Avaliação do serviço de coleta para exame colpocitológico pela escala SERVQUAL / Evaluación del servicio de recolección para examen colpocitológico por la escala SERVQUAL / Avaliação do serviço de coleta para exame colpocitológico pela escala SERVQUAL

ABSTRACT Objective: To analyze women's perception of the quality of the service provided for colposcopy test in the city of Belém (PA), Brazil. Method: Quantitative-descriptive study on 400 women who underwent Pap test on the public healthcare network, using the Service Quality (SERVQUAL) model. We used the Cronbach's alpha index to measure the reliability of the scale, and data were analyzed by quartiles of the gaps of the dimensions: tangibility, responsiveness, reliability, assurance, and empathy. Results: The assurance dimension, corresponding to the knowledge and courtesy of staff, featured the highest degree of importance to users; and empathy, which corresponds to the staff's concern with women's needs, featured the lower degree. The most expressive negative gaps concerned the structure of services and the attitude of healthcare professionals when collecting the material. Conclusion: All gaps featured negative relationship between what was expected and perceived, expressing dissatisfaction regarding the service.

RESUMEN Objetivo: Analizar la percepción de mujeres acerca de la calidad del servicio de colpocitología oncótica en Belém (PA). Método: Estudio cuantitativo-descriptivo con 400 mujeres que realizaron el examen de colpocitología oncótica en la red pública de salud, utilizando el modelo Service Quality (SERVQUAL). Se utilizó el Alpha de Cronbach para medir la confiabilidad de la escala, y los datos fueron analizados por los cuartiles de los gaps de las dimensiones: tangibilidad, responsividad, confiabilidad, credibilidad y empatía. Resultados: La dimensión credibilidad, correspondiente al conocimiento y a la cortesía de los funcionarios, presentó mayor grado de importancia para las usuarias; y la empatía, que corresponde a la preocupación demostrada por los funcionarios con las necesidades de las mujeres, exhibió menor grado. Los gaps negativos más expresivos se refieren a la estructura de los servicios y a la actitud de los profesionales con ocasión de la recolección del material. Conclusión: Todos los gaps presentaron relación negativa entre lo esperado y lo percibido expresando la insatisfacción con relación al servicio.

RESUMO Objetivo: Analisar a percepção de mulheres acerca da qualidade do serviço de colpocitologia oncótica em Belém (PA). Método: Estudo quantitativo-descritivo com 400 mulheres que realizaram o exame de colpocitologia oncótica na rede pública de saúde, utilizando o modelo Service Quality (SERVQUAL). Utilizou-se o Alpha de Cronbach para medir a confiabilidade da escala, e os dados foram analisados pelos quartis dos gaps das dimensões: tangibilidade, responsividade, confiabilidade, credibilidade e empatia. Resultados: A dimensão credibilidade, correspondente ao conhecimento e cortesia dos funcionários, apresentou maior grau de importância para as usuárias, e a empatia, que corresponde à preocupação demonstrada pelos funcionários com as necessidades das mulheres, exibiu menor grau. Os gaps negativos mais expressivos dizem respeito à estrutura dos serviços e a atitude dos profissionais por ocasião da coleta de material. Conclusão: Todos os gaps apresentaram relação negativa entre o esperado e o percebido expressando a insatisfação em relação ao serviço.

WHAT ARE THE MOST IMPORTANT FACTORS REGARDING ACCEPTANCE TO THE COLONOSCOPY?: Study of related tolerance parameters

Context Colonoscopy plays an indubitable role in the setting of clinical practice, however, it is an invasive exam; complex, lengthy, embarrassing, not devoid of risks and discomfort that yields fear and anxiety in the majority of patients. In a new era of rising competition between health institutions, where the quality of health care and client satisfaction are praised, studies regarding tolerance-related colonoscopy issues yield great potential to be explored. In the present study, tolerance is defined as willingness to repeat the exam. Objectives Evaluate information associated to bowel preparation, the exam itself and post-examination period that might interfere with the tolerance to the colonoscopy. Methods Analysis of the tolerance to the colonoscopy at three stages (pre, post, and during) through a checklist: patient's questionnaire and a medical assessment form were used. Results In this present study, 91.2% of 373 patients exhibited positive tolerance to the colonoscopy. Aspects related to a negative level of tolerance were patient gender (12.9% of women versus 3.2% of men would not repeat the exam), age extremes (less than 20 years and greater than 80 years of age), and abdominal pain, both during the bowel preparation and after the procedure. Conclusions Gender, age, patient cooperation and abdominal pain were the decisive components regarding tolerance to the colonoscopy. Notably, in two phases of the exam, the abdominal pain was the most important feature associated to a lessened tolerance. .

Contexto É inquestionável o papel da colonoscopia na prática clínica, entretanto, trata-se de exame invasivo, complexo, demorado, impudico, não isento de riscos e desconforto, que gera receio e ansiedade à maioria dos pacientes. Em uma nova época de elevada competição entre instituições de saúde, na qual se valoriza a qualidade dos serviços prestados e satisfação dos clientes, estudos sobre fatores relacionados a tolerância à colonoscopia oferecem grande potencial a ser explorado. No presente estudo considerou-se tolerância a disposição de repetir o exame. Objetivo Analisar informações relacionados ao preparo, exame e pós exame que interferem na tolerância à colonoscopia. Métodos Análise da tolerância à colonoscopia em três momentos da colonoscopia (pré, pós e durante) através de check list: “formulário do paciente” e “ficha de avaliação médica”. Resultados No presente estudo 91.2% de 373 pacientes apresentaram tolerância positiva à colonoscopia. Os fatores relacionados à tolerância negativa foram o sexo feminino (12.9% mulheres and 3.2% dos homens não repetiriam o exame), extremos de idade (<20 anos e >80 anos) e dor abdominal durante o preparo intestinal e após o procedimento. Conclusões Gênero, idade, cooperação do paciente e dor abdominal foram fatores determinantes da tolerância à colonoscopia. Significativa em duas fases do exame, a dor abdominal foi o fator mais importante relacionado à redução da tolerância. .

Estudio endoscópico en familiares de primer grado de pacientes operados por cáncer colorrectal / Screening colonoscopy among first degree relatives of patients with colorectal carcinoma

Background: First degree relatives of patients with colorectal carcinoma are at a higher risk of having the disease than the general population. Therefore, they should be subjected to screening colonoscopy. Aim: To assess the effectiveness of colonoscopy among first degree relatives of patients with colorectal carcinoma. Material and methods: A free colonoscopy was offered to first degree relatives of patients operated on for colorectal cancer between 1998 and 2000. As inclusion criteria, subjects had to be asymptomatic, older than 40 years or less than 10 years younger than the index case. Each subject was contacted twice, inviting him/her to have a colonoscopy performed. Results: Two hundred forty three relatives were contacted for the study and in 76, a colonoscopy was performed. Among the latter, a neoplasm was found in 13 (17 percent): One adenocarcinoma and 12 adenomas. Three of these lesions were located in the right colon. The main reason given by the 176 subjects that did not agree to have a colonoscopy was lack of interest. Conclusions: Screening colonoscopy is effective to detect adenoma and adenocarcinomaamong first degree relatives of patients with colorectal carcinoma, however only 31 percent of all potential relatives agreed to undergo a colonoscopy.