CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / Pesquisa transversal, que teve por objetivo realizar diagnÃstico situacional do uso do implante subcutÃneo com etonogestrel (ImplanonÂ) na perspectiva do conhecimento, satisfaÃÃo e seguranÃa à saÃde das usuÃrias. A populaÃÃo correspondeu Ãs usuÃrias de Implanon (N=181) da 2 Coordenadoria Regional de SaÃde do Estado do Cearà e a amostra tipo censo correspondeu a 106 sujeitos. Os dados foram coletados de marÃo a novembro de 2014, por meio de entrevistas. Foram processados no software Statistical Package for Social Sciences (SPSS) versÃo 20.0, receberam anÃlise estatÃstica descritiva e bivariada (testes de RazÃo de VerossimilhanÃa e de &#61539;2), considerando significÃncia estatÃstica das diferenÃas entre proporÃÃes p<0,05. A mÃdia de idade das participantes foi de 31,32Â6,18 anos e de anos de estudos 11,83Â3,74 anos; 77,4% declararam-se casadas ou em uniÃo estÃvel. Predominou renda per capita de âmais de  a  salÃrio mÃnimoâ (40,6%). O conhecimento sobre o Implanon apresentou maiores proporÃÃes nos itens ânÃo previne DST/HIV/aidsâ (95,3%), reversibilidade (93,4%), eficÃcia (91,5%), tempo adequado para troca do mÃtodo (91,5%) e mecanismo de aÃÃo (83,0%). Constatou-se associaÃÃo entre conhecimento sobre tempo para troca do Implanon e municÃpios (p=0,016), em que os municÃpios 1 (28,0%) e 2 (17,6%) apresentaram maiores proporÃÃes de conhecimento inadequado; quanto à reversibilidade do Implanon (p=0,051) e o mÃtodo nÃo prevenir DST/HIV/aids (p=0,030), o municÃpio 1 apresentou maior proporÃÃo de conhecimento inadequado, ou seja, 20,0% e 16,0%, respectivamente. Anos de estudos influenciou o conhecimento sobre o tempo adequado para a troca do mÃtodo (p=0,015). Predominou o conhecimento sobre as alteraÃÃes menstruais (72,6%). MunicÃpio e anos de estudos influenciaram o nÃvel de conhecimento sobre as alteraÃÃes sistÃmicas (p=0,016 e p=0,040, respectivamente), com o municÃpio 1 apresentando maior proporÃÃo de ausÃncia deste conhecimento (24,0%) e 80% das usuÃrias de atà 5 anos de estudos apresentaram ausÃncia deste conhecimento. Sobre as complicaÃÃes todos os itens prevaleceram âsem conhecimentoâ, com maior conhecimento quanto ao sangramento abundante (35,8%) e cefaleia intensa (34,0%). MunicÃpio influenciou o conhecimento sobre a complicaÃÃo sangramento abundante (p=0,012), com o municÃpio 2 apresentando maior percentual de desconhecimento (94,1%); acerca da infecÃÃo no local da inserÃÃo (p=0,024), os municÃpios 3, 4 e 1, apresentaram os maiores percentuais de desconhecimento (97,7%; 96,0%; e 90,9% respectivamente). A ausÃncia de conhecimento sobre cefaleia intensa teve associaÃÃo com anos de estudos (p=0,015), com os maiores percentuais de ausÃncia de conhecimento recaindo sobre menos anos de estudos. Tempo de uso do mÃtodo nÃo influenciou o conhecimento. A maioria das participantes (71,7%) mostrou-se muito satisfeita, verificando-se associaÃÃo entre satisfaÃÃo e maior tempo de uso do Implanon (p<0,0001). RepercussÃes incisionais acometeram 15,1% das participantes e nÃo houve associaÃÃo com municÃpio, tempo de uso do Implanon e anos de estudos (p>0,05). Todas as usuÃrias apresentaram pelo menos um efeito adverso, predominando a amenorreia (74,5%). ComplicaÃÃes acometeram 27,4% das participantes, predominando o sangramento abundante (17,9%). Quanto à seguranÃa à saÃde, 74,5% das usuÃrias do Implanon estavam nas categorias 1 e 2 dos critÃrios mÃdicos de elegilibidade para uso de anticoncepcionais, 25,5% na categoria 3 e nenhuma na categoria 4. / Cross-sectional study aimed to conduct a situational diagnosis of the use of etonogestrel subcutaneous implant (ImplanonÂ) in the perspective of knowledge, satisfaction, and safety to the health of female users. The population comprised the female users of Implanon (n=181) from the 2nd Local Health Coordination of the Cearà State, Brazil, and the census sampling method accounted for 106 individuals. Data collection took place through interviews from March to November 2014. Data analysis occurred through the Statistical Package for Social Sciences (SPSS) software version 20.0, and received descriptive statistics and bivariate analysis (Likelihood Ratio and Chi-square tests), considering statistical significance of differences among proportions p<0.05. Average age of participants was 31.32Â6.18 years and average years of education were 11.83Â3.74. 77.4% of them reported being married or in stable relationship. Per capita income from âover  to  minimum wageâ (40.6%) prevailed. Knowledge about Implanon presented higher proportions in items âdoes not prevent STD/HIV/AIDSâ (95.3%), reversibility (93.4%), efficiency (91.5%), adequate time for changing method (91.5%), and mechanism of action (83.0%). We verified association between knowledge of adequate time for changing Implanon and municipalities (p=0.016), in which municipalities 1 (28.0%) and 2 (17.6%) showed higher inadequate proportions of knowledge. Regarding reversibility of Implanon (p=0.051) and the method does not prevent STD/HIV/AIDS (p=0.030), municipality 1 presented higher proportion of inadequate knowledge, 20.0% and 16.0%, respectively. Years of education influenced knowledge about adequate time for changing method (p=0.015). There was a predominant knowledge about menstrual alterations (72.6%). Municipality and years of education influenced the level of knowledge about systemic changes (p=0.016 and p=0.040, respectively), in which municipality 1 had a higher proportion of ignorance (24.0%) and 80% of users with up to 5 years of study did not have this knowledge. About complications, âlack of knowledgeâ prevailed in all items, with greater knowledge of profuse bleeding (35.8%) and severe headache (34.0%). Municipality influenced the knowledge of profuse bleeding complications (p=0.012), with municipality 2 presenting greater percentage of ignorance (94.1%); as for infection at the insertion site (p=0.024), municipalities 3, 4 and 1 had the highest percentage of ignorance (97.7%, 96.0% and 90.9%, respectively). Lack of knowledge about severe headache was associated with years of education (p=0.015), with the highest percentages of ignorance among those with fewer years of study. Time of method use did not influence knowledge. Most participants (71.7%) proved to be very satisfied, revealing an association between satisfaction and longer use of Implanon (p<0.0001). Incisional complications affected 15.1% of participants and had no association with municipality, time of Implanon use, and years of study (p>0.05). All users demonstrated at least one adverse effect, predominantly amenorrhea (74.5%). Complications affected 27.4% of participants, with special reference to profuse bleeding (17.9%). With relation to health safety, 74.5% of Implanon users belonged to categories 1 and 2 of the medical eligibility criteria for contraceptive use, 25.5% to category 3, and no one to category 4.

