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EVALUATION OF PRODUCTS AND SERVICES OF A NURSING LIBRARY:

USER SATISFACTION1

Sheila Kátia Cozin2

Ruth Natalia Teresa Turrini3

Cozin SK, Turrini RNT. Evaluation of products and services of a nursing library: user satisfaction. Rev Latino-am

Enfermagem 2008 julho-agosto; 16(4):758-64.

The goal of the study was to evaluate the quality of the services provided by the library at the Nursing School

of the University of São Paulo. A questionnaire evaluating users’ satisfaction with the service was employed,

covering five quality components: tangibles, reliability, responsiveness, assurance and empathy. The Satisfaction

Rate was calculated through the degree of importance in relation to satisfaction. The analysis of the openended

answers was quanti-qualitative. For Reliability and Empathy, the users showed dissatisfaction with the

training for bibliographic research and the librarian’s willingness to meet the clients’ information needs,

respectively. Responsiveness did not fully satisfy the users, disagreeing with the providers. However, both

agreed that the archives are outdated. Among the tangible aspects, equipment and noise were criticized most

often. The results show that the library offers good service quality to its users.

DESCRIPTORS: libraries, nursing; library materials; consumer satisfaction; nursing

EVALUACIÓN DE LOS PRODUCTOS Y SERVICIOS EN UNA BIBLIOTECA DE ENFERMERÍA:

SATISFACCIÓN DEL USUARIO

El estudio tuvo por objetivo evaluar la calidad de la atención en la biblioteca de la Escuela de Enfermería de la

Universidad de São Paulo. Se utilizó un cuestionario que evalúa la satisfacción del usuario a través de cinco

componentes de calidad: tangible, confiable, receptivo, seguridad y empatía. La Tasa de Satisfacción se calculó

mediante la razón entre el grado de importancia y satisfacción. El análisis de las preguntas abiertas fue cuanticualitativo.

En Confiabilidad y Empatía, los usuarios se mostraron insatisfechos con los entrenamientos para

búsqueda bibliográfica y sobre el empeño del empleado para atender las necesidades de los clientes. Los

usuarios no estuvieron plenamente satisfechos con la receptividad, sin embargo ambos concordaron que la

bibliografía estaba desactualizada. Dentro de los aspectos tangibles, los equipos y el ruido fueron los más

criticados. Los resultados demostraron que la biblioteca ofrece servicio de calidad a sus usuarios.

DESCRIPTORES: bibliotecas de enfermería; materiales bibliográficos; satisfacción de los consumidores;

enfermería

AVALIAÇÃO DOS PRODUTOS E SERVIÇOS DE UMA BIBLIOTECA DE ENFERMAGEM:

SATISFAÇÃO DO USUÁRIO

O estudo teve por objetivo avaliar a qualidade do atendimento da biblioteca da Escola de Enfermagem da

Universidade de São Paulo. Utilizou-se questionário que avalia a satisfação do usuário com o serviço através

de cinco componentes da qualidade: tangibilidade, confiabilidade, receptividade, segurança e empatia. A taxa

de satisfação foi calculada pela razão entre grau de importância e de satisfação. A análise das perguntas

abertas foi quanti-qualitativa. Em confiabilidade e empatia, os usuários mostraram-se insatisfeitos quanto aos

treinamentos de busca bibliográfica e ao empenho do funcionário da biblioteca em atender as necessidades de

informação dos clientes, respectivamente. A receptividade não satisfez os usuários plenamente, discordando

dos prestadores, porém, ambos concordam que o acervo está desatualizado. Equipamentos e ruídos foram,

dentre os aspectos tangíveis, os mais criticados. Os resultados evidenciaram que a biblioteca oferece serviço

de qualidade aos seus usuários.

DESCRITORES: bibliotecas de enfermagem; acervo de biblioteca; satisfação dos consumidores; enfermagem

1 Article taken from scientific initiation study, funded by the São Paulo State Research Support Foundation, FAPESP, Brazil, nº 04/06549-5. Honorable Mention

at 13th SIICUSP; 2 Master´s student, e-mail: sheilakatia@hotmail.com; 3 Ph.D. in Public Health, Faculty, e-mail: rturrini@usp.br. University São Paulo School

of Nursing, Brazil.

Disponible en castellano/Disponível em língua portuguesa

SciELO Brasil www.scielo.br/rlae

Artigo Original

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INTRODUCTION

The increasing search for high-quality

service pushes companies to improve their work

methods in order to valuate their products in order to

grant them a better image in the market. Information

services, including libraries, are examples of a market

with a high rotation of users and data, which need to

renew regularly in order to be up-to-date with

technological advances, and also to satisfy their clients.

