Introduction: One of the most important components in the evaluation of the quality of health services is, with out a doubt, user satisfaction. Nursing staff performance is a key point in determining quality of care because the nurse is the person who maintains the closest link with patients and the community.

Objective: To know the level of satisfaction of the beneficiaries based on the care received by the nursing staff working in the external consultation service of the ISSSTE of Rioverde, S.L.P, in the period September-October 2012.

Methodology: A descriptive study was carried out, which included outpatients. As instrument, a multiple choice questionnaire was used, using the Likert Scale with 13 items. It consists of 2 sections that included sociodemographic data and questions that assess the quality of care.

Results: Of the studied population, 66% went on a morning shift and 34% on an afternoon shift. 32% expressed that the care provided by nursing was immediately. 76% of the patients mentioned that the nurse called him by name and offered a kind treatment. 85% agreed that the nurse practitioner treated him with respect.

Conclusion: The dignified treatment is identified as a point of relation in the evaluation of nursing care and its relation with the perception of the same by the user, which refers to the acceptability that behavior both verbal and nonverbal is established in the relationship of the nursing professional with every person, beyond a simple greeting.

Keywords: satisfaction, nursing, care

ISSSTE, institute of security and social services of state workers

Donabedian claims that it is impossible to describe quality correctly, not including customer opinion as it provides us with information about the success or failure of the health system to meet expectations.¹ One of the most important components in the evaluation of the quality of health services is, without doubt, the satisfaction of the users.^2,3 The author defines the degree of quality as "the extent to which the attention rendered is capable of achieving the most favorable balance between dangers and benefits" Nursing staff performance is a key point in determining quality of care because the nurse is the person who maintains the closest link with patients and the community.^3-5

In Mexico, important strategies have been carried out in order to improve health services. Implementing actions that respond to the demands of users that demand more and more quality care every day. In addition to increasing demand for quality, it is essential that this care be provided with warmth, improving the nurse-patient relationship to raise the level of user satisfaction. Perception can be evaluated by measuring the elements that a health service provider must have: decent treatment, respect, ethics and professionalism.^6-8 The objective of this research was to know the level of satisfaction of the beneficiaries, with respect to the care provided by the nursing staff of the outpatient clinic of Hospital ISSSTE of Ríoverde, SLP, during the period from September to October year 2012.

A non - experimental, descriptive study was carried out, including patients from the external consultation of the morning and afternoon shifts. The universe of the study is 17,854 beneficiaries of the ISSSTE. A non-probabilistic sampling was used, for the convenience of the patients who visited the outpatient clinic (376 patients), the sample was obtained with the formula for finite population. A multiple choice questionnaire was used as a collection tool, which uses the Likert Scale with 13 items. It consists of 2 sections in the first section sociodemographic data were included and in the second the questions assessing the quality of care. This questionnaire explored several communicative domains focused on the nurse-patient relationship; Availability, Timely service, Individual attention, Respect, Kindness, Equality. A pilot test was performed validating the reliability of the instrument and obtaining a Crombach alpha of 0.744. The responses of the questionnaire were subjected to statistical analysis using the SPSS Software (version 18.0 for Windows) a descriptive statistic was used to obtain a global perception of patient satisfaction.

It took into account 248 beneficiaries who attended the morning shift 75.4% (187) women and 25.5% (61) men. With age range of 18 to 72 years with predominance the ages of 45 to 53 years 65.3% of the population were married, the predominant degree of schooling was degree finished in 35.1% followed by right-holders with schooling finished and finished primary school represented with 15.3% both. The results show that the nursing staff came to the call of the rightful owner and immediately attended with 31%. The 51.2% of respondents said that the nurse shows a good physical appearance. In the item evaluated in the presentation of the nursing staff with the rightful owner was mostly found that the nurse does not appear with the rightful owner before any intervention. 89.5% considered that nursing staff always treated all beneficiaries equally without discrimination. 65.3% of the population indicated that the nurse was always available to solve any situation and doubt of the beneficiary. Seventy-three percent of eligible respondents always felt secure during the procedures and care provided by the nursing staff. In the items presented we can observe that the nurse always provides a decent treatment appropriate to the beneficiaries (Figure 1).