M.A. / In 1994 a landmark conference, the International Conference on Population and Development, took place during which the importance of family planning was clearly underlined. In spite of the importance with which this issue is viewed by health departments around the world seventy-five million unintended pregnancies occur around the world every year. Several factors may contribute to this multi-faceted problem. The difference between clients’ expected family planning services and the extent to which these clients’ expectations are met is one such factor. Improving family planning service delivery in line with clients’ expectations is essential to putting clients first. To do so, clients’ perspectives on family planning service delivery should be assessed. Whilst accompanying family planning students at the Johannesburg Metropolitan Health Department, the researcher encountered clients who expressed dissatisfaction with the lack of interpersonal skills and information provided by service providers. Despite the Department of Health’s policies that are in place for the provision of family planning services the researcher became aware of women who considered becoming family planning clients and would then discontinue utilising services because their expectations of the service delivery were not met.

Class of 2005 Abstract / Objectives: To assess whether the satisfaction of women with the pharmacist administered bio-identical hormone replacement therapy consultation service has improved since the implementation of a follow up call program at Reed’s Compounding Pharmacy. Methods: A questionnaire was mailed to 200 randomly selected women who had completed their HRT consultation and received all three follow-up calls provided by Reed’s Compounding Pharmacy within the time frame from July 22, 2003 to April 22, 2004. The returned surveys were then organized and analyzed using Microsoft Excel. Additionally, independent t-tests were used to compare data collected in 2001 vs. 2004 on relevant questionnaire items of interest. Main results: Of the 200 surveys sent out to patients, 125 replied (a response rate of 62.5%). Over 50% heard about it through referral from their provider, and almost 35.2% from a friend or a relative. Regarding the follow-up call service, 95.9% of the patients either agreed or strongly agreed that it was helpful; however, only 73.8% feel comfortable discussing their concerns with student interns, who are responsible for the follow-up calls. In the assessment of new health conditions developed after natural hormone therapy initiation, 94.3% of the respondents reported with no new health conditions. T-tests revealed an improvement in patient satisfaction items between 2001 and 2004 with p-values < 0.05. Principal Conclusions: The results of the study showed that there was an improvement in patient satisfaction with the consultation service since 2001, and most of the differences found were statistically significant. The survey result also showed that participants were happy about the follow-up calls, which in terms, perhaps contributed to the increase in satisfaction.

