Analysis of the relationship between management capability of general practice team leaders and the team performance in community health service centers based on structural equation model / 中华全科医师杂志

Objective:To analyze the relationship between capacity of general practice team leaders and the team performance in community health service centers.Methods:This study was a cross-sectional study. A questionnaire survey was conducted between November and December 2022, among general practice team leaders and general practitioners (GPs) from 18 community health service centers in the urban and suburban areas of shanghai selected by stratified sampling method. The personal information questionnaire, leadership of general practice team leader questionnaire,and work performance scale of general team members were used for the survey. The relationship between leadership of general practice team leaders and team performance was analyzed based on structural equation model (SEM).Results:A total of 944 questionnaires were distributed and 856 valid ones were returned with a response rate of 91.0%, including 110 general practice team leaders and 749 were GPs. The SEM analysis showed that some dimensions of the management ability of the general practice team leader had significant effect on the employee organization loyalty (organizational management: β=0.37, teaching and research management: β=-0.29, strategy and cultural construction: β=0.23, personal quality: β=0.11) and work performance (special business management: β=0.95, organizational management: β=0.54) (all P<0.05); and employee organization loyalty played a partial mediator role in relationship between leadership of general practice team leaders and work performance with a mediating effect of 39.50%. Conclusion:The management ability of the general practice team leader directly affect or indirectly affect the work performance of team members through team members′ organizational loyalty.

Dimensiones que caracterizan la lealtad de los clientes internos en servicios de salud

Introducción: La satisfacción de los integrantes de una organización de cualquier tipo y, en particular, de aquellas que prestan servicios médicos es un tema de mucho interés e importancia si de lograr altos niveles de satisfacción y, por ende, de lealtad de los pacientes y sus familiares se trata. Objetivo: Determinar las dimensiones y atributos para la satisfacción y lealtad del cliente interno en instituciones de salud en Barranquilla durante el año 2021. Método: Se realizó un estudio exploratorio descriptivo en instalaciones relacionadas con los servicios de salud en Barranquilla en 367 funcionarios (n=367) aunado con la revisión de la literatura correspondiente. Se aplicó un cuestionario con el fin de conocer las dimensiones y atributos antes mencionados. Los atributos fueron agrupados por eje de acuerdo a su mayor peso y sobre la base de esto fue definida el nombre de las dimensiones considerando diversos estudios realizados y la experiencia. Se realizaron pruebas para determinar fiabilidad y validez para la encuesta, así como pruebas de adecuación muestral. Se aplicó el análisis factorial y componentes principales. Resultados: El 79 % de la varianza total abarcó las dimensiones: trabajo en equipo, reconocimiento laboral, condiciones de trabajo y beneficios laborales. Se mostró una distribución de los atributos en las dimensiones capaz de explicar la situación en un alto nivel. Conclusiones: El cliente interno es factor clave en una organización, considerándose adecuados los atributos propuestos para la satisfacción y lealtad del mismo en instituciones de salud.

Introduction: Satisfaction of internal members of any organization, in particular those which provide medical services, is of a great interest and importance when it comes to achieve high levels of satisfaction and, therefore, loyalty of both patients and their families. Objective: To determine dimensions and attributes to get internal customer satisfaction and loyalty in health institutions in Barranquilla, throughout 2021. Method: An exploratory descriptive study was carried out in healthcare facilities in Barranquilla. The study was conducted in 367 health officials (n=367). Also it was carried out a review of related literature. It was applied a questionnaire to determine the dimensions and attributes. The attributes were grouped by axis according to those with widest impact and, based on this assess, the name of the dimensions was defined taken into account various previous studies and experiences. Factor and principal component analyses were applied. Results: The 79 % of the total variance covered the following dimensions: teamwork, job recognition, working conditions and work benefits. The attributes distributed in the dimensions can certify the high level found. Conclusions: The internal customer is a key factor in any institution, and the proposed attributes for customer satisfaction and loyalty in health institutions are considered adequate.

Introdução: A satisfação dos membros de uma organização de qualquer tipo e, em particular, daqueles que prestam serviços médicos é um tema de grande interesse e importância se pretendemos alcançar elevados níveis de satisfação e, portanto, de fidelização dos pacientes e seus parentes são tratados. Objetivo: Determinar as dimensões e atributos para a satisfação e lealdade do cliente interno em instituições de saúde em Barranquilla durante o ano de 2021. Método: Estudo descritivo exploratório realizado em instalações relacionadas a serviços de saúde em Barranquilla em 367 funcionários (n=367) juntamente com a revisão da literatura correspondente. Aplicou-se um questionário para conhecer as dimensões e atributos mencionados. Os atributos foram agrupados por eixo de acordo com seu maior peso e com base nisso foi definido o nome das dimensões considerando diversos estudos e experiências. Foram realizados testes para determinar a confiabilidade e validade da pesquisa, bem como testes de adequação da amostra. Aplicou-se análise fatorial e componentes principais. Resultados: 79% da variância total cobriu as dimensões: trabalho em equipe, reconhecimento do trabalho, condições de trabalho e benefícios do trabalho. Foi apresentada uma distribuição dos atributos nas dimensões, capaz de explicar a situação em alto nível. Conclusões: O cliente interno é um fator chave em uma organização, considerando adequados os atributos propostos para a satisfação e fidelização do mesmo nas instituições de saúde.

