Influence of Hospital Service Quality on the Satisfaction of Cancer Patients / Influência da Qualidade do Serviço Hospitalar Sobre a Satisfação de Pacientes Oncológicos

Eduardo Dias Coutinho; Flavia Freguglia Lima

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<line> Centro Unv*rsitário Santo Agostinho </line>

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<line> www*.fsanet.com.*r/revista </line>

<line> I*SN Impresso: 180*-6356 ISSN *letrô*ico: 2317-2983 </line>

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<line> Infl*ence of Hospital Service Qualit* o* the Satis*ac*ion of **ncer Patients </line>

<line> **fluência da *ualidade do *ervi*o *ospitala* Sobre a Satis**ção d* Paciente* Onc*lógic*s </line>

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<line> *duardo *ias Coutinho </line>

<line> Doutor *m A*ministração pe** *niversid*de do Grande Rio (*NIGRANRI*) </line>

<line> Analista em *iência e Tecnolo*ia *o Instituto Nac*onal de Câ*ce* (INCA) </line>

<line> E-ma**: eduard*.co*tinho@inca.g*v.** </line>

<line> Flavia F*eguglia de Lima </line>

<line> M*s*re em Gest*o e Estratég*a pela Universida*e Fe*eral Rural do *io d* Ja*eiro (*FRRJ) </line>

<line> Anal*st* e* Ciência e *ecn*logia do Insti*uto Nacional de Câncer (INCA) </line>

<line> E-ma*l: flavia.lima@in*a.*o*.b* </line>

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<row> En*ereç*: Edu**do Dias Coutinho </row>

<row> *N*A - Rua *arquês de P*mbal, 125, **º *ndar, Centro, </row>

<row> Rio de Janei*o, RJ, Br*s*l. CEP: 2023*-*4* </row>

<row> End*reço: Fla*ia Fregugl** de Lima </row>

<row> I*CA - Rua M*rquês de P*mbal, *25, 11º and*r, Centro, </row>

<row> *io de J*neiro, RJ, B**sil. CEP: 20*30-240 </row>

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<row> Editor-C*efe: *r. *onny Kerley de Alenc*r </row>

<row> *odrigu*s </row>

<row> Artig* *ecebi*o em 25/09/2023. Última v*rsão </row>

<row> r**ebida em 17/10/2023. Aprova*o em 18/10/*023. </row>

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<line> Avaliado pelo sistem* Tripl* R*view: Desk *eview a) </line>

<line> pe*o Ed*t*r-Ch*fe; e b) Double B*ind Review </line>

<line> (avaliação *ega por do*s av*l*adore* da área). </line>

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<line> Revisão: Gram*tical, Norm*ti** </line>

<line> e de For*ataçã* </line>

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<line> Influ*n*e of H*spital Service Qu*lit* on the Satisfac*ion of Cancer Pat*e**s </line>

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<line> RESUMO </line>

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<line> Th* objective o* thi* study was to *nvestigat* the satisfaction of cancer p*ti*nt* with the </line>

<line> service quality of a *razil*an p*blic hospital located in t*e city of Ri* de J*neiro. The *tudy is </line>

<line> quantitative, based on *pplicati** of a questionnaire to a sample *o**os*d of 245 o**pat*en*s </line>

<line> ** the hospi*al. The *ata were *reated with *t*uctura* equation modeling suppo*t*d *y partial </line>

<line> le*st squares (PLS-S*M). **e *e**lts indicate* the patients plac* va*ue on *he quali*y of the </line>

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<line> se*vice re*dered by physicians, quality of the adm**istrative serv*ce, quality of the </line>

<line> hospita* </line>

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<par>

<line> f*cilitie* and quali*y *f *he nursing service, in that ord*r. The mai* t*eoretical contribu*ion is </line>

<line> t*e *dentification, in contra*t to *revious fi*di*gs in the li*erature, th*t the ca*c*r p**ien*s *n </line>

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<line> **r sampl* att*i**ted *itt*e *mpor*ance *o the nursi*g **rvice, e*en tho*gh nurs** </line>

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<line> healt*care professionals who i*teract the most with patients. </line>

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<line> Keyw*rds: Service quality, patien* satisfaction, cancer patient, pub*ic hos*ital, cancer. </line>

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<line> RESUMO </line>

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<line> O o*jetivo de*te e*tudo f*i *nves*igar a satisfação de pa**ent*s oncológi*os com a quali*ade </line>

<line> do serviço de um hospital público b**sileiro localiza*o na cidade do Rio de J*neiro. * estudo </line>

</par>

<par>

<line> é quantita*ivo, baseado na aplicação de </line>

<line> qu*stioná*io a *ma amostra composta po* </line>

</par>

<par>

<line> pac*entes ambu*atoriais </line>

<line> d* hosp*tal. O* dados *oram tratados </line>

<line> com mode*agem de equações </line>

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<line> es*ru*urais, calcad* em mínimos quadrado* parciais (PL*-SEM). Os resulta*os indicaram q*e </line>

<line> os pacientes valo**zam a qualida*e do serviço p*estado pelos médicos, * q*alida*e *o serviço </line>

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<line> administra*ivo, a qual*dade </line>

<line> das instalaç*es h*s**talares </line>

<line> d* serviço </line>

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<par>

<line> enferm*gem, nesta ordem. A princ*pa* c*ntr*buição te*rica é a identifi*aç*o, em c*ntraste </line>

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<line> com *ch*dos a*teriore* da *iteratura, de qu* *s pacien**s oncológicos </line>

<line> *a *ossa amost*a </line>

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<line> at*ib**am pouca importâ*c*a ao serviço de enfermage*, ainda que os *nfermeiros s*jam os </line>

<line> pr*fissionai* de *aúd* que ma*s interagem c*m os pa*ientes. </line>

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<line> Palavras-ch*ve: Qu*li*ade *o serviço, sa*isfaçã* do pa*i*nte, pacient* o*co*ó*ico, </line>

<line> h*spital </line>

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<par>

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<par>

<line> Rev. FS*, Teresina *I, v. 21, n. 2, art. 3, p. 44-66, fev. 2*24 </line>

<line> www4.fsa*et.com.br/*evista </line>

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<par>

<line> E. D. Coutinho, F. F. L**a </line>

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<line> 1 INTROD*CTION </line>

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<line> Th* satisfaction of patients with the s*rvice rend*red is ** fu*damental impo*tance t* </line>

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<line> **spita*s, since s*tisfied </line>

<line> patients *ot on*y *emain l*y*l, t*ey t*nd to *x*ress positive </line>

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<line> comments and reco*mend the hospi**l to </line>

<line> other potent*al users. Thi* hel*s soli**f* </line>

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<line> hospit*l\s image a*d expand its par*ic*pation in the market (Janda*ath & *yram, 20*6; Silva, </line>

<line> Ferr*ira & Daniel, **18; Stef*nini et a*., 2019). B*sides this, satisfaction tends *o have </line>

<line> **sitive psyc*ologi*a* **f*c*s tha* c*n stre*gthen the im*une *ys**m and incre*se motivation </line>

<line> and discipline t* fo*lo* the medical guidance and tre*tment regim*n, in turn contributin* t* </line>

<line> re*ove*y (Dang et al., *01*; Gup*a, **deghier & Lis, 20*3). </line>

<line> *n the oncological ar*a, this positive psyc*ol*g*cal eff*ct i* even more **po*t*nt since </line>

<line> th* t*eatment of cancer *s ge*****ly prol*nged and debilitating, *ith many negative side </line>

<line> effects, requir**g strong mo**v*tion of *atients *o f*llo* t** orien*a*ions of **e healthca*e </line>

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<line> professionals. So, mo*ivation ca* </line>

<line> *mp*o*e th* efficacy of the tr*atment an* the c*ances of </line>

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<line> rec**ery (Gupta, Ro*eghier & Lis, 2*13; Padmana*han, *es*i* & Ha*dad, 2017). </line>

<line> Any fac**r *hat can exert a *o**tive in*luen*e on *he effi*acy o* *a*cer treatm**t and </line>

<line> t** chances of recovery *s highl* re*evant. Can*er is the second *eading cau*e of death du* t* </line>

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<line> di*eas* in the wo*ld, an* the rates </line>

<line> of i**i**nce are *ising in many coun*ries. I* 201*, </line>

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<line> approxima*ely 18 *i*li** peop*e were diagnosed with *anc*r in the world a*d * mil*ion </line>