Purpose To assess patient satisfaction with the use of Portable Video Media (PVM) for the purpose of taking informed consent for common urological outpatient procedures performed under local anaesthesia. Methods Patients undergoing the following procedures were approached for recruitment: flexible cystoscopy with or without biopsy, transrectal ultrasound-guided prostate biopsy or flexible cystoscopy with insertion or removal of a ureteric stent. Audio-visual media were developed for each procedure, with each script translated from English into isiXhosa and Afrikaans. The study involved a cross-over for each patient between Standard Verbal Consent (SVC) and PVM consent, with each patient randomised to start with SVC or PVM consent. Each of these consent-arms were assessed via a questionnaire. Results 60 patients completed participation, with PVM as the first exposure for 28 patients and 32 patients receiving SVC as their first arm of the study. When comparing the overall satisfaction between SVC and PVM consent (the total scores out of 18 for the questionnaire), patients scored significantly higher for PVM consent (M = 16.3 ± 2.4) compared to SVC (M = 15.4 ± 2.9) (p = 0.002). 92% of the total patient sample preferred PVM consent. Conclusion PVM proved superior to SVC in improving satisfaction in the consent process for common outpatient urological procedures performed under local anaesthesia.

The aim of the study was to identify, evaluate and compare the determinants of patient satisfaction in fee-for-service, and health maintenance organisation (HMO), medical service delivery centres. Staff at both centres, who were also patients, were surveyed to determine the congruence with patients’ quality improvement priorities. The survey was conducted using a questionnaire consisting of closed questions given to patients as they departed from the medical centres. The questionnaire was tested for convergent and divergent validity, content analysis and reliability. A rating scale was then applied to yield the scores for each determinant. The unique Patient Satisfaction Priority Index was determined using determinants that were rated low on satisfaction but high on importance. The results revealed that patients at the fee- for- service medical centre were significantly more satisfied than patients at the HMO. The priority index for patients were found to be different to that of the staff at both medical centres, proving that staff and patient priorities were incongruent. Accordingly, the recommendations were that patient satisfaction be continuously evaluated at medical service delivery centres, in order to achieve a competitive advantage, sustainability and growth in South Africa’s highly competitive private healthcare industry. Copyright / Dissertation (MBA)--University of Pretoria, 2008. / Gordon Institute of Business Science (GIBS) / unrestricted