IMPACT OF EMOTIONAL BRANDING AND CUSTOMER LOYALTY OF CONSUMERS TOWARDS NESTLE FOOD PRODUCTS IN INDIA: AN ANALYSIS

Nestle food products have been dominating the food industry and ruling the heart of Indians for long. This study is an attempt to understand the impact of emotional branding and customer loyalty of consumers towards such food products. In today's world, marketers have been extensively using emotional branding to create an impact and this study will help us to the situation better

BRAND, BRAND LOYALTY, AND LOYALTY PROGRAMS: A SYSTEMATIC REVIEW OF EXISTING RESEARCH LITERATURE

The business world is facing lots of challenges due to competitive global markets. Disruptive innovations in technology raised a question for many businesses regarding the longevity of advantages they are enjoying on their investments in current technology. Product differentiation is much tougher nowadays because of the competitors imitating the leaders in market matching the standards fairly. To solve this problem companies use brand and brand loyalty to enjoy long-term competitive advantage. The main objective of this paper is to review the existing academic literature on brand, brand loyalty and loyalty programs and its advantages to the businesses. The researchers have used secondary data sources to know how companies are using these tools for creating competitive advantages. This paper gives details regarding the benefits of having a strong brand and creating and developing brand loyalty for the organizations and its customers. The outcomes of this review paper show that brand and brand loyalty programs are an essential part of any given business

A lealdade dos espectadores de futebol e seus antecedentes: uma revisão sistemática / Lealtad y antecedentes de los espectadores de fútbol: una revisión sistemática / Football spectator's loyalty and yours pedictors: a systematic review

O objetivo deste estudo foi identificar os antecedentes da lealdade dos torcedores de clubes de futebol. Foi realizada uma revisão sistemática utilizando artigos originais de 2009 a 2019, indexados na "Academic Search Ultimate", "Business Source Ultimate", "Scopus" e "Web of Science"; 166 foram encontrados e 21 incluídos. Nos resultados, a maio-ria dos artigos foi com base no contexto europeu. Em relação ao instrumento e análise, todos os estudos utilizaram questionário com escala Likert que variava entre 5 e 11 pontos. Análise de Equações Estruturais foi o principal método de análise dos dados. Como resultado, os principais preditores encontrados foram a satisfação e a identificação. Sugere-se análises no contexto das Américas, em especial no Brasil (AU).

This study aimed to identify the antecedents of soccer club fans' loyalty. A systematic review was carried out, using original articles from 2009 to 2019, indexed in "Academic Search Ultimate", "Business Source Ultimate", "Scopus" and "Web of Science", 166 were found and 21 were included. In the results, most of the articles were in the European context. Regarding the instrument and analysis, all studies used a questionnaire with a Likert scale that varied between 5 and 11 points. Structural Equation Modeling was the main method of data analysis. As a result, the main predictors found were satisfaction and identification. Analyzes are suggested in the context of the Americas, especially in Brazil (AU).

El objetivo fue identificar los antecedentes de la lealtad de los torcedores de clubes de fútbol. Fue realizóada una revisión sistemática, utilizando artículos originales de 2009 a 2019, indexados en "Academic Search Ultimate", "Business Source Ultimate", "Scopus" y "Web of Science", se encontraron 166 y se incluyeron 21. En los resultados, la mayoría de los artículos estaban en el contexto europeo. En cuanto al instrumento y análisis, todos los estudios utilizaron un cuestionario con escala Likert que varió entre 5 y 11 puntos. El Modelo de Ecuaciones Estructurales fue el principal método de análisis de datos. Los principales predictores encontrados fueron la satisfacción y la identificación. Se sugieren análisis en el contexto de las Américas, especialmente en Brasil (AU).

La relación entre la calidad en el servicio, satisfacción del cliente y lealtad del cliente: un estudio de caso de una empresa comercial en México / The relationship between service quality, customer satisfaction, and customer loyalty: A case study of a trading company in Mexico

Resumen La calidad en el servicio se considera una alternativa para que las empresas puedan obtener una ventaja competitiva y sostenible en un entorno económico globalizado. Las pequeñas y medianas empresas deben ofrecer una mayor calidad en el servicio que las empresas grandes, y así obtener la preferencia de los clientes. El objetivo de este estudio fue identificar la relación entre la variable calidad en el servicio y las variables satisfacción del cliente y lealtad del cliente. Se utilizó el coeficiente de correlación de Spearman y un método estadístico basado en análisis factorial exploratorio que apunta a extraer la varianza máxima del conjunto de datos dentro de cada factor. Los resultados permitieron observar una correlación altamente significativa, positiva y fuerte de la variable de calidad en el servicio con satisfacción del cliente (r = 0.820) y lealtad del cliente (r = 0.803). Un hallazgo importante también fue la asociación entre la dimensión aspectos tangibles con las variables satisfacción del cliente (r = 0.910) y lealtad del cliente (r = 0.919). Por otro lado, en el análisis factorial, a través de la varianza total explicada, se observó que el autovalor es superior a 1 en los cinco primeros casos, donde el porcentaje de la varianza alcanza un valor máximo de 54.886 % en su primer factor. Entonces, con cinco factores se consigue explicar un 73.713 % de la varianza de todos los datos originales. El estudio presentó la limitación de su aplicación en solo una empresa. Se confirmó que a través de una mejor atención y servicio al cliente, la calidad en el servicio constituye una excelente herramienta para la rentabilidad y sostenibilidad de la empresa.