<line> p**ple died of *he dis**se (Bü**elberg & F*o*ea, *0*7; Bray et al., 2018). In Br*zil in 2018, </line>

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<line> cance* *a* resp*ns*ble </line>

<line> *or *24,727 death*, ma*in* it the *oun***\s second *eading fat*l </line>

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<line> di*ease. At current trends, about </line>

<line> 625 thousand new c*ses w*ll be diagnosed in 2021. </line>

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<line> Aggra*ating this situation *re the high cost of tre*tment an* the negative impa*t o* *he dise*s* </line>

<line> on the *hysica* and emot*on*l *t*te of *he patie*t (IN*A, *019a, *019b). </line>

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<line> Because of t*e high negativ* </line>

<line> impa** of ca**e* on t** welfar* o* </line>

<line> the Bra*ilian </line>

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<line> populatio* (IN*A, 20*9a, *019b) *nd *he importance of the satisfacti*n of **n*er patients to </line>

<line> t*e*r adhesio* *o therapy and rec*very (Dang et *l., 2016; Gupta, Rod**hier & Li*, 20*3), *he </line>

<line> ai* of this *tu*y *as to me*sure the satisfac*ion of c**cer out**tien*s with the q*a*ity of th* </line>

<line> service pr*vided by a *ra*ilian pub*ic hospi*al in *h* c*ty of Rio *e Janeiro, a *heme *hat has </line>

<line> not been widely invest*gated in the *it*rat*re o* outpatie*t onco*ogic*l services. </line>

</par>

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<line> Rev. FSA, Teresina, v. 21, n. 2, a*t. *, p. 44-66, fev. 202* </line>

<line> www4.fsanet.com.b*/revis** </line>

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<line> Infl*ence of Hospita* Ser*ice Qu**ity on the Satisfa*tio* of Canc** Patients </line>

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<line> * LITERATUR* REVIEW </line>

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<row> This se*t*on is divide* int* t** subsect*ons. The first cove*s the conce*ts of *at*ent </row>

<row> *atisfaction *nd t** sec*nd the quality h*spital *ervi*es per*e**ed by individuals, to propose a </row>

<row> model to asse*s patient *atisfac*ion a*cording t* t*eir *erceptio* of the q*al*ty of **e se*vice </row>

<row> render*d. </row>

</column>

<par>

<line> P*ti**t sati*f*ction </line>

<line> In g*ne*al, the satisfaction of consumers can be defin** a* their pos*t*ve af*ective </line>

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<par>

<line> response af*er a consumpt*on ex*e*ien**. I* results from th* *on*ormity or </line>

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<par>

<line> t*eir *x*ect*tion* about a s*rvice *endered by a company (O*iver, 1980). </line>

</par>

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<line> In th* area of h*alth care in p*rticular, *he expec*ations ** the consumers o* hos*ital </line>

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<line> servi*es (patients) are d*rected at fa*tors p**ceived </line>

<line> as fundamental for their recovery </line>

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<par>

<line> reductio* *f suf*eri*g, al*hough they also value aspect* that c*ntribute to their physical </line>

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<par>

<line> emot*ona* co*for* (Cou*inho et a*., 2019; Coutinho & Vi**ra, 20**; *alil et *l., 2017). </line>

</par>

<par>

<line> Theref**e, m*eting or exc*eding patie*ts\ expectation* with </line>

<line> the object*ve of elici*ing t*eir </line>

</par>

<par>

<line> satisfact*on with th* hos*ital\s servi*es have gre*t importance, bo*h for the *osp*tal </line>

</par>

<par>

<line> patients *hemsel*es (**ak*e et al., 2*17; *upta et al., 201*). The *eason is that patie**s\ </line>

<line> satisfaction with * ho*pital\s services has a po*itive *mpact on *he*r loyalty and t*e l*kelihood </line>

</par>

<par>

<line> they will express </line>

<line> posi*ive co*men*s *bout **e hosp*t*l a*d recommend ** to others, thus </line>

</par>

<par>

<line> improv*ng *he hospital\s image (Bo*k*e et al., 2017; La Fata, Lup* & *i*z*a, 2019; Sil**, </line>

<line> Ferre*ra & Daniel, 2018). </line>

<line> *oo* patient *atisfacti*n is a*so a basic indicator for hospitals to obtain accredita*io* </line>

</par>

<par>

<line> cert*ficat*s *nd ranki*g a* reference instit*tions </line>

<line> i* *ertain medical s*e*ializ*tions, </line>

<line> enabli*g </line>

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<par>

<line> them to ob*ain fu*ding for *esearch, staff tra*nin* a*d t* upgrade the*r *uality, i* a virtuous </line>

<line> circle (Car*ucci, Renna & Schiuma, 2013; *ah*an & N*gs*abandi, 201*). </line>

</par>

<par>

<line> Besides t*is, </line>

<line> sa*isfied patients tend *o ex*erience </line>

<line> positive p*yc*ological *ff*cts </line>

</par>

<par>

<line> strengthen their *mmuno*ogical system and their motivatio* to follow the o*i*nt*tions of </line>

</par>

<par>

<line> healthc*re *rofessio*al*, which can have * posi**v* *ffect on their recovery (Dan* et al., 2016; </line>

<line> Gupta, *odeghier & Lis, 2013; Nezenega, Gac*o & T*fere, 201*). Gupta, Rodeghier and Lis </line>

</par>

<par>

<line> (2013), in s*rvey am*ng A*erican **nce* patient*, i*entifi*d t*at t*ose who wer* more a </line>

<line> s*t*sf*ed w*th the service al*o had better hea*th outcomes, which the auth*r* att*ibuted *o </line>

<line> Re*. FSA, T*resina P*, v. 21, n. 2, ar*. 3, *. 44-66, fev. 2024 www4.fsanet.com.br/r*vi*t* </line>

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<par>

<line> E. D. C*utinho, F. F. Lima </line>

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<par>

<line> positive psy*ho*o*ic*l ef*ect* *ha* strength*n th* immunity and motiv*tion and discipline to </line>

</par>

<par>

<line> a**ere to the *reatment regi*en. </line>

</par>

<par>

<row> I* **rn, Dang e* al. (*016) also identifie* that pa*ient satis*act*on w*th *ospita* serv*ce </row>

<row> in the United St*tes has a positive in*luence *n adhe*ion to HIV therapy, con*ributing to the </row>

<row> efficacy of t*e treatme*t. Similar results *ere found by N*zen*ga, G*cho *nd Tafere (2**3) </row>

<row> among Ethiop*an tuberculosis patien*s. </row>

</column>

<par>

<line> Percei**d qu*lity of h*spital ser*ic*s </line>

<line> Start*ng in th* 1980s, the concept of *erceived servi*e qual*t* *ec*me a *opic **r </line>

</par>

<par>

<line> various studie*, suc* *s Grönroos (1988) and Parasuraman, Zeit*aml </line>

<line> and Berry (1988). T*e </line>

</par>

<par>

<line> perceptio* of individ*als regardin* t*e quality *f a se**ice is *h* resul* of their expectations </line>

<line> a*o*t *** *ervi*e in question that w*ll be re*de*ed by a particular c*mpan*. C*nsumers tend </line>

</par>

<par>

<line> to have a pos*ti*e percep*io* </line>

<line> *hen *heir expectations abou* the s*r*ice are met or exceede* </line>

</par>

<par>

<line> (Grönr*os, 19*4, 1988; Paras*r*ma*, *eith*ml & B*rry, 1985, 1988). </line>

<line> Parasuraman, Zeithaml an* Berr* (1988) identif*ed tha* the quality of * *er*ice is </line>

<line> compose* of five dimensi*ns: reliability, responsive*ess, s**urity, empathy and tangibili*y. *n </line>

</par>

<par>

<line> tu*n, Grön*oos (1988) found that perc*ived </line>

<line> qual*ty is constituted o* </line>

<line> *wo dimensi*ns: </line>

</par>

<par>

<line> functional and technical. The func*ional dimension refers to *he relationship </line>

<line> betwee* the </line>

</par>

<par>

<line> service </line>

<line> provider a*d cons*mer that occu*s *u***g co*sum*tion of t*e service, while the </line>

</par>

<par>

<line> technical dimension involve* th* technical knowledge a*pl*ed by the service provider to </line>

</par>

<par>

<line> **liver t** **s*red re*u*t to *he consumer. </line>

</par>

<par>

<line> T** two studi*s indic*ted abo*e h*ve influenced *arious investigations *f the s*rv*ce </line>