Figure 1 Qualification in general of the care provided by the nursing profesional.
Source: Direct.

In general, the population qualified nursing care as: good with 51.2%, excellent 39.9%, followed by regular 8.5%, and only 0.4% of the population thought it was bad (Figure 2). The nurse respects the privacy and private life of people always in 88.3% of cases (Figure 3). It was found that 86.7% believe that nurses always present ethical and moral aspects in the sense of entitlement.

Figure 2 The Nursing professional respects their privacy when it is taken care of.
Source: Direct.

Figure 3 Consideration of the nurse who has the patient referring to moral and ethical issues.
Source Direct.

The findings obtained in the present investigation, where the beneficiaries give their opinion directly on the nursing care in the area of ​​external consultation, reveal a degree of satisfaction in general terms that ranges from good (53%) to excellent (38 %). More specifically, the following results describe the nurse-patient relationship, integrating the following aspects of nursing care and results: I call him by name (76%), he gives respect (85%), he is kind (76%) (76%), respects their privacy (86%), egalitarian treatment (86%), respects their privacy (86%), the percentages shown were favorable to be placed on a scale of never to always, in the frequency of always being the figures shown in each aspect to evaluate previously. In contrast, in the evaluation referred to, if the nurse presents herself; the highest percentage was never (38%). These results lead to the proposals made by González-Valentin. which suggest updating nurses in communication skills in order to modify factors that intervene in the best patient satisfaction.⁹

It seems that the nurse is not present is not relevant data in the patient's care for the nursing staff, however, it seems that the perception of the patient's care changes with this simple echo. According to Barragán in a study carried out on this subject, a high percentage (91.3%) of the patients did not know the name of the nurse who attended them.⁸

Gattinara BC in 1995¹⁰ reveals that 50% of the population surveyed reported that the time spent by the staff of health nursing was insufficient, differing somewhat with the results obtained in the present research, in which 64% stated that the nursing staff was always willing to listen to and care for him, however there is still a considerable percentage that does not have the same perception (36%), this data reveals that we need to continue working on aspects that allow us to establish guidelines in the care of the care provided in each service that integrates nursing care.

In the item referring to the equal treatment of patients, regardless of economic situation and place of origin, 86% stated that nurses did not make any distinction between the population, this result also contrasts with what was found in the Gattinara study BC where 62.9% stated that health workers treat the rich better than the poor. On the other hand, the study by Godínez J et al.¹¹ reveals that the nursing professional treated 58% of the patients with respect, and was willing to treat 54% of them with good results, but they reflect progress in it can be inferred that the results of Gattinara BC and cols have foundations because if there is no equal treatment there can be no respect and availability for the attention of each patient or the individuality of their needs.

In general terms and as it was plated in a beginning of the section the evaluation of the attention was qualified as good, nevertheless, as it was possible to be appreciated throughout the text the evaluation of the same integrates diverse aspects that influence in the final perception of the attention so it will be necessary to turn to see each one of these aspects to determine the faults and to be able to attend them. There are studies that support the results of the present study, such as that of God in July 2013,¹² where a high degree of patient satisfaction is also evidenced according to the care provided by the nursing staff. On the other hand, other studies have been found that differ from the favorable results, in these aspects it is important to refer to the term dignity since it is finally this term that will significantly influence nursing care to the user, dignity can be perceived from two angles, one as a representation that make oneself of its dignity character and two as the image that others are made of us. The two angles play an important part in the evaluation of the treatment that the nursing staff provides, in this sense the image that others make of us in terms of dignified treatment implies to the nursing staff to integrate in their attention the respect, the information, interest and kindness, in this sense to establish a relationship between the two angles, the representation that one makes of oneself of his dignity character must tie with the treatment received and perceived.¹³

It is said that every person has dignity; dignity is something unique that characterizes us as people with values ​​that allow us to lead a harmonious coexistence, dignity within a society has a bidirectional sense, the existence of the dignity of the other. Dignity is a subjective term difficult to measure, however in health care is essential to have a notion of the perception of patients in terms of quality care which has as its central axis the decent treatment, since these are in a situation of vulnerability to a disease, who come to the health service expecting to find interest in their health of the staff that attends to them, that interest is reflected directly in the treatment of the care provided during the stay of the patient within the requested service.