Abstract Service quality is considered an alternative for companies to obtain a competitive and sustainable advantage in a globalized economic environment. Small and medium-sized enterprises must offer a higher quality of service than large companies, and thus obtain customer preference. The objective of this study was to identify the relationship between service quality variable and the customer satisfaction and customer loyalty variables. Spearman's correlation coefficient was used, and a statistical method based on exploratory factor analysis, aiming to extract the maximum variance of the data set within each factor. The results allowed observing a highly significant, positive, and strong correlation, with values of r = 0.820 and r = 0.803, between the variables of service quality, customer satisfaction, and customer loyalty. An important finding was the association between the tangible aspects dimension with the customer satisfaction and customer loyalty variables, with values of r = 0.910 and r = 0.919, respectively. On the other hand, in the factor analysis, through the explained total variance, it was observed that the eigenvalue is greater than 1 in the first five cases, where the percentage of the variance reaches a maximum value of 54.886 % in its first factor. Then, with five factors, 73.713 % of the variance of all the original data is explained. The study presented the limitation of its application in only one company. It was confirmed that, through better customer care and service, service quality constitutes an excellent tool for the profitability and sustainability of the organization.

Study of the academic loyalty of authors of the nursing Sci-Tech periodicals and training strategy / 中华医学科研管理杂志

Objective:This paper aims to analyze the status of academic loyalty for authors of the nursing Sci-Tech periodicals, and to explore the corresponding training strategies.Methods:Academic loyalty for authors of the nursing Sci-Tech periodicals was surveyed by general information questionnaire and academic loyalty scale.The survey was conducted both online and onsite.Results:The score index of academic loyalty for authors of the nursing Sci-Tech periodicals is 79.43%, and the total score is 43.13±7.47.The scoring indicators of academic loyalty scale from low to high are academic ideal, academic effort and academic identity.Conclusions:The academic loyalty for authors of the nursing Sci-Tech periodicals is at a higher medium level. In order to improve the academic loyalty, we should establish scientific academic core values, respect academic ethics and norms, actively participate in academic activities, strengthen on-going professional knowledge learning, being accountable and responsible, nurture and cultivate academic spirit.

Determinants of farmers' loyalty to dairy processors in Minas Gerais, Brazil / Determinantes da fidelidade dos produtores de leite aos laticínios em Minas Gerais, Brasil

ABSTRACT: The current study explores variables associated with the loyalty of dairy farmers to dairy processors in the Brazilian context. A multivariate discrete choice (Logit) model and alternative formulations assess the associations between loyalty metrics and farm and processor characteristics for a sample of 32 dairy farmers in 16 municipalities at the Zona da Mata in Minas Gerais. Twenty-two dairy processors were identified as milk buyers in the area studied, but each farmer indicated that they could sell to an average of five alternative buyers of milk. Farmers' attributes such as production scale or the technological level are not statistically significantly associated with loyalty in this sample. The current milk price paid to farmers in our sample is not associated with increased loyalty (sales to a single processor for 6 or more years) in all estimated models; although, further research on this impact is merited to inform buyer-pricing policy. Variables associated with increased loyalty include payment of premiums for quality, farmer years of experience and cooperation among farmers in the purchase of inputs. Delayed payment is associated with reduced loyalty. We could not determine the effect of participation in technical assistance programs offered by processors on loyalty, because in our sample all farmers received free university-provided technical assistance. The payment of a premium based on milk volume was also unassociated with loyalty determination. The small size of our sample limits the ability to generalize our results but provides exploratory results that facilitate future investigation.

RESUMO: O objetivo deste estudo é explorar as variáveis importantes associadas à fidelidade dos produtores de leite aos laticínios no contexto brasileiro. Um modelo de escolha discreta multivariada (Logit) e formulações alternativas foram usadas para avaliar as associações entre métricas de fidelidade e características de fazendas e processadores em uma amostra de 32 produtores de leite de 16 municípios da Zona da Mata, em Minas Gerais. Vinte e dois laticínios foram identificados como compradores de leite na região estudada, entretanto, cada produtor indicou que tem, em média, a possibilidade de vender o leite para cinco empresas diferentes. Os atributos dos agricultores, como escala de produção ou nível tecnológico, não foram estatisticamente associados significativamente à fidelidade. O preço atual do leite pago aos agricultores nessa amostra não está associado a probabilidade de aumento da fidelidade (vendas para um único laticínio por seis anos ou mais) em todos os modelos estimados. No entanto, pesquisas adicionais sobre esse impacto são necessárias para subsidiar políticas de preços aos produtores. As variáveis associadas ao aumento da fidelidade incluem pagamentos de prêmios pela qualidade, anos de experiência dos agricultores e a cooperação entre os agricultores na compra de insumos. O atraso no pagamento está associado à redução de fidelidade. Não foi possível determinar o efeito da participação em programas de assistência técnica oferecidos pelos processadores na fidelidade, provavelmente porque todos os produtores estudados recebem assistência técnica de graça de uma Universidade. O pagamento de prêmios com base no volume de leite também não foi associado à determinação da fidelidade. O pequeno tamanho de nossa amostra limita a capacidade de generalizar nossos resultados, mas fornece resultados exploratórios que facilitam investigações futuras.

Dr. Ángel Fernández Vila: Medicina y Revolución

Este trabajo refiere la historia del Dr. Ángel Fernández Vila, hombre que ha dedicado la vida al sacerdocio de la Medicina, además de su entrega incondicional a la Revolución. El acercamiento a su vida y obra se realizó a través de una entrevista realizada por la autora, con la que se logró que narrara los momentos más importantes de una larga trayectoria llena de logros y vivencias inolvidables. Desde su humilde origen en una Cuba sumida en la explotación, que contribuyó a liberar con su acción, hasta el quehacer después del triunfo de la Revolución que incluye su actividad como dirigente, militar, médico y profesor. Es por eso que el objetivo es valorar su vida y obra teniendo en cuenta la labor realizada. Es un ejemplo de consagración, valor, honradez, honor, entrega, humanismo y lealtad a la Revolución. El Dr. Fernández Vila tiene una brillante hoja de servicios y fecunda trayectoria revolucionaria, lo que lo hace distinguirse como combatiente en primera fila de la Revolución.