</par>

<par>

<line> quality perce*ved by pa*i*nts </line>

<line> in *he health secto*. The findings have indicated that pat*ents\ </line>

</par>

<par>

<line> gre*test expect*tions ab*ut *he </line>

<line> hospital service (*ure and/or reduction of </line>

</par>

<par>

<line> *e*era*l* with high exp*ctations abo** the fu*cti**al </line>

</par>

<par>

<line> and techn*cal quali*y of the service *endere* by the *octor (Coutinho et al., 2019; Ja*i* *t al., </line>

<line> 2017; J*ndava*h & Byram, 2*16). </line>

<line> Th* f*nctional quality of the serv*ce ***vided by physicians (*enceforth medical </line>

</par>

<par>

<line> b* unders*ood th*o**h </line>

<line> v*rious in*icator* inherent to t*e doc***\s "bedsi*e </line>

</par>

<par>

<line> manner", such as: emp*thetic, r*spectful, court*ous an* w**coming attitude; *ime de*o*ed to </line>

</par>

<par>

<line> listening *o and </line>

<line> ex*mining th* patient; and conce*n with explaining the parti*ularities of the </line>

</par>

<par>

<line> disease an* treatment. In </line>

<line> te*hnical </line>

<line> *ual*ty of the medic*l ser*i*e refers *o </line>

</par>

<par>

<line> specialized kno*l*dge of t*e doc*or *n performing cli*ical diagnoses; ski*l in in*erpreti*g </line>

<line> R*v. FSA, Teresina, v. 21, n. 2, ar*. 3, p. 44-66, f*v. 202* w*w4.fsane*.com.br/*evi*ta </line>

</par>

</page>

<page>

<par>

<line> Influence of Hospit*l *er*ice Quali*y on t*e Sati*faction of Cancer Patien*s </line>

</par>

<par>

<line> laboratory *e*t res*lts and *re*ari*g reports; choice an* execution of the m*st suitable </line>

<line> su*gical technique; *nd prescripti*n *f the most effec*ive drugs to *rea* the partic*lar a**ment </line>

<line> (Coutinho & Vieira, 201*; Jandavath & *yram, 2**6). </line>

</par>

<par>

<line> The *unctional dim*nsion of the qu*lity of the service </line>

<line> provided </line>

<line> by th* physician can </line>

</par>

<par>

<line> b* easily perceived by patients, since </line>

<line> do no* *eed **ecialized knowledge t* as**ss </line>

</par>

<par>

<line> doctor\s attitude and behavior. This does not hold regarding the perc*iv*d *ech*ical quality o* </line>

<line> t*e service, *inc* patients as a rule do not have suff*cient specialized technical *nowle*g* t* </line>

</par>

<par>

<line> judge the d*ct*r\s decisions, so the*r evaluatio* *ainly de*e*ds on </line>

</par>

<par>

<line> reduction </line>

<line> of *a*n and physical limitatio*s, as*ects that are not always re*ated *ith the </line>

</par>

<par>

<line> *echnic*l quality of the medical service (Coutinho et al., 2019; Coutinho & Vieira, 2*18; Jalil </line>

<line> et al., 2017; J*ndavat* & By*am, 201*). </line>

<line> I* *hi* sen*e, these two dimensions of the qual*ty of *edical ser*ice *re *u*damental </line>

<line> for hospitals, sinc* the* h*ve * dire** po*itive influe*ce on **tients\ *atisfac*io* with t*e </line>

<line> services rendered (Co*t**ho et al., 2019; Cout*nho & *ieira, 2018; *alil et al., 2017). </line>

<line> The survey *on*uc*ed by Jalil et al. (2017) am*ng outpat*ents of a pu*lic hospital in </line>

<line> Pakistan found *hat t*e func*ion*l quality of t** service *end*red by doctors *as important fo* </line>

</par>

<par>

<line> the satisfac*ion of p*tients, w** </line>

<line> mainly va*ued the </line>

<line> explanation *bout *he *r*atme*t a*d the </line>

</par>

<par>

<line> time devoted *o </line>

<line> hear a** exam*ne the p**ient. The techni*al *ual*ty </line>

</par>

<par>

<line> cons*der*d important by *ati*nts, in terms of *he*r recovery and a*leviatio* of pain and </line>

<line> The studi*s carried out by Cou*inho e* al. (2019) and Cout*nho and Vieira (2018) </line>

</par>

<par>

<line> outp*tien** of Brazil\s *atio*al </line>

<line> C*ncer I*stitute al*o fo*nd q*ality of the medical </line>

</par>

<par>

<line> *e*vic* to b* *n imp*rt*nt f*ctor posit*vel* influ**cing p*tient satis*actio*. In th*s* *tudies, </line>

</par>

<par>

<line> the patie*** </line>

<line> stat*d they mai**y valued th* doctor\s effort in h*lping *he*, t*e expla*a**on </line>

</par>

<par>

<line> about t*e therapy, *he technic*l competence, the time devote* to </line>

</par>

<par>

<line> coherence of the cl*nica* diag*osis. </line>

</par>

<par>

<line> Various *th*r studies </line>

<line> have dem*nstrated that the **ality </line>

<line> of medical se*vice </line>

</par>

<par>

<line> posit*ve impact *n </line>

<line> patient satis*action with hos**tal services, s*ch as *h* *urv*y* c**duc*ed </line>

</par>

<par>

<line> b* **abbir, Malik and M*lik (2016) among patients ** public hospita*s in Pakistan; *iovanis </line>

<line> e* al. (2018) *mong hospit*l patients in Greece; and S*maedi et al. (20**) with public hospital </line>

<line> p*tients in Indonesia. </line>

</par>

<par>

<line> hypothesis concern* the importance </line>

<line> of the qu*lity of medical </line>

</par>

<par>

<line> *erv*ce on pa*ient satisfact*o*: </line>

</par>

<par>

<line> *ev. FSA, Teres*na PI, v. 21, n. 2, art. 3, p. 44-66, *ev. 2024 </line>

<line> www4.fsanet.com.br/revista </line>

</par>

</page>

<page>

<par>

<line> E. D. Coutinho, F. F. L*m* </line>

</par>

<par>

<line> H1: The medica* service qual**y (*SQ) *as a d**ect positive effect o* on*ological </line>

<line> patient satisfa*tion (*PS). </line>

<line> Another i*portan* f*ctor that has a positive influ*nc* on patient sa*is*a*tion with </line>

</par>

<par>

<line> *ospital serv**es is t** q*ality of the n*rsing service, since on av*r*ge n*rses i**eract </line>

</par>

<par>

<line> patients more than a*y ot*er cat*gory *f heal**c*re professionals, and their services a*e *eys </line>

<line> to the *ffica*y *f the med*c*l treatme*t (Giovanis e* al., 2018). </line>

</par>

<par>

<line> Pa*ients, bec*use of their conditio* of p****cal and </line>

<line> e*otional vuln*rab*li*y, need to </line>

</par>

<par>

<line> feel welcome* by hea**hcare professionals as well *s receive technically co**ect tre*tment. </line>

</par>

<par>

<line> N**s*s *re the main pr*tagonis*s of th* i*te*a*tion wit* *atients, often </line>

<line> d*ri*g intima*e </line>

</par>

<par>

<line> delicate moments (Karac* & Dur*a, 2019). </line>

</par>

<par>

<line> *h* su*vey conducted by *i*vanis et al. (*018) identifi** that th* </line>

<line> quality ** *he </line>

</par>

<par>

<line> nursing se*v**e ha* *osi*ive a </line>

<line> effect on th* sa*isfaction o* Greek hospita* patients, who </line>

</par>

<par>

<line> attributed s**nifica*t *mpo*ta*ce to the empathy, </line>

<line> profession*lism </line>

<line> and courtesy of nurses, </line>

</par>

<par>

<line> alon* w*th their t*chnical </line>

<line> co*petence. Simil*r results we** obtained in stu*ies among </line>

</par>

<par>

<line> hospit*l p*tien*s in various other countries, s*c* as Turkey (Karaca & Durna, 2019); </line>

</par>

<par>

<line> Indonesia </line>

<line> (*umaed* et al., 2016); Chin* (Z**eldin, </line>

</par>

<par>

<line> le*ding to o*r second hy*othesi*: </line>

</par>

<par>

<line> Th* n*rsing servic* qua*it* (NSQ) has a </line>

<line> direct pos**ive effect on onco*ogical </line>

</par>

<par>

<line> patient s*tisfaction (O*S). </line>

<line> Besid*s t*e quality of *he se*vices rendered b* do*tors and nurses, patients als* tend to </line>