The dignified treatment determines to a great extent the perception of the treatment granted by the nurse, under the following terms the right to a dignified and respectful treatment towards the user, refers to the acceptability that the behavior both verbal and nonverbal is established in the relationship of the professional nursing with every person, beyond a simple greeting. Therefore it is worthy to attend to him with opportunity, delicacy, courtesy and in conscience emphasizing that the term conscience integrates the term knowledge. It is worth providing adequate and pertinent information so that the user can make a decision, is to pose alternative solutions. Worthy is to provide you with an environment of trust, comfort and hope if possible, alongside your loved ones. It is worthy to treat him with patience, perseverance, tolerance and prudence, besides being loyal to him and jealous guardian of his circumstances regardless of his origin, social position, state of cleanliness, smell or pathology.

Once clarified the integrated aspects within the term of decent treatment which is identified as a point of relation of the nursing care and the perception of the same by the user, satisfactory results are appreciated in the present investigation, since in a general way the evaluation of nursing care by the user is established in terms of good (53%) and excellent (38%).

None.

The authors report no conflicts of interest.

1. Donabedian. The quality of medical care. Mexico: A The Mexican press; 1994.
2. Lean PR. Expectations and satisfaction of primary care users. Semergen. 1998;24(9):711–718.
3. Val-pardo I, Corella JM. Health systems; Diagnosis and planning. Edición Díaz de Santos, Ediciones Díaz de Santos. Madrid, Spain: Springer; 2001. p. 60–61.
4. Becerra B, Andrés J, Moreno M, et al. Quality perceived by nursing users in three public hospitals. Global Nursing. 2013.No.29.
5. Puebla VDC, Ramírez GA, Ramos PP, et al. Patient perception of care given by nurses. Rev Enferm Inst Mex Soc Insurance. 2009;17(2):97–102.
6. Ortega VMC, Leija HC, Puntunet BML. Manual of Evaluation of the Quality of the Nursing Service; Strategies for its application. Mexico: Médica Panamericana, UNAM; 2014. p. 1–10.
7. Acosta L, Burrone MS, López MJN, et al. Analysis of user satisfaction in first-level health centers in the province of Córdoba. Global Nursing, Argentina: Springer; 2011.
8. Ortiz-Espinosa RM, Muñoz-JS, Torres-Carreño E. Satisfaction of the users of 15 Hospitals of Hidalgo México. Rev Esp Salud Pública. 2004;78(4):543–532.
9. Barragán JA, Pedraza YD, Rincón MR. Perceived quality of nursing care by hospitalized users, Tunja, 2011. Rev Fac National Public Health. 2013;31(2):187–193.
10. Polit FD, Hungler PB, Palacios MR, et al. Scientific Research in Health Sciences: Principles and Methods. 6th Ed. USA: McGraw-Hill Interamerican Editor; 2007.
11. Godinez JF, Reyes CR, Ariza HFJ, et al. Level of satisfaction of external consultation users in a public hospital. Rev Psicologia y Salud. 2014;24(1):97–107.
12. War DC, Alba DM, Ruiz MR, et al. Evaluation of the satisfaction of users of nursing consultation in Health Centers based on technical and communication quality indicators. Global Nursing. 2013; No. 31.
13. Sentinel monitoring. Protocol of dignified treatment by nursing. 2nd ed. Regional hospital of high specialty of oaxaca, Mexico: Springer; 2006.