This paper is about the life story of Dr. Angel Fernández Vila, a humble and modest man who devoted his life to Medicine and gave himself totally to the work of the Revolution. An approach to the life and work if this outstanding doctor was achieved by an interview carried out by the author. He narrated the most important events of a long career full of unforgettable achievements and experiences, talked about his humble origin in a country which lived in the exploitation, and detailed the way he contributed to liberate it with his action and profession. After the triumph of the Revolution he worked as a leader, military man, medical doctor and professor; therefore, it is important to value his life and work considering his magnificent job. He is an example of dedication, values, honesty, honor, commitment, humanism and loyalty to the Revolution. Dr. Fernández has a distinguished record of service and a successful career and is a paradigm for all the health workers, what distinguishes himself as a combatant in the front line of the Revolution.

The relationship between military loyalty and both character strengths and psychological resilience / 解放军医学杂志

Objective: To explore the correlation between military loyalty and both character strengths and psychological resilience, and understand the influence of personality factor on military loyalty. Methods: The correlation between military loyalty, character strengths and psychological resilience can be found by correlation analysis. Hierarchical regression analysis explored the influence of demographic and personality factors on military loyalty. Analysis of mediating effect was conducted for finding the role that psychological resilience plays in character strengths mediating the military loyalty. Results: A total of 476 valid questionnaires were retrieved. Military personnel showed a significant positive correlation of character strengths and psychological resilience with loyalty (P=0.000); character strengths and psychological resilience had significant positive predictive effects on the loyalty of military personnel, of which character strengths had a positive predictive rate (β=0.42, P=0.000) for the loyalty of military personnel and explained 15.6% of the total variation in loyalty. The positive prediction rate (β=0.38, P=0.000) of military psychological resilience for loyalty explained 13.0% of the total variation of loyalty; psychological resilience not only has a significant positive predictive effect on the loyalty of military personnel, but also plays a partial mediating effect of character strengths on the loyalty of military personnel, with the mediating effect accounting for 29.3% of the total effect. Conclusion: Character strengths and psychological resilience can effectively and positively predict the loyalty of military personnel, while psychological resilience partially regulates the improvement of the loyalty of military personnel.

Determinants of customer loyalty in the banking industry: A comparative study of private and govt sector banks in Trichy district / 国际药学研究杂志

The Banking industry is the backbone of every economy and has a major role to play in the wellbeing of a nation. The competition in the banking sector is so severe that the banks are finding it very difficult to increase their market share. Acquiring customers as well as retaining them is a big challenge faced by them. Banks have to capitalize on service delivery so as to ensure customer satisfaction and customer loyalty. Therefore, the banks have to formulate clear strategies in meeting the dynamic customer demands and ensuring customer satisfaction. The objective of this research is to ascertain factors influencing customer loyalty amongst the banking customers in Trichy District. Descriptive research was carried out in identifying the problems as well as developing the concepts of this research. A total of the sample size of this research is 420 customers. Various research tools like Cronbach’s alpha test, ANOVA, correlation, and a weighted arithmetic mean were employed in this study. The research found that Brand awareness and Perceived Quality are the strongest factors in generating brand loyal customers. These factors have a greater role in modern day banking to ensure customer satisfaction and provide the edge over the competitors.

A satisfação e as intenções comportamentais dos sócios-torcedores de um clube pernambucano em relação aos serviços prestados no campeonato brasileiro de futebol ­ série A / The satisfaction and the behavioral intention of the supportive member of a Pernambuco club in relation to the services provided / La satisfacción y la intención conductual del socio hincha de un club pernambucano en relación a los servicios prestados

O objetivo deste estudo foi analisar a satisfação e as intenções comportamentais dos sócios-torcedores de um clube de Pernambuco no Campeonato Brasileiro de Futebol ­ Série A. O estudo é caracterizado como pesquisa descritiva, com a população composta por sócios-torcedores do clube. Os dados foram coletados por meio de questionário de escala multi-itens do tipo Likert com cinco alternativas. Os dados foram analisados no software IBM SPSS Statistics 20, através da estatística descritiva, utilizando média, moda, mediana, desvio padrão, soma, medidas percentuais e gráficos. Os resultados apresentam números positivos em relação à satisfação com os serviços auxiliares, indiferença em relação ao jogo e resultados positivos nas intenções comportamentais. Conclui-se que houve resultados positivos em relação à qualidade de serviço, equilíbrio quando tratou-se da satisfação com os jogos e resultados bastante positivos quando se questionou sobre as intenções de consumir mais produtos e serviços do clube na visão de seus sócios-torcedores entrevistados.

The objective of this study was to analyze the satisfaction and behavioral intentions of the supporters of a Pernambuco club in the Brazilian Football Championship - Serie A. The study is characterized as descriptive research, with the population made up of club members-supporters. The data were collected through a multi-item Likert scale questionnaire with five alternatives. The data were applied in IBM SPSS Statistics 20 software, analyzing them in a descriptive way, using mean, fashion and median, standard deviation, sum, percentage measures and graphs. The results present positive numbers in relation to the satisfaction with the auxiliary services, indifference in relation to the game and positive results in the behavioral intentions. It was concluded that there were positive results regarding the quality of service, balance when it was the satisfaction with the games and very positive results when asked about the intentions to consume more products and services of the club in the vision of its partner-fans interviewed.