<line> *ttribute significant importance to the qual*ty *f t*e hospital\s administrative service, such a* </line>

<line> the ease of *chedul**g appointments, waiting ti*e f*r consultatio*s *nd te*ts *nd the </line>

<line> pro*edure t* obtain medic*n*s (Bentaye*, *ahri*hi & Roussea*, 2019; Giova*i* et al., 2*18; </line>

<line> S*abbir, Malik & Mali*., 2016). </line>

<line> The st*dies perfor*ed b* Giovanis et al. (2018), Shabbir, Malik and Mal*k (20*6) and </line>

</par>

<par>

<line> Durrah, Allil and Kahwaji (2015) found tha* the </line>

<line> quali*y *f the adm*n*strativ* service has a </line>

</par>

<par>

<line> *ositive in**uence on *a*ient *atisfaction, *eading to our *hird hyp*thesis: </line>

</par>

<par>

<line> H3: The administrati*e service quality (*SQ) h*s a *irect positive effe*t </line>

</par>

<par>

<line> onc*lo*ic*l p*tient satisfaction (OPS). </line>

</par>

<par>

<line> Rev. F*A, *er*sina, v. 21, *. 2, art. 3, p. 44-66, fev. 2024 ww*4.fs*net.*o*.br/revista </line>

</par>

</page>

<page>

<par>

<line> In*lu*nce of Ho*pital S**vice Qua*i*y on the Sati*faction of Cancer Pat**nts </line>

</par>

<par>

<line> Patie*t satisfactio* is als* sub*ect to the positive influe*c* of the *ual*ty of the </line>

</par>

<par>

<line> hospi*al i*stallations, *nvolv**g as*e*** </line>

<line> like *lea*l*ness, *omfort, modernity, *ood si*naling </line>

</par>

<par>

<line> to facilitate internal navigation a*d est*et*c beauty (Coutin*o et al., 2*19; Cout*nho & *ie*ra, </line>

<line> 2018; Deshwal & Bhuy*n, 2018). </line>

<line> *arious studies have found that the qual*ty of hospital facilities has a *osit**e </line>

<line> influence on patient satisfa*tion. Coutinho et al. (2019) and Coutinho and Vieira (201*) </line>

</par>

<par>

<line> identified co*fort, </line>

<line> g*od s*gnag* *nd *sth**ic attra*tiveness *s factors for cancer patients\ </line>

</par>

<par>

<line> satisfaction. Deshwal and B*uyan (2018) fou** that *he decoration, *leanliness, comfort and </line>

<line> modernit* of equ**ment and fu*nish*ngs ha** a pos*tive impact on the s*tisfaction o* cancer </line>

<line> patients in India. The s*** results wer* *ound by Jandavath and Byra* (2*16) amo*g Indian </line>

</par>

<par>

<line> by Giovan*s et al. (2018) among Greek patients a*d Shabbir, *alik **d </line>

</par>

<par>

<line> Malik (2016) amo*g Pakistani patients. </line>

<line> Hence, ther* is ample ev*dence of the import*nce of hospital *ac**ities on patie*t </line>

<line> satisfaction, under*innin* the f*llowi*g hypothesis: </line>

<line> H4: The hosp*t*l facilities quality (*FQ) has a direct positive effec* on *ncological </line>

<line> *atient *atisfaction (OPS). </line>

<line> Fig*re * *resents t*e p*oposed mod*l and t*e respective hypotheses. </line>

<line> F*g*re * - Satis*ac*ion-quality *odel. </line>

</par>

<par>

<line> Source: Own el**ora*i*n. </line>

<line> Next, we de*cri*e the method*logy used to collect t*e da*a and the anal*sis of </line>

</par>

<par>

<line> results. </line>

</par>

<par>

<line> Rev. FSA, Teres*na P*, v. 21, n. 2, art. 3, p. 44-66, fev. 2024 </line>

<line> www4.*sane*.co*.br/revis*a </line>

</par>

</page>

<page>

<par>

<line> E. D. Coutinh*, F. F. Lima </line>

</par>

<par>

</par>

<par>

<row> In order to *es* t*e hyp*theses formulated for the st*dy, * cro*s-sec*i*nal sur*ey was </row>

<row> carri*d out (Para*uraman, G*e*al, & Krishna*, *006) with a non-p*obabilistic sampl* of the </row>

<row> popu*ati** of interest. The data proc*ssing fo* *he hypoth*s*s t*sting w*s *one *hrough </row>

<row> structu*al equation modeling based on partial *eas* squares (PLS-SEM) (Hair et **., *017; *air </row>

<row> e* al., 2014; Hensele*, H*bo*a & Ray, 2016). </row>

</column>

<par>

<line> Population and sample </line>

<line> The popula*i*n studied consisted of all c*ncer outpat*ents *f a p*blic hospital located </line>

</par>

<row> in *he cit* of Ri* de Janei*o. The s*mple was no*-pro**bili*tic and *a* se*e*ted by </row>

<row> *onve*ienc*, composed of 245 patien**. Accor*i*g to Hair et al. (*017), in st*dies that ap*ly </row>

<row> structu*al equation modeling base* on part*al l*ast squa*es (PLS-*EM), *t is recom*ended to </row>

</column>

</par>

<par>

<line> employ *t least 10 observatio*s </line>

<line> for *ach ind*cator of the mod*l, and for the sample to </line>

</par>

<par>

<line> c*mposed ** at le*st 2*0 elements. There**re, </line>

<line> our sample of 245 respondent* meets *h* </line>

</par>

<par>

<line> quality parameters of </line>

<line> t** statistical *ool used. Since the selection of the sample w*s not </line>

</par>

<par>

<line> rando*, *e decided to ta*e a **utious stance an* use more than 1* o*se*va**on* per o*ser*ed </line>

<line> v*riable, *ince **e model pr*p*se* here has 18 ind*ca*ors. </line>

<line> * .2 Collection *nd treatment of the data </line>

</par>

<par>

<line> T*e data were c*llect*d </line>

<line> by means of * s*ructur*d questionnaire, s*o*ed on a Likert </line>

</par>

<par>

<line> scale w*t* five </line>

<line> from (to*ally **sag*ee) *o 5 (t*t**ly agree). The data w*re 1 </line>

</par>

<par>

<row> treated with P*S-SEM using th* SmartP*S software, **rsion 2.0 (Ringle, Wende & Will, </row>

</column>

<par>

<line> Vari*bles o* the m*del and items of the *u*stionnaire </line>

<line> I* *tructural *qu*tion modelin*, the *w* mos* *ommon *ypes of variables are latent </line>

</par>

<row> and *bserved. The l*tent v*r*a*les, also denote* as c**st*ucts or factors, cannot be direct*y </row>

<row> estimated, so th*y are measured v** the ob*erved varia*le*, also called in*icat*rs (Hair *t al., </row>

</column>

</par>

</page>

<page>

<par>

<line> Inf*uence of Hospit*l Service Qual**y on the Sat*sfaction of Cancer Patients </line>

</par>

<par>

<line> The da*a c*llec*ion instru*ent *mployed in t*is study was *nspired by the </line>

<line> que*tionnai*es app*ie* *y Coutinho et al. (2*19) **d Cou*inho and Vieir* (*018), based on </line>

<line> s*ales adapted from the *itera*ure for a*plication i* the conte*t of outpa*ient cancer *reat*en*. </line>

<line> Besi*es this, *e ad**d in*i*at*rs inhere*t to *he quality of *he administrative service to those </line>

<line> used *n the *revious studies mentioned ab*ve, a* **n be seen in Ta*le 1. </line>

<line> Table 1 - Oncology Patient Satisfaction Scale </line>

</par>

<par>

<line> Construct* </line>

<line> Indicators </line>

<line> *eferences </line>

</par>

<par>

<line> Med*cal Servic* Quali** (MSQ) </line>

<line> The doctor gives an *xpla*ation ab**t the treatment of the *isea*e. The docto* li*tens calmly to what th* patient is fe*lin*. The d*ctor\s diagnosis i* c*herent with what the p*tien* is feeling. T*e doctor trie* *ard to help the patient. The **cto* is compete*t. </line>

<line> Qi* et al. (201*); Durrah, All*l and Kahwaji (2*1*); Juhana *t a*. (2015); Rahman an* </line>

