Qualidade de um instrumento para avaliação da satisfação de usuários de salas de vacina: propriedades psicométricas

Abstract

The assessment of satisfaction from the perspective of the user with health care services aims to know the reality of these services and comprises a dynamic process influenced by factors such as the perception of the state of health and disease, beliefs, sociodemographic condition and involves other aspects of care offered to the user. The evaluation of health services requires instruments methodologically accepted by the scientific community, however, only one validated instrument was found to assess the level of user satisfaction, specifically, in the vaccine rooms. This dissertation aimed to assess the quality of this instrument, called the “Vaccine Room Evaluation Scale from the User’s Perspective - EASV-U”. This instrument has already been validated for its content and has shown satisfactory reliability. A methodological study was conducted, which used data from a cross-sectional survey to assess the construct validity, internal consistency and interpretability of the EASV-U. A sample comprised of 1,300 users, parents or guardians of children under one year of age, who consecutively sought assistance in the last months participated in the study. On the day of the interview, the user should be seeking this assistance at least for the third time in that same vaccine room. Users of all 18 vaccine rooms in the municipality of Montes Claros - MG, from July 2015 to May 2016 were interviewed. Statistical procedures used in the construct validation process were: exploratory factor analysis followed by confirmatory factor analysis to determine how much the results found really represent the construct to be measured. The AFE presented KMO = 0.94 and Bartlett p = 0.000, with the grouping of 11 items in 3 factors: Factor I - Satisfaction with the physical / organizational structure (Structure) of the vaccine room; Factor II - Satisfaction with the professional / interpersonal relationship (Process) of the vaccine room; and Factor III - Satisfaction with the logistical structure (Inputs) of the vaccine room. These values explain that 78.88% of users' satisfaction with the vaccine room is related to the items grouped by the three factors. The EASV-U showed satisfactory internal consistency for the scale with global Cronbach's alpha equal to 0.949 and for each factor, the alpha values were: Factor I equal to 0.876; Factor II, 0.920 and Factor III, 0.867. The AFC legitimized the three-factor model of the scale with the adjustment indices: χ² / gl = 4.33; RMSEA = 0.051 (90% CI = 0.042-0.60); CFI = 0.991; TLI = 0.984; GFI = 0.981. The interpretability was presented after estimating the average and the minimum and maximum values of the EASV-U, followed by the categorization of the different factors identified considering the lower limit of the confidence interval as the cutoff point. Those with scores for each factor below this value were considered dissatisfied. Those who presented values above this cutoff point were considered satisfied with the construct measured in the factor. EASV-U showed adequate psychometric qualities for a measurement instrument with regard to the methodology adopted for its construct validity and reliability, in addition to presenting ease for its application and interpretability. EASV-U may play a key role in assessing user satisfaction with vaccine room services. In addition, it can be used as a source to build and monitor health indicators and to guide priority decision-making actions by the public management of health care services, based on the user's evaluation, and it can also be used in future research with the theme addressed.