El objetivo del estudio fue analizar la satisfacción y las intenciones comportamentales de los socios aficionados de un club de Pernambuco en el Campeonato Brasileño de Fútbol - Serie A. El estudio se caracteriza como una investigación descriptiva, con la población compuesta por socios-aficionados del club. Los datos fueron recolectados por medio de un cuestionario de escala multi-ítems del tipo Likert con cinco alternativas. Los datos fueron aplicados en el software IBM SPSS Statistics 20, analizándolos de una manera descriptiva, utilizando promedio, moda y mediana, desviación estándar, suma, medidas porcentuales y gráficos. Los resultados muestran cifras positivas en relación con la satisfacción con los servicios auxiliares, la indiferencia hacia el juego y los resultados positivos en las intenciones del comportamiento. Se concluyó que hubo resultados positivos en relación a la calidad de servicio, equilibrio cuando se trató de la satisfacción con los juegos y resultados bastante positivos cuando se cuestionó sobre las intenciones de consumir más productos y servicios del club en la visión de sus socios-aficionados entrevistados.

Patient Decision Making Process In A Dental Environment

An understanding of patient's decision making process helps a Dentist to present various treatment options in an appropriate and a legitimate way. The dynamics of today's practice is changing, where information search is made through various media. Patients pass through sequential steps comprising of, problem recognition, pre-purchase information search, evaluation of alternatives, purchase decision and post-purchase outcome and reaction before a choice is made. This paper provides an overview of how choices are made scientifically which helps the dentist to sustain an established practice and to successfully deliver the Dental treatment.

In Which Type of Healthcare Do Patients Show Greater Loyalty? (Public Sector Management vs. Public-Private Partnership) / ¿En qué tipo de asistencia el paciente manifiesta una mayor lealtad? (Gestión pública vs. colaboración público-privada) / A que tipo de assistência o paciente manifesta uma maior lealdade? (Gestão pública vs. colaboração público-privada)

Abstract Introduction: The present study analyses the patients behavior in a setting with different management types: public sector management and public-private partnership. More specifically, the objective is to establish in which healthcare type (hospitalization, ambulatory surgery, emergencies, outpatients consultation) do the patients show a stronger loyal behavior when they are in different management scenarios. Material and methods: A descriptive analysis based on secondary data collected from an internal database of the Conselleria de Sanidad of the Valencian Community in Spain, a scenario with two different healthcare management types (public sector management and public-private partnership) was conducted. Results: Higher patient flows in two healthcare types (emergency and outpatient consultation); disparate growth of the patients' net basis; partnership favors maintaining the relationship with the patient thus preventing dropout; specialization of the public-private partnership in an assistance type: ambulatory surgery. Conclusion: The obtained results identify the healthcare types with higher patients' loyalty, as well as the extent to which the management type affects this loyalty behaviour.

Resumen Introducción: el presente trabajo analiza el comportamiento del paciente en un entorno con diferentes tipos de gestión: pública y colaboración público-privada. Más concretamente, el objetivo es conocer en qué tipo de asistencia (hospitalización, cirugía sin ingreso, urgencias, consultas externas) el paciente muestra un comportamiento de lealtad cuando se encuentra ante diferentes escenarios de gestión. Materiales y métodos: análisis descriptivo a partir de datos secundarios obtenidos de una base de datos interna de la Conselleria de Sanidad en la Comunidad Valenciana (España), un escenario con dos modelos de gestión sanitaria (pública y colaboración público-privada). Resultados: mayores flujos de pacientes en dos tipos de asistencia (urgencias y consultas externas), crecimiento dispar de la base neta de pacientes, el partenariado favorece el mantenimiento de la relación con el paciente, evitando su deserción, especialización de la colaboración público-privada en un tipo de asistencia: cirugía sin ingreso. Conclusión: los resultados obtenidos identifican los tipos de asistencia con mayor lealtad del paciente, así como en qué medida el tipo de gestión afecta a esta lealtad.

Resumo Introdução: o presente trabalho analisa o comportamento do paciente em um ambiente com diferentes tipos de gerenciamento: pública e colaboração público-privada. Mais especificamente, o objetivo é saber em que tipo de assistência (hospitalização, cirurgia sem admissão, emergências, consultas externas) o paciente mostra comportamento de lealdade quando há diferentes cenários de gerenciamento. Materiais e métodos: análise descritiva a partir de dados secundários obtidos a partir de uma base de dados interna do Conselho Valenciano de Saúde (Espanha), um cenário com dois modelos de gestão da saúde (pública e colaboração público-privada). Resultados: maiores fluxos de pacientes em dois tipos de assistência (emergências e consultas ambulatoriais); crescimento desigual da base líquida de pacientes; a parceria favorece o mantimento do relacionamento com o paciente, evitando sua deserção; especialização da colaboração público-privada em um tipo de assistência: cirurgia sem admissão Conclusões: os resultados identificam os tipos de assistência a lealdade mais paciente e em que medida tipo de gestão afeta essa lealdade.

Effects of Job Demand and Recovery Experience from Job Stress on Job Embeddedness among Workers in the Service Industry

PURPOSE: The purpose of this study is to identify the effects of job demand and recovery experience from job stress on job embeddedness among workers in the service industry. METHODS: The participants were 223 workers from the service industry in P and Y Cities with the help of a structured self-report questionnaire, administered between July 10 and August 20, 2017. The data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson correlation coefficients and stepwise multiple regression. RESULTS: There were significant differences in job embeddedness in terms of satisfaction with salary, continuous service, perceived stress level and the perceived health status of the subjects. There were significant positive correlations between role clarification in job demands (r=.55), recovery experience from job stress (r=.27) and job embeddedness. From the multiple regression analysis, the most significant factors affecting job embeddedness were found to be role clarification in job demands (β=.47), recovery experience from job stress (β=.23), and perceived stress level (β=.18). These variables explain 34.0 % of the total variance in job embeddedness. CONCLUSION: In order to increase job embeddedness among workers in the service industry, it is necessary to prepare measures to increase recovery experience from job stress and to decrease role clarificationin job demand, and perceived stress level.

