Qualidade dos serviços e satisfação dos usuários : explorando experiências no espaço da atenção básica no município de Fortaleza/Ceará

Abstract

This study falls in the field of research about the quality of services and health programs, focusing the user satisfaction, designed as a component of quality assurance and, in itself, a result of health care. In view of the nature of the object of study, the approach adopted was the qualitative and analytical demarcated dimensions relate to the completeness and the humanization of health care. This is a study that aimed to understand the satisfaction of users of the Primary Care of the city of Fortaleza /CE on quality health care related to the size and full humanization of care. The study was conducted in the city of Fortaleza, Ceará, which has 88 Family Health Centers (FSC), distributed by the six regional which divides the city. Intended to cover the different regions, due to represent different contexts of implementation, as well as different social spaces. Investigated in each center, where selected users based on subjective criteria that could allow accumulation on the object of study. The sample was, therefore, type theory, and its size based on the principle of theoretical saturation. Thus has it with 43 users to perform the interviews. Depending on the strategy of triangulation method, different techniques are combined, and the main non-directive interviews and systematic observation. Interviews were conducted in homes of users and, once transcribed, the discursive material was processed and subjected to interpretative analysis based on referential hermeneutic. The material has the discursive construction of interpretative network, which is divided into three analytical (themes), which were: A) experiences of users' satisfaction; B) experiences of dissatisfaction, and C) the quality of services in view of the user. Among the results are: the satisfaction on the expansion of coverage of services, resulting in improved access and structure, even structural problems persist. However, users showed dissatisfaction regarding the lack of specialists, barriers to access and integration between specialist units and delay in delivery of specialized tests. The relationship with the units and the professional is something that moves between satisfaction and dissatisfaction, polarize between the host and listener, but revealing experience of lack of privacy, barriers to communication and inattention to the demands. Considering the foregoing, users suggest improvements regarding the organization of health services (flows of information and care, integrality, schedule changes the markings of consultations), the relationship of health professional / user (communication and human health). In summary, it is evident that users feel satisfied at times with the assistance it provided, but have lived experiences that are opposed to this meeting. Still, this research reaffirms the importance of measuring the satisfaction of users as a means to bring about symbolic mediations involved in the production of care, increasing thus the decision-making ability of managers to the construction and implementation of policies and programs aimed at consolidating the SUS and committed to its ideals