Since “service is an act or performance that

benefits clients through a desired change in – or on

behalf of – the service receiver”(1), the focus of the

renewal of libraries are the users, represented by

their opinion about the service provided, from the

availability of information in the various databases to

the performance of the professional providing services

there. At university libraries, concerns about quality

are even higher, because the users need the information

for their educational, research and extension

processes. The constant evaluation of the service is

indispensable to adapt and update the products and

services at the speed demanded by the clients.

For an effective response to the demands and

specificities of the community libraries’ management

and work practices should be reorganized(2), with the

indispensable creation and application of quality

indicators according to the profile of the users and

their expectations about the service and products

offered(3).

The clients’ expectations are the true

standards to evaluate the quality of the service(4). The

results obtained by two researchers(4) showed that

the clients evaluated the quality of the service by

comparing what they expect with what they receive.

The clients’ expectations of the services can be

differentiated in two levels: a desired level, reflecting

the service the client expects to receive (the relation

of what can be with what should be), and an adequate

level, which points to what the client considers

acceptable. When there is a small or inexistent

discrepancy between these levels, service

performance is satisfactory.

In the past years, the Integrated Library

System of the University of São Paulo (SIBi/USP) has

striven for quality through constant technological

renewal. In 2001, the first strategic planning for the

implementation of a new management model for the

SIBi/USP was presented, the Quality Assessment

Program (PAQ), whose objective was to develop a

continuous methodology to evaluate the quality of

products and services offered to SIBi/USP clients(5).

Therefore, people responsible for the PAQ created

an instrument based on a model used for the

evaluation of service quality, the SERVQUAL(6).

SERVQUAL is a scale that measures the

consumers’ perception about the quality of services

in five Gaps (Figure 1), which show the criteria

considered by the consumers in their final judgment

about the quality of services, making it easier for

service managers to understand the problems that

may possibly hinder the full satisfaction of the clients.

The analysis of the consumers’ answers allowed the

researchers(7) to identify dimensions of satisfaction:

Responsiveness (willingness to help the clients and

provide service quickly); Assurance (the knowledge

and courtesy of the employees, and their ability to

convey trust and responsibility); Tangibles

(appearance of the physical facilities and personnel);

Reliability (ability to perform the service accurately,

according to what was promised) and Empathy

(individual attention given to clients).

Gap 2 Gap between the

provision of service

and the external

communications

with the clients.

Gap between the

service specifications

and provision of

service

Gap between the

perceptions of

management and the

service specifications

Gap between the

expected service and

received service

Gap between the

consumer’s

expectations and

management’s

expectations

Word of mouth

Communications

Service

specifications

External

communication

to consumers

Personal

needs

Past

experiences

Management

Perceptions of

consumer

expectations

Service

Delivery

Expected

service

Perceived

service

Gap 3

Gap 5

Client

Service provider

Gap 4

Gap 1

Source: Parasuraman A, Zeithaml V, Berry LL. A conceptual model of service quality and its

implications for future research. J Marketing. 1985;49:41-50. (Reprinted with the authorization of

Journal of Marketing, published by the American Marketing Association)

Figure 1 – A model proposed to represent the gaps in

the client-company relationship

The use of this scale in the evaluation of

library services first happened in a study(8) that

generated the paper Service Quality in Academic

Libraries, and provided suggestions for the evaluation

of library services, especially in the academic

community.

The evaluation of the services provided by

the library permits a review of service goals, how it

works and the management model, pushing the

evolution process of self-criticism and promoting, with

its results, the solution of the problems identified in

the institution through the testimonies of all those

involved in the evaluation process.

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MATERIAL AND METHOD

This is a cross-sectional, descriptive study.

The project was approved by the Ethics Committee

at the University of São Paulo School of Nursing (EE/

USP) and the Research Commission of the EE/USP.

The study population consisted of internal

users (faculty, graduate and undergraduate students,

specialization students and assorted EE/USP

employees) and external users (faculty, graduate

students, specialization students, students from other

schools, healthcare professionals, among others) of

the Wanda de Aguiar Horta library at EE/USP. A

proportional random sample was extracted from the

faculty, undergraduate students and stricto sensu

graduate students of the EE/USP, in order to guarantee

that the smallest category would include at least 30

subjects. Therefore, the final sample was composed

of 31 faculty, 82 graduate students and 127

undergraduate students. The amount of 30 individuals

was intentionally set for the following categories:

specialization students, EE/USP employees and

external users. Ten library employees present at the

time of data collection also received the

questionnaires. Collection started in December, 2004

and ended in May, 2005.