Fluxograma de acompanhamento e tratamento em gestante com sí­filis: construção de instrumento / Follow up flow chart of the pregnant woman with syphilis treatment: tool building

Conhecida há mais de 500 anos, a sífilis ocorre na população em geral e apesar de possuir tratamento efetivo e de baixo custo, vem apresentando significativo aumento do número de casos. O presente estudo enfoca a ocorrência de sífilis em gestantes. A sífilis na gestação pode evoluir para aborto espontâneo, natimorto e óbito perinatal. O número de casos de sífilis congênita tem sido adotado como um importante indicador de avaliação da qualidade da saúde na atenção básica. Desse modo, cabe às equipes de saúde da atenção básica e da vigilância epidemiológica acompanhar a ocorrência de casos na população em geral e nas gestantes, assim como os casos de sífilis congênita, contribuindo com ações voltadas ao planejamento e avaliação das medidas de tratamento, prevenção e controle. O interesse pelo tema de estudo advém da minha prática profissional em que ocorrem situações evitáveis como tratamentos inadequados de gestantes com teste reagente para sífilis e nascimentos de crianças com sífilis congênita. Assim, a pesquisa estabeleceu como objetivo construir um fluxograma para auxiliar os enfermeiros no acompanhamento e tratamento da gestante com sífilis. Trata-se de um estudo qualitativo do tipo metodológico destinado à produção tecnológica. A investigação foi aprovada por Comitê de Ética em Pesquisa e foi desenvolvida em um município do interior do estado de São Paulo. O instrumento utilizado para coleta de dados foi o grupo focal, realizado em dois encontros. Participaram da pesquisa seis enfermeiros que desenvolvem prática clínica com gestantes na ESF, Atenção Básica, Centro de Especialidades e Pronto Socorro e Hospital do município. Com o material do primeiro encontro foi elaborada a primeira versão do fluxograma. No segundo encontro, o instrumento foi apresentado e validado pelos enfermeiros. A versão final do fluxograma levou em consideração manual e normas técnicas oficiais. A análise de conteúdo, temática do material do grupo focal identificou três categorias: fluxo do pré-natal e investigação de sífilis; atuação dos enfermeiros; e, dificuldades no acompanhamento e tratamento da gestante com sífilis. Por meio dos trechos das falas apresentadas é possível identificar uma fragilidade na comunicação entre atenção básica e o hospital, sendo necessário criar um fluxo de informação entre os enfermeiros. O estudo possibilitou conhecer profundamente a organização da rede de atenção à gestante dentro do município e esperamos com seus resultados convidar outros municípios à reflexão e discussão sobre a organização da rede cegonha, as ações de investigação, diagnóstico, acompanhamento e controle de tratamento da sífilis, especialmente em gestantes, seus parceiros e nos recém-nascidos. Além disso, intenciona-se chamar atenção para as dificuldades enfrentadas por enfermeiros e demais membros das equipes de saúde na redução dos casos de sífilis e sífilis congênita, não ficando restritos à ocorrência na gestante

Syphilis, which has been known for more than 500 years, occurs in ordinary population and despite having a cheap and effective treatment, it has been presenting a significant increase in case numbers. The present study focus on the occurrence of syphilis in pregnant women. During the gestation, syphilis may develop to a spontaneous abortion, stillbirth and perinatal death. The number of congenital syphilis cases has been adopted as an important indicator of quality evaluation of health in basics attention. This way, it is held to the health teams of basic attention and epidemiologic vigilance to follow the cases occurrence in the ordinary population and in pregnant women, as well as the congenital syphilis, which contributes to actions related to the planning and evaluation of treatment ways, prevention and control. The interest by the study themes comes from my professional practice in which avoidable situations as inappropriate pregnant women treatment with tests reactive to syphilis and births of children with congenital syphilis. Tis way, the research has stablished as an objective constructing a flow chart to help nurses in the follow up and treatment of pregnant women with syphilis. It is a qualitative and methodological study, directed to the technological production. The investigation was approved by the Research Ethics Department and it was developed in a city of São Paulo state. The instrument used to the data collect was the focal group, made in two encounters. For the study, six nurses who develop clinical practice with pregnant women were needed. These nurses develop clinical practice with pregnant women in ESF, Basic Attention Specialty Center and Prompt Service and local Hospital. With the material collected oh the first encounter it was possible to build the first version of the flow chart. On the second encounter, it was taken into consideration manual and official techniques. The content analysis, themes of the focal group material, identified three categories: prenatal flow and syphilis investigation, nursing action and, the difficulties in the follow up and treatment of pregnant women with syphilis. By pieces collected form the speeches presented, it is possible to observe a fragile communication between the basic attention and the hospital, being necessary the creation of an information flow among nurses. The study enabled to deeply know the net organization of pregnant women attention in the city and we hope with its result to invite other cities to think and discuss about the net pregnancy organization, investigative actions, diagnosis, following up and syphilis treatment control, especially during pregnancy, these women's partners and newborns. Besides, it's intended to call attention on the difficulties faced by nurses and other health professionals in the reduction of the cases of syphilis and congenital syphilis, not being restricted the occurrence during pregnancy

Organizational commitment, psychometric qualities and invariance of the Meyer and Allen Questionnaire for Portuguese Nurses / Commitment organizacional, qualidades psicométricas e invariância do questionário de Meyer e Allen em enfermeiros portugueses / Compromiso organizacional, cualidades psicométricas e invarianza del cuestionario de Meyer y Allen para enfermeros portugueses

