations and childbirth was sought in the government health facilities. Average expenditure in government health facilities was 16.6% less for acute care, 15% less for hospitalization and 50% less for childbirth than in the private healthcare facilities. Out-of-pocket expenditure was mostly on medicines followed by diagnostic and laboratory tests. Among households experiencing hospitalization, 56.5% had incurred catastrophic expenditures, which was significantly higher in the poorest compared to richest household expenditure quartile (p <0.002). CONCLUSIONS: Expenditure on healthcare remains high in Punjab state of India. Efforts to increase utilization of the public sector could decrease out-of-pocket healthcare expenditure.

Developing and validating a tablet version of an illness explanatory model interview for a public health survey in Pune, India.

BACKGROUND: Mobile electronic devices are replacing paper-based instruments and questionnaires for epidemiological and public health research. The elimination of a data-entry step after an interview is a notable advantage over paper, saving investigator time, decreasing the time lags in managing and analyzing data, and potentially improving the data quality by removing the error-prone data-entry step. Research has not yet provided adequate evidence, however, to substantiate the claim of fewer errors for computerized interviews. METHODOLOGY: We developed an Android-based illness explanatory interview for influenza vaccine acceptance and tested the instrument in a field study in Pune, India, for feasibility and acceptability. Error rates for tablet and paper were compared with reference to the voice recording of the interview as gold standard to assess discrepancies. We also examined the preference of interviewers for the classical paper-based or the electronic version of the interview and compared the costs of research with both data collection devices. RESULTS: In 95 interviews with household respondents, total error rates with paper and tablet devices were nearly the same (2.01% and 1.99% respectively). Most interviewers indicated no preference for a particular device; but those with a preference opted for tablets. The initial investment in tablet-based interviews was higher compared to paper, while the recurring costs per interview were lower with the use of tablets. CONCLUSION: An Android-based tablet version of a complex interview was developed and successfully validated. Advantages were not compromised by increased errors, and field research assistants with a preference preferred the Android device. Use of tablets may be more costly than paper for small samples and less costly for large studies.

Patient health satisfaction survey in connecticut correctional facilities.

Although routine in the community, patient satisfaction surveys are relatively rare in correctional settings. This article describes the development of an instrument specifically adapted to the correctional environment and population, the statewide implementation of the survey, the initial results, and the quality improvement initiatives evolving from this effort.

The right tool for the right job: the value of alternative patient experience measures.

Patient-reported experience of care predicts health care outcomes. Fourteen US and Canadian practices intercalated a standard ambulatory care Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey within their usual Internet-based survey to compare results from the Internet survey, Internet CAHPS survey, and a mailed CAHPS survey. They found that practice performance rankings obtained via the multi-item CAHPS survey were equivalent to a single measure captured by the Internet survey.

Measures of quality, costs and equity in primary health care instruments developed to analyse and compare primary care in 35 countries.

BACKGROUND: The Quality and Costs of Primary Care in Europe (QUALICOPC) study aims to analyse and compare how primary health care systems in 35 countries perform in terms of quality, costs and equity. This article answers the question 'How can the organisation and delivery of primary health care and its outcomes be measured through surveys of general practitioners (GPs) and patients?' It will also deal with the process of pooling questions and the subsequent development and application of exclusion criteria to arrive at a set of appropriate questions for a broad international comparative study. METHODS: The development of the questionnaires consisted of four phases: a search for existing validated questionnaires, the classification and selection of relevant questions, shortening of the questionnaires in three consensus rounds and the pilot survey. Consensus was reached on the basis of exclusion criteria (e.g. the applicability for international comparison). Based on the pilot survey, comprehensibility increased and the number of questions was further restricted, as the questionnaires were too long. RESULTS: Four questionnaires were developed: one for GPs, one for patients about their experiences with their GP, another for patients about what they consider important, and a practice questionnaire. The GP questionnaire mainly focused on the structural aspects (e.g. economic conditions) and care processes (e.g. comprehensiveness of services of primary care). The patient experiences questionnaire focused on the care processes and outcomes (e.g. how do patients experience access to care?). The questionnaire about what patients consider important was complementary to the experiences questionnaire, as it enabled weighing the answers from the latter. Finally, the practice questionnaire included questions on practice characteristics. DISCUSSION: The QUALICOPC researchers have developed four questionnaires to characterise the organisation and delivery of primary health care and to compare and analyse the outcomes. Data collected with these instruments will allow us not only to show in detail the variation in process and outcomes of primary health care, but also to explain the differences from features of the (primary) health care system.

Improving the quality of surveys of physicians and medical groups: a research agenda.

Because health care providers have a central role in implementing guidelines, health care reform, and new standards of care and technologies, surveying them about their practices and perspectives is vital for health services and policy research. In November 2010, the National Cancer Institute convened a workshop to review and discuss current methodologies in designing and fielding large-scale surveys of physicians and medical groups. This report summarizes key issues and future directions for four topic areas addressed in the workshop: sample frames for surveying physicians and medical groups; points of contact and response modes; response incentives; and questionnaire design and burden. Recommendations were made for improving sample frame databases, optimizing mixed-mode surveys, and studying use of incentives with gatekeepers and in medical group settings. There is particular need for empirical assessment of factors that motivate or impede participation of physicians, other types of clinicians, and medical groups in survey research.

Psychiatrists' perceptions of potential reasons for non- and partial adherence to medication: results of a survey in bipolar disorder from eight European countries.