Two hundred thirty-two questionnaires were

answered, 129 from undergraduate students, 26 from

faculty, 31 from graduate students (stricto sensu), 12

from specialization students, 19 from EEUSP

employees and 15 from external users, which

represented 70.3% of the initially determined sample,

excluding the library employees.

The questionnaire used for data collection

was elaborated from a pre-existent questionnaire used

by SIBi/USP in its PAQ. This instrument consisted of

Likert-style questions covering the five dimensions

of quality: tangibles (physical presentation of the

environment (T1), equipment (T2), communication

material (T3)), reliability (employees that inspire trust

(C1), security and reliability of the information

provided (C2), security and reliability in training for

information access (C3), reliable orientation about the

selection of information sources (C4), reliable

information on the library website (C5)),

responsiveness (providing services within the

promised time frame (R1), quickness in the lending

service (R2), flexibility in the lending process among

the USP libraries (R3), quickness in the reprographic

service (R4), provision of copies of documents from

other libraries (commuting) within an acceptable time

frame (R5), quickness/agility in the acquisition of

books, journals and other publications (R6), updated

archives (R7), efficiency in the safekeeping of material

and organization of the archives (R8), provision of

online services (R9), adequate working hours (R10)),

assurance (employees that were qualified to answer

questions (A1), accessible and polite employees (A2),

employees that know how to use the electronic

information sources (A3), skillful use of equipment

(A4)) and empathy (attentive service (E1), efforts to

see to the information needs (E2), individual attention

(E3), ease of communication with the employee (E4),

employee’s attitude (E5)), evaluated according to the

Degree of Importance and the Degree of Satisfaction.

Since the instrument was also applied to the

library employees (providers), the results obtained

from Gap f, named as such by the authors of this

project, could be associated to represent the service

providers’ perception about their own performance,

understanding that the Degree of Importance these

employees attributed to the service would represent

what they consider important as the service standards

and that the Degree of Satisfaction would represent

their performance as providers.

Open-ended questions were included in the

questionnaire to validate the respondents’ opinion in

relation to five pre-conceived dimensions of quality

and the need to apprehend specific information about

the library.

Satisfaction of the client and the service

provider was calculated as indicated by the authors

responsible for the scale(4):

Relative satisfaction rate (TSR) = (Value

attributed to satisfaction ¸ Value attributed to

importance) × 100.

The difference of the TSR obtained for the user

up to full satisfaction (100% - TSR) corresponds to Gap

5, and the difference of the TSR obtained for the service

provider up to full satisfaction (100%) corresponds to

Gap f. Both gaps can be positive values (the service does

not fully satisfy the expectations), equal to 100% (the

service satisfies the expectations) or negative (satisfaction

with the service is higher than expected).

For the TSR analysis, the use of medians was

chosen, so that the central measurement would not

be strongly influenced by extreme values, and

because the satisfaction of some users was higher

than their expectations, which could offset the

satisfaction average. Intergroup comparison was

done with the variance analysis test, and a significance

level of 5% was adopted. For the analysis of the openended

questions, the central theme was identified with

a later recoding of the answers to allow for a

quantitative-qualitative analysis.

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RESULTS AND DISCUSSION

Undergraduate students were the users most

often present at the library, since they are at school

every day, and because they need to develop study,

evaluation, seminar and other activities demanded

by the Nursing course. The opposite situation occurred

with external users, since these seek the service for

Category

Daily Weekly Bi-weekly Monthly Rarely Never used Total

n % n % n % n % n % n % n %

Undergraduate 1styear 7 20.6 19 55.9 4 11.8 1 2.9 3 8.8 - - 34 14.6

Undergraduate 2ndyear 6 21.4 17 60.7 3 10.7 2 7.1 - - - - 28 12.1

Undergraduate 3rdyear 7 20.6 18 52.9 4 11.8 2 5.9 3 8.8 - - 34 14.6

Undergraduate 4thyear 2 6.1 20 60.6 6 18.2 5 15.2 - - - - 33 14.2

Professor - - 8 30.8 7 26.9 7 26.9 4 15.4 - - 26 11.2

Graduate 2 6.5 12 38.7 5 16.1 7 22.6 4 12.9 1 3.2 31 13.4

Specialization - - 5 41.7 - - 4 33.3 2 16.7 1 8.3 12 5.2

EEUSP employee 3 15.8 - - 2 10.5 - - 7 36.8 7 36.8 19 8.2

External user 2 13.3 2 13.3 - - 2 13.3 9 60.0 - - 15 6.5

Total 29 12.5 101 43.5 31 13.4 30 12.9 32 13.8 9 3.9 232 100

specific research. Weekly utilization was the frequency

modality most respondents mentioned most often.