ABSTRACT Objective: to evaluate the psychometric qualities of the Portuguese version of the Organizational Commitment Questionnaire for the nursing context, through confirmatory analysis and invariance, aiming to evaluate the reliability, internal consistency, construct validity and external validity of the instrument. Method: confirmatory factor analysis of the Portuguese version of the questionnaire was carried out with a sample of 850 nurses, in hospital context. The analysis was complemented using specification search. Goodness of fit was evaluated through different indices. Reliability, internal consistency and construct validity were estimated. The invariance of the model was evaluated in two subsamples of the same sample, in order to confirm the external validity of the factorial solution. Results: the refined model demonstrated good overall fit (χ2/df=6.37; CFI=0.91; GFI=0.92; RMSEA=0.08; MECVI=0.62). The factorial structure was stable (λ:Δχ2(14)=18.31; p=0;193; Intercepts: Δχ2(14)=22.29; p=0.073; Covariance: Δχ2(3)=6.01; p=0.111; Residuals: Δχ2(15)=22.44; p=0.097). Conclusion: the simplified model of the questionnaire demonstrated adequate goodness of fit, representing a stable factorial solution. The instrument was fit to monitor and evaluate the organizational commitment of Portuguese nurses.

RESUMO Objetivo: avaliar as qualidades psicométricas da versão portuguesa do Questionário de Comprometimento Organizacional, para o contexto da enfermagem, através de análise confirmatória e de invariância, visando a confiabilidade, consistência interna, validade de construto e a validade externa do instrumento. Método: procedeu-se à análise fatorial confirmatória da versão portuguesa do questionário, numa amostra de 850 enfermeiros, em contexto hospitalar. Complementou-se a análise com recurso à pesquisa de especificação. A qualidade de ajustamento foi avaliada através de diferentes índices. Estimou-se a confiabilidade, consistência interna e validade de construto. A invariância do modelo foi avaliada em duas subamostras, da amostra global, por forma a confirmar a validade externa da solução fatorial. Resultados: O modelo obtido após refinamento demonstrou bom ajustamento global (χ2/df=6,37; CFI=0,91; GFI=0,92; RMSEA=0,08; MECVI=0,62). A estrutura fatorial revelou-se estável (λ:Δχ2(14)=18,31; p=0,193; Interceptos: Δχ2(14)=22,29; p=0,073; Covariância: Δχ2(3)=6,01; p=0,111; Resíduos: Δχ2(15)=22,44; p=0,097). Conclusão: o modelo simplificado do questionário revelou boa qualidade de ajustamento, apresentando uma solução fatorial estável. O instrumento revelou-se ajustado para monitorizar e avaliar o comprometimento organizacional dos enfermeiros portugueses.

RESUMEN Objetivo: evaluar las propiedades psicométricas de la versión portuguesa del Cuestionario de Compromiso Organizacional para el contexto de enfermería a través del análisis de confirmación e invarianza, para evaluar la fiabilidad, la consistencia interna, la validez de constructo y la validez externa del instrumento. Método: se procedió a un análisis factorial confirmatorio de la versión en portugués del cuestionario, con una muestra de 850 enfermeros en el ámbito hospitalario y se complementó el análisis con un recurso a la investigación de especificación. La calidad del ajuste se evaluó a través de diferentes índices. Se estimó la confiabilidad, la consistencia interna y la validez de constructo. La invarianza del modelo fue evaluada en dos sub-muestras de la muestra global, para confirmar la validez externa de la solución factorial. Resultados: el modelo obtenido tras el refinamiento demostró un buen ajuste global (χ2/df=6,37; CFI=0,91; GFI=0,92; RMSEA=0,08; MECVI=0,62). La estructura factorial reveló estable (λ:Δχ2(14)=18,31; p=0,193; Interceptos: Δχ2(14)=22,29; p=0,073; Covariancia: Δχ2(3)=6,01; p=0,111, Residuos: Δχ2(15)=22,44; p=0,097). Conclusión: el modelo simplificado del cuestionario demostró una buena calidad de ajuste, presentando una solución factorial estable. El instrumento resultó estar ajustado para monitorear y evaluar el compromiso de la organización de los enfermeros portugueses.

Impact of medical staff loyalty on patient satisfaction:a study based on structural equation model / 中华医院管理杂志

Objective To learn the relationship and operating mechanism between medical staff's loyalty and patient satisfaction.Methods Medical staff and inpatients of a tertiary hospital in Nanjing were sampled at a 1:2 ratio for study,with 840 questionnaires released and 269 valid questionnaires recovered;medical staff service quality as perceived by inpatients served as the intermediate variable,with Mplus7.0 used to build a structural formula model for an empirical study of the relationship between staff loyalty and patient satisfaction.Results Staff loyalty exerts certain positive influence on patient satisfaction and staff service quality ( P direct effect value 0.143).Conclusions Structural formula model can reveal the relationship and extent of the influence of staff loyalty on patient satisfaction.This indicates that hospitals should enhance the loyalty,medical competence and communication skills of their medical staff for higher patient satisfaction.

Customer relationship management in the agricultural machinery market / Customer relationship management no setor de máquinas agrícolas

ABSTRACT: Customer Relationship Management can be regarded as a business approach. The objective was to know the customers, meet their expectations, and thus build customer loyalty. Although, the agricultural sector makes significant economic contributions to the Brazilian market and induces sharp competition among its companies, a huge opportunity still presents itself for the diffusion and implementation of CRM in the agricultural machinery sector. This study aimed to highlight the importance of customer management, by introducing the customer relationship management (CRM) concept. This is possible in the event of reselling agricultural machines, with the intention of retaining the customers and raising the profitability of these companies. It is necessary to understand CRM as more than a mere a concept or a tool. It is a business strategy, an endeavor that must be endorsed by the entire company. The concessionaire must be perceived as greater than a mere reseller. It is to be viewed rather as a problem solver, as one who offers services that are high in quality and meet client specifics.