Chan Lai-hung. / Thesis submitted in: December 2000. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 124-136). / Abstracts in English and Chinese. / Acknowledgements --- p.iv / Abstract / English version --- p.v / Chinese version --- p.vii / Chapter Chapter One --- INTRODUCTION / Background --- p.1 / Maternity care practice in Hong Kong --- p.4 / Purpose of the study --- p.4 / Significance of the study --- p.5 / Organization of the thesis --- p.5 / Chapter Chapter Two --- LITERATURE REVIEW / Introduction --- p.6 / Conceptual theories of patient satisfaction --- p.7 / The importance of labour experience in a woman's life --- p.10 / Studies about women satisfaction during childbirth --- p.13 / Cultural influence to the woman satisfaction --- p.16 / Measuring woman satisfaction in labour --- p.19 / Conclusion --- p.21 / Chapter Chapter Three --- RESEARCH METHODOLOGY / Research design --- p.22 / The setting --- p.23 / The sampling --- p.24 / Data collection / Data collection procedure --- p.25 / Data collection method --- p.26 / Interview schedule --- p.29 / Data management technique --- p.30 / Data analysis / Definition of content analysis --- p.31 / Steps involved in content analysis --- p.32 / Trustworthiness and credibility of the study / Sampling --- p.35 / Data collection method / interview schedule --- p.36 / data collection: time & place --- p.36 / Credibility of the research as the instrument in the study --- p.37 / Increasing credibility of data analysis by discussion --- p.38 / Ethical issues of the study / Official approval for the study --- p.38 / Confidentiality --- p.39 / Informed consent --- p.39 / Handling complaint from participants --- p.40 / Conclusion --- p.41 / Chapter Chapter Four --- FINDINGS AND DISCUSSION OF THE STUDY / Demographic information of the participants --- p.44 / The author's experience about interview --- p.44 / Sense of security : core component of women satisfaction --- p.45 / The components of satisfaction with care during labour / Chapter 1. --- Companionship / Chapter 1.1 . --- husband as a companion --- p.49 / Chapter 1.2. --- midwife as a companion --- p.59 / Chapter 2. --- Information and guidance support --- p.63 / Chapter 3. --- Competence & attitude of the caregivers / Chapter 3.1. --- supportive attitude : encouragement --- p.71 / Chapter 3.2. --- competence of the caregivers --- p.74 / Chapter 3.3. --- caring attitude of the caregivers --- p.77 / Chapter 4. --- Physical comfort / Chapter 4.1 . --- "providing warmth, avoid 'cold'" --- p.82 / Chapter 4.2. --- perineal wound care --- p.85 / Chapter 4.3. --- pain management --- p.87 / Chapter 5. --- Outcome of labour / Chapter 5.1. --- seeing a healthy baby --- p.93 / Chapter 5.2. --- the labour process --- p.96 / Chapter 6. --- Environment & facilities --- p.103 / The midwife-client relationship: A trusting relationship --- p.106 / Conclusion --- p.112 / Chapter Chapter Five --- "SUMMARY OF THE FINDINGS AND IMPLICATIONS FOR MIDWIFERY PRACTICE, EDUCATION AND RESEARCH" / Summary of the findings --- p.113 / Limitation of the study --- p.118 / Recommendations / Midwifery practices --- p.119 / Education --- p.120 / Further research --- p.121 / Personal implications --- p.122 / Conclusion --- p.123 / REFERENCE --- p.124 / APPENDICES / Chapter A. --- Demographic Data Sheet --- p.137 / Chapter B. --- Interview Fieldnote Record --- p.138 / Chapter C. --- Interview Schedule --- p.139 / Chapter D. --- Demographic Data of the Participants --- p.140 / Chapter E. --- "Approval letter from Clinical Research Ethics Committee, The Chinese University of Hong Kong" --- p.141 / Chapter F. --- "Approval letter from Central Nursing Division, The public hospital." --- p.142 / Chapter G. --- "Approval letter from Department of Obstetric and Gynaecology, The public hospital" --- p.143 / Chapter H. --- Informed Consent from the Participant (English & Chinese version) --- p.144-145 / Chapter I. --- Subject Information Sheet for the Participants (English & Chinese version) --- p.146-147 / Chapter J. --- Transcription of a interview --- p.148-155

Source: Masters Abstracts International, Volume: 47-06, page: 3553. Advisers: Michael L. Parchman; Jimmy L. Perkins. Includes bibliographical references.

Source: Masters Abstracts International, Volume: 47-06, page: 3565. Adviser: Benjamin Amick. Includes bibliographical references.

Thesis (M.P.H.M. (Primary Health Care Management))--Mahidol University, 2008. / LICL has E-Thesis 0038 ; please contact computer services.

Background Patient satisfaction is an important assessment of hospital’s service quality. Patients from emergency department (ED) usually have high expectation on receiving timely and high quality medical service. They generally have low patient satisfaction. Patient satisfaction has been identified to be associated with willingness to return and recommendation of the medical service to others. Therefore, to identify the factors associated with patient satisfaction in ED is important. Factors associated with patient satisfaction could vary by different ED systems. This project aimed at synthesizing factors associated with patient satisfaction in ED in Mainland China, Hong Kong and Taiwan, and comparing the different factors associated with patient satisfaction among the three areas and make recommendations on interventions to improve patient satisfaction in ED. Methods This review retrieved published literatures from PubMed, CNKI, and Taiwan electronic periodical services (TEPS). There is no restriction on study design, study population and measurements of patient satisfaction. Studies reporting factors associated with patient satisfaction in ED, and studies reporting effective interventions of improving patient satisfaction in ED were included. A total of 20 including 12 studies about Mainland China, two studies about Hong Kong and six studies about Taiwan were included. Results Common factors associated with patient satisfaction in emergency services have been identified in Mainland China, Hong Kong and Taiwan as well as other countries. These common factors included patients' characteristics, technical skills of medical staff, service attitudes, communication skills, professional ethics, provision of sufficient information, waiting time, allocation of resources and physical environment of ED. Different health systems can explain some unique factors identified in different areas. Satisfaction with medical expenses has been identified as a factor associated with overall patient satisfaction of ED in Mainland China, which could be due to that patients in Mainland have higher out-of-pocket share. Hong Kong has a gate keeper system which results in a large number of inappropriate ED users and thereby increases the waiting time and causes the ED crowding. Conclusion On the basis of the identified factors, potential interventions such as providing patients with sufficient information and improving medical staff’s technical skills, service attitude and communication skills can be implemented to increase patient satisfaction. Future studies should focus more on the evaluation of specific interventions. / published_or_final_version / Medicine / Master / Master of Public Health