The use of the library by graduate students

was inexpressive. The research activities performed

by this group demand a higher frequency of library

use. However, this result could be attributed to the

availability and ease to access electronically-stored

information.

0

0,05

0,1

0,15

0,2

0,25

0,3

R1 R2 R3 R4 R5 R6 R7 R8 R9 R10

Gap 5

Gap f

Table 1 – Distribution of the respondents, in categories, according to the frequency of use of the Wanda de

Aguiar Horta library (EEUSP), São Paulo, 2005

Among the dimensions of quality,

Responsiveness (Figure 2) showed the highest

difference of full satisfaction with the service: Eight

out of ten indicators of this dimension presented a

Gap 5 of 25%. Although this result does not represent

a significant difference between what is perceived and

what is expected from the service, it stands out

because responsiveness is highlighted as the second

most important dimension for service quality(9).

Figure 2 – Distribution of the values for Gap 5 and f

according to the responsiveness indicator (R). Wanda

de Aguiar Horta Library (EEUSP), São Paulo, 2005

The archives deserve priority to fully meet

the user’s expectations, since the indicator up-to-date

archives (R7) presented a 25% Gap, for both users

and employees, besides obtaining a high frequency

of open-ended answers, indicating the existence of

outdated topics in the archives. In the indicator

Provision of online services (R9), the 25% Gap notes

the need to offer more services to the users, such as

requests for copies of articles.

The difference observed in indicators R7, R9

and Efficiency in the safekeeping of material and

organization of the archives (R8), as evaluated by

the providers, shows that they acknowledge the

importance of storing the material, indispensable to

find a given text or book, and this service deserves

more attention. A misplaced text or book may be

considered lost, and this activity reflects the

organization of the service directly.

In the dimension Assurance, only the

indicators Employees who were qualified to answer

questions (A1), and Employees who know how to use

the electronic information sources (A3) generated a

Gap 5 of 25% among the users, both related to the

technical capacity of the providers. In order to have

the users evaluate the quality of the archive, someone

needs to introduce them to the resources available

for bibliographic research and how they can obtain

the material they need. The users were fully satisfied

with the indicator Accessible and polite employees

(A2), different from the employees, where a Gap f of

12.5% was identified. The employees attribute a

degree of importance to this dimension that is not

fully reproduced in communication with the users.

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For Tangibles, the users and the providers

consensually determined that the indicator Equipments

(T2) has a Gap of 25% to full satisfaction. Even though

Parasuraman considers this dimension the least

important for the quality of service(9), as a result of

technological advances, computers have become

indispensable for good information services in

libraries. According to the providers, the indicator

communication material (T3), a valuable resource to

advertise the services provided, also obtained a Gap

f of 25%.

Although users are satisfied with indicator

T3, the results of the open-ended questions show

that the providers know the importance of the

communication material better than the users. For

the open-ended question about the interest of some

sort of training in capacitating courses for the user,

89.4% of the respondents mentioned training

programs related to bibliographic research, a

course that is currently offered by the library. This

is an evident failure in the advertisement of the

courses.

The same was observed in the answers

about interest in some sort of service the library

does not offer yet, where 41.1% of affirmative

answers mentioned the desire for courses

habitually offered by the library. For the same

question, 11.8% explicitly suggest that the library

should advertise its services.

The individual life history of the providers and

the encouragement they receive during their working

hours are factors that can influence the clients’

evaluation of a service, since the behavior and the

attitudes of the employee can interfere negatively in

professional activity, especially when the work is

articulated by interaction and communication with the

clients. Besides professional motivation, this could

explain the result obtained for the indicator Efforts to

see to the necessities of information (E2) of the

dimension Empathy, in which the users showed a Gap

5 of 25%. For the indicator employee’s attitude (E5),

a Gap f value of 25% shows that the providers can

improve their interpersonal relationship, although

users do not perceive this gap in the providers’

performance.

In a study where SERVQUAL was used, it was

observed that the key dimension for client perception

about an evaluated service is Reliability, since this is

the client’s guarantee that the requested services will

be done correctly and precisely(10). In this dimension,

the only indicator that did not obtain full satisfaction

among the users was Security and reliability in the

training for information access (C3).

The providers still need to improve their

training strategies, so that they can convey more trust

to the users. Because of the Gaps f of the providers,

it was observed that the reliable information on the

library’s website (C5) needs to be improved and

depends on frequent evaluation of the library’s

webpage by the providers themselves, so that updates

can be executed.