RESUMO: O Customer Relationship Management pode ser considerado uma estratégia empresarial que visa conhecer seus clientes para atender suas expectativas, na intenção de fidelizá-los. Apesar da importância econômica do setor agrícola para o mercado brasileiro e o acirramento concorrencial entre suas empresas, há grande oportunidade para a difusão e implantação do CRM no setor de máquinas agrícolas. O objetivo do presente trabalho foi ressaltar a importância da gestão dos clientes, inserindo o conceito de gestão do relacionamento com clientes no caso de revendas de máquinas agrícolas, com o intuito de reter clientes e aumentar a rentabilidade dessas empresas. O CRM deve ser abordado além de um conceito ou uma ferramenta, mas como estratégia de negócio, uma missão que deve ser adotada por toda a empresa. A concessionária deve ser reconhecida, mais que apenas uma revendedora, mas como solucionadora de problemas, prestando serviço de qualidade e adaptado às especificidades de cada cliente.

Identificación de diagnósticos y especialidades con mayor lealtad del paciente como fuente de ventaja competitiva / Diagnosis and specialties identification with more patient loyalty as a source of competitive advantage / Identificaçâo de especialidades e diagnóstico com maior lealdade por parte do pacientecomo uma fonte de vantagem competitiva / Identification des diagnostics et spécialités associés à une plus grande fidélité des patients en tant que source d'avantage compétitifs

Resumen: Objetivo: En un escenario de financiación capitativa y facturación intercentros, guiado por el lema de "el dinero sigue al paciente", su lealtad, manifestada a través de la libre elección de centro, adquiere un carácter estratégico para la gestión sanitaria. En este entorno, resulta de especial relevancia conocer en qué diagnósticos y en qué especialidades médicas y quirúrgicas el paciente muestra una mayor lealtad. Materiales y métodos: En el presente trabajo, daremos respuesta al objetivo, empleando como metodología un análisis confirmatorio y considerando, como datos secundarios, las asistencias de hospitalización y cirugía sin ingreso, realizadas a pacientes de la Comunidad Valenciana en el año 2012 (más de 1 millón de registros del aplicativo COMPAS). Resultados: Los resultados de este análisis confirman el diferente comportamiento de lealtad del paciente ante diferentes diagnósticos y especialidades, y permiten su identificación. Conclusión: Existe un diferente comportamiento de lealtad del paciente según diagnósticos y especialidades, favoreciendo el diseño de la cartera de servicios con una visión estratégica con la qué lograr una ventaja competitiva.

Abstract: Objetive: When there is a pay per person system and a management model is based on the aim "money follows patient", patient loyalty becomes a priority for health management. In this framework, we study in which diagnosis and specialties patients become more loyal. Materials and methods: Hospitalization and outpatient surgery records from patients of the Region of Valencia (Spain) during 2012 (more than 1 million of records from a database called COMPAS) are considered as secondary data for empirical research. Results: Results show that loyalty behavior is different depending on diagnosis and health specialties. At the same time, it is allowed to identify those diagnosis and health specialties where patients are more loyal. Conclusions: A different loyalty patient behavior depending on diagnosis and specialties has been identified. In consequence, managers could be able to design their health portfolio in order to get a competitive advantage.

Resumo: Objetivo: Num cenário de financiamento por pessoa e faturação entre os centros, com o slogan "O dinheiro segue o doente", a sua lealdade, expressa através da livre escolha do centro de atendimento, assume um caráter estratégico para a gestão da saúde. Neste cenário, é especialmente relevante saber em que diagnósticos e especialidades o paciente apresenta maior fidelidade. Materiais e métodos: A presente investigação tenta responder ao objetivo delineado usando como metodologia uma análise confirmatória. Foram usados como dados secundários, os atendimentos hospitalares e cirurgias realizadas a pacientes da Região de Valência (Espanha) em 2012 (mais de um milhão de registos). Resultados: Os resultados desta análise confirmam o comportamento diferente de lealdade relativamente a diferentes diagnósticos e especialidades, e permitiram a sua identificação. Conclusão: Há um comportamento diferente de lealdade de acordo com diagnósticos e especialidades, favorecendo o design de um portfólio de serviços com uma visão estratégica com o qual se poderá alcançar uma vantagem competitiva.

Résumé Objectif: Dans un scénario de financement de la santé publique par capita et où chaque unité est responsable de son propre revenu, selon la devise «l'argent suit le patient", la fidélité des patients, qui s'exprime par le libre choix d'un hôpital ou d'un centre de santé pour leur traitement devient un objectif stratégique pour la gestion sanitaire. Dans ce contexte, il est particulièrement important de connaitre quels sont les diagnostics et les spécialités médicales et chirurgicales associés à une plus grande fidélité des patients. Matériel et méthodes: L'étude empirique qui répond à l'objectif utilise une analyse de confirmation en employant comme données secondaires les prestations d'hospitalisation et de chirurgie ambulatoire dispensées aux patients de la Région de Valencia (Espagne) en 2012 (plus d'un million de données provenant du logiciel COMPAS du système nationale espagnol de santé publique). Résultats: Les résultats de cette analyse confirment l'existence de différents comportements de fidélité des patients selon les diagnostics et les spécialités, et permettent leur l'identification. Conclusion: L'existence de ces différences dans la fidélité des patients va en faveur de la planification et l'offre d'un choix de spécialités et de services sanitaires avec une vision stratégique pour obtenir des avantages compétitifs par hôpital ou centre de santé.