</par>

<par>

<line> Nur*in* S*rv*ce Quality (*SQ) </line>

<line> T*e nurs* tr*e* hard to help the patient. The nurse att*nd* *he p*t*ent without hast*. The nurse *s compe*ent. </line>

<line> Osmangani (2015); Jandavath and </line>

</par>

<par>

<line> Hospital F*cilities Quality (H*Q) </line>

<line> Th* appearanc* o* the *o*pital is agreea**e. Th* ho*pit*l has good sig*age *o the pa**ent can **o* where to go. The hospital\s physical facilities are co**ortable. </line>

<line> By*am (20*6); Sumae*i et al. (2016); Jal*l et al. (201*); Co*tin** and Viei*a (2018); Co**inho et al. (2019). </line>

</par>

<par>

<line> Administrati*e Service Quality (*SQ) </line>

<line> Whe* the *a*ient arr*ves at the hospital, he/she is re**i*ed qui*kly. T** patient c*n sch*dule consultat***s e*sily. Th* ho*pital *upplies the me*icin** necessa*y to treat the p*tie**. </line>

<line> Sha*b*r, Ma*ik and Malik (2016); Giovanis et al. (20*8). </line>

</par>

<par>

<line> On*ol*gi*al Pati**t **t*sfaction (OPS) </line>

<line> I\m *a***f*e* with th* medica* treatment. I\m satis*ied with the a*mi*istrative service of the hospit*l. I\m satisfied with m* recovery. In gen*r*l, I\* satisfied wi*h the service prov*ded by hospi*al. </line>

<line> Gup*a, Rodeghi** and Lis (2013); Qi* e* al. (20*4); Du*rah, Allil a** K*hwaji (2015); J*hana et al. (2*15); S*m*ed* et al. (2016); **utinho *nd Vieir* (20*8); Coutinho et *l. (2019). </line>

</par>

<par>

<line> So*rce: *dap*ed from C*utinho and Vieira (2018) an* Coutinho e* al. (2019). </line>

</par>

<par>

<line> Rev. FS*, Te*esina P*, v. 21, n. 2, art. 3, p. 44-*6, fev. 2*24 </line>

<line> www*.fs*ne*.com.br/*evista </line>

</par>

</page>

<page>

<par>

<line> E. *. *outinho, *. F. Lima </line>

</par>

<par>

</par>

<par>

<row> This section is div*de* into two *ubsec*ions. T*e fi*st charac*eri*es the prof*le o* the </row>

<row> s*m*le a*d **e s*cond *n**yze* the data b* *tr*ctural equation mod*l*ng based ** parti*l leas* </row>

<row> *quares (PLS-SEM). </row>

</column>

<par>

<line> Table * describes the p*ofi** of the sample, composed of 245 respon*en**. </line>

<line> Table 2 - Profile *f the s*mple </line>

</par>

<par>

<line> Frequenc* </line>

<line> Percentage </line>

</par>

<par>

<line> Male Female T**a* </line>

</par>

<par>

<line> A*e range </line>

<line> Freque*cy </line>

<line> Per*entage </line>

</par>

<par>

<line> Between 26 an* 35 year* B*twe*n 36 and 50 years Between *1 an* 65 ye*rs Over 6* year* Tot*l </line>

</par>

<par>

<line> S*hool*ng Level </line>

<line> P*rcentage </line>

</par>

<par>

<line> Fun*am*ntal school inc*mplet* *u**amental school com*lete Secondary sc*ool c*mple*e College complete Adv*nced *pecialization comple*e Total </line>

</par>

<par>

<line> S*urce: Own *laborati*n. </line>

<line> As can be seen in T*ble 2, the majority of the *espo*dents were males, *nd the majority </line>

<line> (193, 7*.77%) were over *0 *ears of *ge, re*lecting *he fac* that cancer i* more co*mon in </line>

<line> ol*er people. The samp*e was *lso he*vily skewed to pa*ients with low **hooling levels, si*ce </line>

<line> only (8.57%) had college *egre*s an* only 1 (0.41%) had advanced specialization. This can </line>

<line> be explained by th* fact th* hospita* i* question is part of the p*bl*c healt* servic*, which </line>

<line> *a*nly ser**s people with *ower inco*e* because *hose with high*r incomes typically ha** </line>

<line> pr*va*e health insur**ce. </line>

</par>

<par>

<line> www4.fsanet.com.br/*evi*ta </line>

</par>

</page>

<page>

<par>

<line> In*l*ence *f *os*ital Service Qu*lity on the Satisfaction ** Ca*cer Patie*ts </line>

</par>

<par>

<line> 4 .* Str*ctural equati*n mode*ing </line>

</par>

<par>

<line> Thi* sub*ecti*n is divided *nt* </line>

<line> two parts. *he *irst pre*ents the *nalys*s of *he </line>

</par>

<par>

<line> measurem*nt m*del a*d *he second evaluates the struct*ral model (Hair et al., 20*7). </line>

<line> 4.2.* Measurement m*del </line>

<line> The measurement model, *ls* called the external m*del, refers to the re*ationship </line>

<line> betwee* t*e constructs *nd *ndicators. Wh*n a*plying PLS-SE*, i* is *uit*b** to *valuat* the </line>

<line> m*asurement model by calculati*g t*e interna* re*iability, converge** *a**dity *n* </line>

</par>

<par>

<line> discri*in*nt val*dity *f the </line>

<line> latent v**ia*le* (*ai* et </line>

<line> al., 2017; Hai* et al., *01*; Hense*er, </line>

</par>

<par>

</par>

<par>

<line> The internal *eliabili*y of the factor* was evaluated by c*mputing *he c*mpo*ite </line>

</par>

<par>

<line> reliability (CR) and Cronbach\s alph*, which serve to verify if the samp*e, </line>

<line> wit* a*equate </line>

</par>

<par>

<line> prec*sion, ha* biase* and w*ether the o**erved variables repr*sent the data r*liably. C* values </line>

<line> above 0.70 ar* expected, but values greater *han 0.90 a*e *o* desired. Fo* Cro*bach\* alpha, </line>

</par>

<par>

<line> value* greater t*a* 0.70 are </line>

<line> considere* adequate, alt*ough t*ose </line>

<line> greater tha* 0.60 ar* </line>

</par>

<par>

<line> ge*e*al*y co**i**red acceptable *n the social sci*nces (Ha*r, Howard, & *i**l, 2020). </line>

<line> The convergent val*dity of the factors was e*aluat*d b* examining the average </line>

<line> variance extracted (AVE). An AVE valu* o* a latent v*ria*le g*eater *h*n 0.*0 means *hat on </line>

<line> average it explai*s mo*e tha* *0% of the var*ance *f it* ind*cators, which i* considered </line>

<line> adequa*e. </line>

<line> *s shown in Table 3, the constr*cts had suit*ble valu*s ** inter*al re*iability and </line>

<line> conve*gent **lidity. </line>

<line> T***e 3 - Evaluati*n of *he internal *eliability and con*ergent validity of the co*structs </line>

</par>

<par>

<line> Indicator* </line>

</par>

<par>

<line> Composit* reliability Cr*nbac*\s al*ha Aver*ge variance ext*acted </line>

</par>

<par>

<line> *ith *esp*ct to the discriminant validity of **e factors, it presented ad**uate results </line>

<line> according to the criterion of Fornell and Lar*k*r (19*1) and analysis of the cross-loa*ings, as </line>

<line> can b* note* in Tab*e 4. **e Forne*l-Larcke* cri*eri*n correlat*s t*e square root o* *he AVE </line>

<line> Rev. FSA, Te*esina PI, v. 21, n. 2, art. 3, p. 44-66, fev. 202* www4.fsan*t.com.br/revista </line>

</par>

</page>

<page>

<par>

</par>

<par>

<line> of all the factor* of the mo*el, and fo* the model *o h*ve adequ*te di*criminant vali*ity, the </line>

<line> square root of th* AVE of *ach con*tr*ct *eeds t* be hi*her th*n the individual *orrelatio*s </line>

</par>

<par>

<line> *ith all the other fa**ors of the model. In turn, the values of t** cro*s-loadings *va**ate </line>

</par>

<par>

<line> indic*tors in**vidually, to verify their a*s**iations w*th all the *onstructs *f *he model via the </line>

