Satisfação de usuários hipertensos atendidos nos serviços de Atenção Primária à Saúde: instrumento para avaliação do tratamento

Abstract

The control of hypertension depends on the establishment of an adequate and continuous treatment, so that the assessment of user satisfaction may be an important indicator of quality of services, influencing the behavior of the subjects on the care adopted in health. This study aims to validate an instrument to evaluate the satisfaction of users with hypertension about the treatment offered by the Family Health Strategy. This is an observational, cross-sectional study. The sample was obtained by random methods, and consists of hypertensive individuals older than 19 years of both sexes registered in the Hiperdia program of the cities of João Pessoa and Campina Grande, in 2009. Three factors were pre-established for analysis:access to treatment, treatment adherence and list services. The validation process was carried out in two successive stages, by consulting specialists and through statistical analysis, from the exploratory factor analysis, analysis of internal consistency and finally the confirmatory factor analysis. From the assessment of specialists, the three factors initially proposed were considered valid, being made the adjustments and suggested inclusions, thus obtaining a new version of the questionnaire for statistical analysis, composed of 29 items. Exploratory factor analysis determined the retention of four factors, made up of 15 of the 29 original items, with 67.806% of the total explained variance. 80% of variables presented higher factor load 0.70. The Cronbach's alpha calculated for the instrument revealed a high overall internal consistency, with the value of 0.872 for the four factors evaluated. Through confirmatory factor analysis it was obtained convergent and discriminant validity of the four factors and the fit indices showed a good fit of the final structural model obtained. The four factors were retained and validated labeled as follow: access to treatment, adherence to treatment, focus on family and community and list services. The validation of the factors, from all indicative of reliability and validity used in this study, showed that the evaluation of satisfaction of hypertensive patients in the matters relating to the processing is valid and reliable. It suggests that the proposed and validated instrument might be used in a very similar health services to allow assess the satisfaction of hypertensive patients about the treatment offered by the primary health care.