BACKGROUND: Partial/non-adherence to medication by patients with bipolar disorder is associated with exacerbation of symptoms, neurocognitive decline and increased risk of suicide and has a major influence on patient outcomes. Understanding psychiatrists' views on the causes and management of non-adherence are vital to address adherence problems effectively. METHODS: A 15-question survey was conducted of 2448 psychiatrists treating patients with bipolar disorder in eight European countries to ascertain their perceptions of the level and causes of non-adherence, and their preferred methods by which to assess it. RESULTS: A majority of patients (57%) were estimated to be partially/non-adherent. Three in four psychiatrists responded that most patients who deteriorated after stopping medication were unable to attribute this to non-adherence. An irregular daily routine/living circumstance affecting adherence was considered the most important reason for patients discontinuing medication. Only 4% of psychiatrists deemed intolerable side effects had led to most patients stopping their medication; 11% responded that drug/alcohol consumption may have impacted on adherence to medication for the majority of patients. LIMITATIONS: The survey was not distributed to all psychiatrists in the countries and the impact on the results, of any difference in the demographics of the respondents with respect to the population of psychiatrists across the eight countries, is not known. CONCLUSIONS: Partial/non-adherence remains a considerable problem amongst patients with bipolar disorder. There is a need for increased knowledge concerning partial/non-adherence at the level of the clinician-patient interaction, to reduce its impact and bring about improved clinical outcomes.

Assessment of the status of prehospital care in 13 low- and middle-income countries.

BACKGROUND: Injury and other medical emergencies are becoming increasingly common in low- and middle-income countries (LMICs). Many to most of the deaths from these conditions occur outside of hospitals, necessitating the development of prehospital care. Prehospital capabilities are inadequately developed to meet the growing needs for emergency care in most LMICs. OBJECTIVE: In order to better plan for development of prehospital care globally, this study sought to better understand the current status of prehospital care in a wide range of LMICs. METHODS: A survey was conducted of emergency medical services (EMS) leaders and other key informants in 13 LMICs in Africa, Asia, and Latin America. Questions addressed methods of transport to hospital, training and certification of EMS providers, organization and funding of EMS systems, public access to prehospital care, and barriers to EMS development. RESULTS: Prehospital care capabilities varied significantly, but in general were less developed in low-income countries and in rural areas, where utilization of formal EMS was often very low. Commercial drivers, volunteers, and other bystanders provided a large proportion of prehospital transport and occasionally also provided first aid in many locations. Although taxes and mandatory motor vehicle insurance provided supplemental funds to EMS in 85% of the countries, the most frequently cited barriers to further development of prehospital care was inadequate funding (36% of barriers cited). The next most commonly cited barriers were lack of leadership within the system (18%) and lack of legislation setting standards (18%). CONCLUSIONS: Expansion of prehospital care to currently underserved or unserved areas, especially in low-income countries and in rural areas, could make use of the already-existing networks of first responders, such as commercial drivers and laypersons. Efforts to increase their effectiveness, such as more widespread first-aid training, and better encompassing their efforts within formal EMS, are warranted. In terms of existing formal EMS, there is a need for increased and more regular funding, integration and coordination among existing services, and improved organization and leadership, as could be accomplished by making EMS administration and leadership a more desirable career path.

Satisfacción de los padres de los pacientes en una unidad de cuidados intensivos pediátricos / Parents’ satisfaction in a single pediatric intensive care unit

El objetivo fue validar y aplicar un instrumento para medir satisfacción de padres de pacientes internados en Cuidados Intensivos Pediátricos del Hospital Italiano de Buenos Aires. Población y métodos. Aplicamos el cuestionario Picker’s Pediatric Acute Care luego de traducirlo y determinar su validez de construcción, contenido y consistencia interna. Calculamos puntaje de satisfacción general y dominios. La población fue dividida en Alto y Bajo Grados de Satisfacción según la respuesta a la pregunta “ ¿Cómocalificaría los cuidados recibidos?” Las variables asociadas con estos grupos fueron identificadas. Resultados. Validez de construcción, contenido y consistencia interna fueron adecuados (α de Cronbach= 0,87). El puntaje de satisfacción generalfue 85,7 (IC95 por ciento 83,5-87,8). Los puntajes por dominios fueron, impresión general, 84,8 (IC95 por ciento82,3-87,3); accesibilidad y disponibilidad, 88,8 (IC95 por ciento 86,4-91,2); consideración y respeto, 85,7(IC95 por ciento 83,1-88,3); coordinación e integración decuidados, 84,6 (IC95 por ciento 80,9-88,3); información y comunicación, 85,5 (IC95 por ciento 82-89); relación entre padres y equipo de salud, 89,5 (IC95 por ciento 86,7-92,3); confort físico, 91,8 (IC95 por ciento 89-94,6) y continuidad de cuidados 70,9 (IC95 por ciento 64,9-76,9). Este últimopuntaje, significativamente menor a los anteriores, permitió identificar un aspecto por mejorar. El 89 por ciento (89/100) de los padres se incluyó en el Grupo Alto Grado de Satisfacción. El 100 por ciento manifestó que sus hijos habían recibido cuidados que necesitaban cuando los necesitaban y 98,2 por ciento que sus hijos habían sido tratados con dignidad y respeto, y que tanto a médicos como a enfermeras les interesaba calmar el dolor. Conclusiones. La validación del instrumento fue adecuada. Los cuidados oportunos y el trato digno y respetuoso se asocian con altos niveles de satisfacción.