</par>

<par>

<line> factor loadings. This a*alysis serves to confirm </line>

<line> *ow st*ongly th* **serv*d variables are </line>

</par>

<par>

<line> associated w*th the*r respective factors (Hair et al., 2020). </line>

<line> *able 4 - Discriminant v*lidity o* *he constructs </line>

</par>

<par>

<line> Crite*ion </line>

<line> Indica*or </line>

<line> p-value </line>

</par>

<par>

<line> Fornell-Larck*r **iterion (*981) </line>

</par>

<par>

<line> A*alysis of t** cr*ss-loadi*gs </line>

<line> Indicator M*Q1 MSQ* MS*3 MSQ4 MSQ* N*Q1 NSQ2 NS*3 *S*1 ASQ2 ASQ3 *FQ1 HFQ2 HFQ3 OPS1 OPS2 **S3 O*S4 </line>

<line> p-value <0 .0 0 1 <0 .0 0 1 <0 .0 0 1 <0 .0 0 1 <0 .0 0 1 <0 .0 0 1 <0 .0 0 1 <0 .0 0 1 <0 .0 * 1 <0 .0 0 1 <0 .0 0 1 <* .0 0 1 <* .0 0 1 <0 .0 0 1 <0 .0 0 1 <0 .0 * 1 <* .0 0 1 <* .* 0 1 </line>

</par>

<par>

<line> *o*rce: Ow* elaboration. </line>

<line> Besides the a*pects discussed above, the anal*sis of *he cross-l*a**n*s a*l*w* </line>

</par>

<par>

<line> identifying the most im**rta*t obse*ved vari*bles for ea*h laten* varia*le, which </line>

</par>

<par>

<line> that have a loading in a *actor th*t is hi*her than the loadi*gs of all the </line>

</par>

<par>

<line> sam* factor (Hair *t al. 2017). Fo* example, the main ind*cator of *he </line>

</par>

<par>

<line> facto* MSQ (medical servi*e quality) was MSQ2 (time </line>

<line> g*ven *y the doctor t* hear*ng </line>

</par>

<par>

<line> pat*en*), wh*le *he most important indicato* of the </line>

<line> l*tent varia*le NSQ (nu*sing servic* </line>

</par>

<par>

<line> www4.fsane*.com.b*/revista </line>

</par>

</page>

<page>

<par>

<line> In*luence of Hos*ital S*rvic* Quality on **e Sati*faction of *ancer Pa*ie**s </line>

</par>

<par>

<line> qua*ity) was N*Q3 (techni*al competence o* *he nurse). Regarding t** constructs ASQ </line>

<line> (administrative *ervi*e quali*y) and HFQ (*ospita* fa**litie* quality), thei* p*in*ip** indicators </line>

<line> were ASQ3 (*up*ly of med*cine to t*e patient) *nd HFQ3 (co*fort of the hospital facilities), </line>

<line> respecti*ely. </line>

<line> 4.2.2 S**uctural model </line>

<line> The *tr*ctural mod*l refers *o the re*atio*ship between th* lat**t var*abl*s. I*s </line>

</par>

<par>

<line> eva**ation mainly enables **entifying the level </line>

<line> of *redictiv* accu**cy of </line>

</par>

<par>

<line> empirical support for th* *ypotheses. This i*vol*es c*lcu*ating the Pearson coefficient of </line>

<line> de*erminatio* (*²) and determ*ning t** st*en*** and signif*can*e of the path coeffi*i*nts (). </line>

<line> Furthermore, th* *val*atio* *f the s*ructur*l *odel also involves verific**ion *f the effect size </line>

<line> (f²) and predictive **le*an*e (Q²) of *he co*s*ru**s (Hair et a*., 20*4, 20*7). </line>

<line> The P*ar*on coeffi*i*nt (R²) m*asur*s the predicti** accuracy *f the model, *y </line>

<line> ascertai*ing to what ex*ent the *ndependent va*ia*les *xplain the variance of *he dependen* </line>

</par>

<par>

<line> *ariables of th* **del. The values of R² *ange fro* 0 to 1, and the </line>

<line> pr**ictive ac*u*a*y *s </line>

</par>

<par>

<line> great*r *s the va*u*s of R2 </line>

</par>

<par>

<line> endog*nous construct OPS </line>

<line> had R² valu* of 0.575, meaning </line>

</par>

<par>

<line> exog*no*s constructs MSQ, NSQ, *SQ and HF* *xpla**ed 57.5% of the v*riance of </line>

</par>

<par>

<line> p*tients\ *atisfaction *ith *he ho**i*al servi*e. </line>

</par>

<par>

<line> Th* indi*ators Q² and f² *easure the model\s fit. The ind*cat*r Q², a*so call*d the </line>

</par>

<par>

<line> Stone-Geis*er indica*or, has *he objecti*e of evalua**ng *h* </line>

<line> pred*ctive rel*v*nce *f </line>

</par>

<par>

<line> *ndepend*n* varia*les *ith respect to the mode*\s depend*nt variables. Value* of Q² grea*e* </line>

</par>

<par>

<line> than 0 are consid**ed a*equ*te, and the p*edi*tive </line>

<line> q*ality of the mode* improves as Q² </line>

</par>

<par>

<line> approaches 1. In t*rn, f², also called t*e Cohen indicator (1988), checks the effect size of t*e </line>

</par>

<par>

<line> exo*enous f*ctors on the e*do*enous constructs. V*lues o* f² </line>

</par>

<par>

<line> cons*dered to be smal*, medium and lar*e, *espect*vely (Hair et al., 201*). </line>

<line> In t*is study, the laten* variab*e OPS had adequate predictive rele*ance, since th* </line>

</par>

<par>

<line> **lue of Q² w*s 0.3*5. With respe*t to the effect size o* t** exogen*us con**ructs on </line>

</par>

<par>

<line> endoge*ous c**str*ct OPS, the *at**t variables HFQ, ASQ, NS* and M*Q had respective f² </line>

<line> va*ues of 0.6*3, 0.558, 0.*83 a*d 0.695. This means tha* *ll *he model\s exogenous constructs </line>

<line> presented large effect sizes on *he construct O*S. </line>

</par>

<par>

<line> Finally, the empirica* support fo* the hypotheses *rop*se* here was ver*fied </line>

</par>

<par>

<line> statistical significance of the pa*h coefficients (). A </line>

<line> value o* * indicates </line>

</par>

<par>

<line> R**. FS*, Teresi*a PI, v. 21, n. 2, art. 3, p. 4*-66, *ev. 20** </line>

<line> ww*4.fsanet.co*.br/revis** </line>

</par>

</page>

<page>

<par>

</par>

<par>

<line> i*depen*en* v*riabl* exerts an influence on the depend*nt variable, *nd the c*usal </line>

</par>

<par>

<line> relati*nship bec*mes negative when is negati*e. T*ese </line>

<line> relations *re o*ly s*p*or**d with </line>

</par>

<par>

<line> st*ti*tical sig*ifican*e lower t*an 5% when the v*lues of t*e Studen* t-*est are great*r than </line>

<line> *n this stud*, the lat*nt variable with the stron*e*t *ositiv* impact on *he factor OPS </line>

<line> was MS*, *it* of 0.5*0, f*l*owed by the follo*in* const**cts: A*Q, w*th = 0.16*; HFQ, </line>

<line> with = 0.1*5; an* *SQ, with = 0.131. Henc*, all the hypot*eses *ere **pported, wit* H1 </line>

<line> and H2 *a*in* statist*ca* s*gnific*nce lowe* than 0.5%, *3 lo*er than *.5%, and H4 lower </line>

<line> than 0.1%, as reported i* Tab*e 5. </line>

<line> Table 5 - E*piri*al *u*port of *h* hy*othe*es </line>

</par>

<par>

<line> Hyp*theses </line>

<line> t-value </line>

<line> p-value </line>

<line> Suppor </line>

</par>

<par>

<line> a direct posit*v* </line>

<line> effec* on MSQ </line>

</par>

<par>

</par>

<par>

<line> direct </line>

<line> positive </line>

</par>

<par>

</par>

<par>

<line> direct </line>

</par>

<par>

</par>

<par>

<line> effect on </line>

</par>

<par>

</par>

<par>

<line> Sou*ce: Own elaboration. </line>

<line> Final*y, all *he h*po*hetical relations between the construct* are bett** de*icted in </line>

<line> Figure 2, *hich s*ows the pat* diagr*m *ith our main statis*ical *esults. </line>

<line> F*gure * - Pat* diagram prese**ing *he *esu*ts </line>

</par>

<par>

<line> *ev. FSA, Teresina, v. 21, n. 2, **t. 3, p. 44-66, fev. 2024 www4.*sanet.*om.br/*evista </line>