When the TSR averages among the

categories of respondents are compared by the ANOVA

test, statistically significant differences are observed

in the dimension Responsiveness for the indicators

R2 (p=0.040), R3 (p=0.005), R6 (p=0.031), R7

(p=0.006) and R10 (p=0.011); in the dimension

Assurance, only for A3 (p=0.047); in the dimension

Tangibles, for T1 (p=0.014); and in the dimension

Empathy, for E1 (p=0.013), E2 (p=0.004) and E5

(p=0.040).

For the category indication of books for

acquisition, it was noticed that, except for the

professors, the library users do not indicate books

for acquisition, probably because this possibility is not

advertised. Besides requesting the purchase of the

books that comprise the list of references for the

courses, the faculties are regularly asked to indicate

books when the library receives grants to enlarge its

archives.

In the question about outdated topics in the

archives, a little more than half of the respondents

mentioned at least one outdated topic, highlighting

themes from the Nursing area itself. This result is

controversial for a specialized library, but possible

because of the budgetary difficulties of the public

school. Technological advances in healthcare demand

frequent acquisitions of books and, due to their high

costs, students resort to book loans more and more

frequently.

Suggestions about the library facilities and

what they would change in the library mainly pointed

to aspects related to the environment, library facilities

and equipment. In the “environment and facilities”

category, they appointed actions for the reduction of

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noise, enlargement of the physical space and

improvements in the comfort of the spaces destined

to studying. In “equipment”, the amount and condition

of the computers for research was emphasized,

supporting the difference in the indicator T2 of the

dimension Tangibles (Gap 5 of 25%) by at least half

of the users.

Regarding what the respondent users most

like or most dislike in the library, opinions diverged.

Environment and facilities”, “archives” and “service

were most often mentioned positively, while

archives”, “noise” and “service” were most often

mentioned as reasons for dissatisfaction. When

referring to the dimension Empathy, the indicators of

service presented Gap equal or lower than 25%,

indicating that, in the open-ended questions, the

respondents express their opinions better. Another

controversy resides in the fact that “environment and

facilities” have received a higher quantitative

amount of suggestions for change. Users tend to

overly valuate the physical aspects of the

environment, even though comfort is essential for

intellectual activities.

The better educated the clients are, the less

sensitive they are to the tangible dimensions(4). The

tangible dimension does not convince the user, but

factors like cleanliness, good ventilation and lighting,

when present and adequate, aid in the decision of

choice or purchase.

FINAL CONSIDERATIONS

These data accomplished the goal of

evaluating user satisfaction regarding the services and

products of the “Wanda de Aguiar Horta” library, by

understanding its clients’ direct perception of the

services/products provided, as well as the impression

they have of the providers. The results showed that,

despite the gaps observed in some indicators, the

library offers good service quality to its users, since

88% of the respondents evaluated the service as good

or excellent. The gaps f of the providers were

important to identify gaps that may be improved

through initiatives taken by the service providers

themselves, and also those that need to be discussed

at higher decision-making levels.

The identification of undergraduate students

as the main library users shows that their needs should

be considered when purchasing books. On the other

hand, the less frequent library use by graduate

students deserves further investigation. Since this

group needs to perform systematic literature reviews

to develop projects, it is important to know whether

the non-use of the library happens because the

archives and the services provided are insufficient; if

the electronic searches and virtual libraries are

meeting the student’s library needs, or if the graduate

students are not dedicating themselves to studying

as required by graduate programs. In any case, since

many graduate students did not answer the

instrument, the amount of data is insufficient for

further considerations.

Institutional communication (advertising,

promotion and announcement of services), even in

public services, also affects the client’s expectations

directly, as seen in the analysis of the answers

obtained with the open-ended questions, where several

respondents cite the need to advertise the services

and products offered by the library. On the other hand,

others refer to the negative influence inefficient

advertising can exert on client satisfaction. Therefore,

investing in institutional communication can be an

efficient strategy to improve the quality of the library

evaluated.

The analysis of the gaps 5 showed that the

following aspects deserve more attention from the

library with a view to meeting users’ needs: updating

the archives, the communication system and the

equipment, advertising the services and training

programs, behavior of users and providers in

maintaining of silence within the library environment,

and accessibility for the providers.

The open-ended questions were important to

validate some indicators of the Likert scale. They

revealed that users also wanted extended work hours

of the library and more efficiency in reprographic

services.

After evaluating the results obtained by this

research, the Wanda de Aguiar Horta library was

considered to provide services with good quality,

satisfying most of its users and the service providers

themselves, presenting only a few punctual problems

that will serve as parameters to improve its services

even more.

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