</par>

</page>

<page>

<par>

<line> Inf**ence of H*spi*a* *ervi*e Quality *n *h* *atisf*ctio* *f Ca*cer *atients </line>

</par>

<par>

<line> 5 DISC*SSION OF T*E RESUL*S </line>

</par>

<par>

<line> *he resu*ts i*dicate t*a* the quality ** the medic*l *er*ice *as the factor with </line>

<line> strongest *o*it*ve *nflue*ce on the *ati*nt satisfaction, *ollowed *y the adm*nistrative s*rvic* </line>

<line> qu*lity, hospital fa*ilities quality a** nur*ing service quality. </line>

</par>

<par>

<line> Patien*s t**d to b*lieve that only the atten*ing **ysician is qualif*ed to select </line>

</par>

<par>

<line> t*eatment with t*e greatest </line>

<line> *hance *f cure **d reducti*n of the resulti*g su*fering. Th*s </line>

</par>

<par>

<line> ex**ain* *he high importanc* attrib*ted *y the res*onden*s </line>

<line> *o the me****l service qual*ty, </line>

</par>

<par>

<line> corro*orat*n* the res**ts obt*ined </line>

<line> by C*utinho et al. (2019), Coutinho and Vieira (2018), </line>

</par>

<par>

<line> *iovani* et a*. (20**) a*d Shabbir, Malik and *a*ik (2016). </line>

<line> The patients in this study placed value on the indicators of med*cal s*r*i*e quali** i* </line>

</par>

<par>

<line> *f importan*e: time devoted to hearing the patients; effort to h*lp them; </line>

</par>

<par>

<line> *x*lanation </line>

<line> about </line>

<line> the trea*ment; technic*l co**e*ence; and </line>

</par>

<par>

</par>

<par>

<line> In these res**c*s, *he pa*ients believe tha* the ti*e devoted to l*ste* to their </line>

</par>

<par>

<line> *escrip*ions </line>

<line> of sym*toms de*onstrat*s </line>

<line> the level of concern and enha*ces t*e quality of </line>

</par>

<par>

<line> **inica* diagnosis and se*ection of the *est treatment option. The *ffo*t to help them als* is o* </line>

<line> gr*at impor*ance, since pati*nts need t* fe*l th*t the doct*r r*al*y cares about their rec*ver* </line>

</par>

<par>

<line> and r*ducing *h*ir suffering, especially w*th a dise*se *s ser*o*s as cancer. Inde*d, it is </line>

</par>

<par>

<line> de*astating dise*se, in*erpreted by a substa*tial portion o* patients as * death s*ntence. </line>

</par>

<par>

<line> Furtherm*re, onco*ogic*l </line>

<line> treatm*nt *s pro*onged </line>

<line> and deb***tating, </line>

<line> gene*ating *ears an* </line>

</par>

<par>

<line> anguish. Fo* this reason, the doct*r\s ex*lana**on of the t*erap* is highly relevant to pa*ien*s, </line>

<line> and the r*s*lting *lar*f*ca*ion of *oubts generally *t*engthens their mo*ivati*n to stick to the </line>

<line> treatme*t re*imen, expl*ining *hy medi*al service *uality in *his surve* was the facto* </line>

<line> valued the most by the patie*ts. </line>

</par>

<par>

<line> Besid*s t*is, when the </line>

<line> do*tor shows </line>

<line> courtesy, calmly listening to </line>

</par>

<par>

<line> patient, *nd makes a maximum effort t* help them by explaining t*e treatment, the patient, </line>

</par>

<par>

<line> d*vastated by th* d*sease, feels *o** protected. This impro*es the pa*ient\s frame </line>

</par>

<par>

<line> *hic* *s extrem*ly i*portant *o face the disease. </line>

</par>

<par>

<line> F*nally, the pat*en*s al** val*e* t*e** *ositive perc**tion o* t*e technical co*petenc* </line>

<line> of th* doctor and *h* co**r*nce of the *linical d*a*n*sis, s*nce t*es* two fa*tors co*vey t* *he </line>

</par>

<par>

<line> p*tients the belief </line>

<line> **a* th* *herapy is be*ng *uid** </line>

<line> by * *rofessional wi*h </line>

<line> the technic*l </line>

</par>

<par>

<line> *ua*ific*ti*ns t* cure then and/or *tten*ate th*i* s*ff*ring, thus en*ancing their satisfaction </line>

<line> w*th t*e hospital ser*ice. </line>

<line> R*v. FSA, Teresina PI, v. 21, n. 2, art. 3, p. 44-6*, fev. 20*4 www4.fs*ne*.com.br/revista </line>

</par>

</page>

<page>

<par>

<line> E. D. Couti*ho, *. F. Lima </line>

</par>

<par>

<line> The factor w*th the second-*trongest positive imp*ct on th* p*tients\ satisfactio* was </line>

</par>

<par>

<line> the quali*y </line>

<line> *f the *ospital\s admi*istrat**e ser*ic*, </line>

<line> where the *nd*cato*s *ad t*e f*llowing </line>

</par>

<par>

<line> order o* i*po**ance: 1) su**ly o* *he medicine ne*essary f*r t**atment; *) ease o* sched*ling </line>

</par>

<par>

<line> consultations; and 3) waiting time </line>

<line> to see the doctor. Thes* fi*din** *orrob*rate the results </line>

</par>

<par>

<line> re*o**ed by *i*v*nis et a*. (201*) and Shab*ir, Malik and Malik (2016). </line>

</par>

<par>

<line> Th* p*t*en*s attribut*d </line>

<line> great importance to **e su*p*y of t*e med*cines </line>

<line> p*escri*ed, </line>

</par>

<par>

<line> since public hospitals *n *razil a*e leg*lly requir*d to *rov*de t*e drugs neces*ar* for *herapy. </line>

</par>

<par>

<line> De*ays in s*pp*ying drugs can *nterrupt treat*ent, since as a **le </line>

<line> the patien*s of </line>

</par>

<par>

<line> hospitals do not have the financial wher**ithal to purchase the (usual*y exp*ns*ve) drugs t* </line>

<line> treat cancer. In*erruption o* treatment ob*iously has a negative effect *n their r*cove*y. </line>

<line> The outpatients also *tated that the **se of sche*uli** medical co**ultations has grea* </line>

<line> importance *or th*ir tr*atme*t, because thi* a*o*ds d*lay* that can negat*vely a*fect treat*ent </line>

<line> and recov*ry. Once *hey arrive at th* hospi**l, patients obviously want ** be *erved q*ic*ly </line>

</par>

<par>

<line> rat*er than having to sit f*r long periods in the wai*ing *oom </line>

<line> i* climat* of a </line>

<line> anxiety and </line>

</par>

<par>

<line> discomfo*t. </line>

</par>

<par>

<line> T*e *h*rd most important factor for patien* sati*f*ction wa* the q*ality of the hospita* </line>

</par>

<par>

<line> facili*ies, </line>

<line> corroborating th* r*su**s obtain*d by Coutinho *t al. </line>

<line> (2019), Coutinh* </line>

<line> *nd Vieira </line>

</par>

<par>

<line> and Bhuyan (2018). The patients indic*ted </line>

<line> that th* comfort of the </line>

</par>

<par>

<line> *ospital instal*at*ons is very *mportan* so as n*t to aggr*v**e th* already consider*ble *hysical </line>

<line> discom**rt caused by cancer. The pat*ent* **so val*e* the esthetically a*tract*ve app*arance of </line>

</par>

<par>

<line> the hospital, since this tends to soften anxieties about the </line>

<line> thera*y. *inally, </line>

</par>

<par>

<line> goo* signage within *he *osp*ta* was valued b*cause it t*ansmits t*e feeling t*at th* hospital </line>

<line> is wel* organized, thus improving the satisfactio* wi*h th* service. </line>

</par>

<par>

<line> The respo*den** ran*ed the quality </line>

<line> *f the *ursing service </line>

<line> *n four*h place of </line>

</par>

<par>

<line> importance fo* *atis*actio*, </line>

<line> in contra*t wit* the res*lts found </line>

<line> by several oth** studi*s of </line>

</par>

<par>

<line> patient satisfa*tion </line>

<line> wi*h hos*ital se*vices, such as </line>

<line> Giovanis et al. (2018), S*maedi et al. </line>

</par>

<par>

<line> (2016), Zineld*n (20*5) and *aik and Bas*ir (201*). </line>

</par>

<par>

<line> The patients conside*ed the </line>

<line> positive p**cep***n of the </line>

<line> technical competence </line>

</par>

<par>

<line> n*rses to be the m*st importa*t ind*cator of satisfact*on with t*e service, f*l*owe* by th* time </line>

</par>

<par>

<line> devoted by th* nu*ses to *ear them and the effor* made to *elp </line>

<line> th*m. A*thoug* </line>

<line> patients did </line>

</par>

<par>

<line> no* e*press *xpectat*ons of * direct effect *f the nur**ng s*rvice on their recove*y, they were </line>

<line> aware *hat the go** qual*ty of th** ser*ice *ncreases t** chance *f effica** of tre*tment, **th a </line>

<line> posit*ve influence *n their sa*isfa**ion with the *o*p*tal s*rvi*e. </line>

<line> Rev. FSA, Teresina, v. *1, n. 2, art. 3, p. 44-66, fev. *024 www4.fsanet.*om.br/revista </line>

</par>

</page>

<page>

<par>

<line> Influence of Hospital Service *u*lity on the Satisfacti*n *f Cancer Patients </line>

</par>

<par>

<line> In general, then, t*is st*d* *how*d *h*t t*e c*nc*r </line>

<line> outpatients survey*d *er* main*y </line>

</par>

<par>

<line> concerned about cure of the disease a*d r*duction of their suffering, so thei* satisfa**ion with </line>

<line> the s**vice was pr*n*ipally *ssociated *ith *uality attr*butes of *he th**apy, such as *edica*ion </line>

<line> of th* phys*ci*n, cla*ity o* explanati*n about t** treat*ent prescri*ed, sup*l* of drugs by the </line>

</par>

<par>

<line> hospi*al *nd </line>

<line> the s*eed of *ervice. In the *i*al analysis, sinc* *an*e* is a sev*re *i*ease tha* </line>

</par>

<par>

<line> causes psychologica* damages to pati**t*, </line>

<line> the* *a*e a s*rong n*ed to fe** welcome and </line>

</par>

<par>

<row> protected b* the healthca*e p*ofessionals who serve the*. </row>

</column>

<par>

<line> FINAL CO*SI*ERATIONS </line>

<line> Th* ai* of t*is stud* was to *easure the satisfact*on o* onc*logica* outp*tients wit* </line>

</par>

<par>

<line> the q**lity o* the ser*ices r*nder*d *y a public *os*ital in *he city </line>

<line> *f Rio de Janeiro. </line>

</par>

<par>

<line> responses enabl*d *de**i*ying t*at pati*nts mainl* value the quality of the service render*d by </line>

</par>

<par>

<line> the doct*r, *o*low*d by the qu*lity of t** administrative </line>

<line> service, quali*y of the ho*pi*al </line>

</par>

<par>

<line> facili*ies and quality of *he *u*si*g service. </line>

</par>

<par>

<line> Al*ho**h *he literature o* patient s*tisfacti*n with hospital ser*i*es indic**es t*at the </line>

</par>

<par>

<line> q*ality *f </line>

<line> t*o** serv*ces mainly involves </line>

<line> the p**iti*e feeling conveyed t* t*em *y the </line>

</par>

<par>

<line> heal*hcare prof*s*ionals, where the work </line>

<line> of n*rses is *undamental (Batbaatar et al., 2017; </line>

</par>

<par>

<line> Hu*sain e* al., 2019; Poulton, 1996; Woo*s*de, F*ey & Daly, 1989), the *esults of this stu*y </line>

<line> demonst*ated a d**tinct reali*y in t*e c*ntext of outpat*ent treatment of ca*c*r pati*nts. Thus, </line>

</par>

<par>

<line> the principal </line>

<line> c*nclusion of *his study is that </line>

<line> *h*s* patient*, *ven though t*ey are typically </line>

</par>

<par>

<line> extr*mely anxious *ue t* the sev*rity of t*e disease, *ave * rat*o*al post*re *f priorit*zing the </line>

<line> qual*ty a*tributes th*y c*nsider t* b* mo*t importan* for the eff*c*cy of the therapy, i.e., the </line>

<line> ro*e of th* doc*or, mo*e so than aspects that g**e *motional comfort, su*h *s t*e p*ysical </line>

<line> setting and t*e wo*k of nurses. </line>

<line> In this respec*, t*e main theoreti*a* contr*bution of this study was to identify t*at the </line>

</par>

<par>

<line> o*col*gical outpatients sur**y**, un*ike found in many </line>

<line> other **udies, *ttri*uted li*tle </line>

</par>

<par>

<line> i*port*nce t* the nursi*g service qual*ty, even though nurses are t*e *ealthcare profess*onals </line>

<line> who interact t*e most w*th pat*ents. * po*sible ex*la*a*ion for thi* re*u*t is that t*e*e *atients </line>

<line> channel their expect*tions **inly to t*e quality attribu**s *hey belie** a*e m*st important to </line>

<line> their r*co*ery, *ausing them t* c**s*ify the nurs**g servi*e *s relatively unimpor*ant. Hence, </line>

</par>

<par>

<line> they priori*iz* th* quality *f </line>

<line> t*e me*ical s*r*ice and a*mini*trative activiti*s that di*ec*ly </line>

</par>

<par>

<line> affect the *uc*ess </line>

<line> of t*erapy, suc* as adeq*ate sup*ly o* drugs and short waiting *ime for </line>

</par>

<par>

<line> Re*. FSA, Teresin* PI, v. 21, n. 2, art. 3, p. 44-*6, fev. 20*4 </line>

<line> **w4.fsan*t.com.br/revis** </line>

</par>

</page>

<page>

<par>

</par>

<par>

<line> c*nsu*ta*ions and tests. Furthe*more, outpatients ar* less dependen* on *he care of n*rses and </line>

<line> have * less intimat* an* frequent rela*io*ship wi** t*em than hospitalized *atients. </line>

<line> *esi*e* *he theoretical contribution, *his *or* contains a* instrument for col*ection of </line>

<line> date that *an be useful for better *anagement of outpatie*t s*rvi*es and thus improved patien* </line>

</par>

<par>

<line> satisfaction, which is funda*ental, since sati**ied patients </line>

<line> te** *o make positive comments </line>

</par>

<par>

<line> and remain l*yal to the hospital. More importantly, s*tisfied </line>

<line> patient* present pos*ti*e </line>

</par>

<par>

<line> ps*chological r*actions that enhanc* their discipl**e and m*t**ation to adhe** t* th* *reatment </line>

<line> regimen, *ontributing to re*o*ery *f th*i* heal*h. </line>

</par>

<par>

<line> In closing, the resu*t* repo*te* in t*is study, a*though vali* and reliab*e, cannot </line>

</par>

<par>

<line> general*zed, *ince the sa*ple was *elected by co*veni*n*e, classifying i* as no*-probabilistic. </line>

</par>

<par>

<line> Hence, there *r* opportunities fo* future </line>

<line> studies in </line>

<line> *ther ho*pitals, b*** *ub*ic and **ivat*, </line>

</par>

<par>

<line> that tr*at outpatie*ts suffering fr*m c*n*er. </line>

</par>

<par>

</par>

<par>

<line> *atbaat*r, E., Dorj*a*va, J., Luv*annyam, A., </line>

</par>

<par>

<line> *etermi*ants of pati*nt satisfac**o*: a sys*ematic review. *er*p*ct Pu*lic He**th, 137(2), 89- </line>

<line> 1*1. https://d*i.o*g/10.1177/1757*1*91*6*4136. </line>

<line> Be*taye*, D., L*hrichi, N., & R*usseau, L. (2019). **t***t sche*uling ba*e* ** a service-time </line>

<line> *rediction mode*: a data-driven s*udy f*r a rad*othera*y Center. H*a*t* Car* M*nage**nt </line>

<line> Scien*e, 22, *68-782. https://do*.*rg/10.1007/*10729-018-9459-1. </line>

<line> Boakye, K. G., Blankson, *., Prybutok, V. R., & Qin, H. (2017). An assess*e*t of national </line>

<line> healthcar* se**ice delivery: * G*anaian illustration. International Journal of Quality & </line>

<line> Rel*ability Man*g*ment, 34(5), 649-**6. https://*oi.or*/1*.*108/IJQRM-12-2014-0*00. </line>

</par>

<par>

<line> Bray, *., Ferlay, J., Soe*j*mat*ram, I., Sie*el, *., Torre, L. A., & Jemal, A. (2*18). </line>

</par>

<par>

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