title: Conceptualisation of patient satisfaction: a systematic narrative literature review.
abstract: OBJECTIVE
  Patient satisfaction concept is widely measured due to its appropriateness to health service; however, evidence suggests that it is a poorly developed concept. This article is a first part of a two-part series of research with a goal to review a current conceptual framework of patient satisfaction and to bring the concept for further operationalisation procedures. The current article aimed to review a theoretical framework that helps the next article to review determinants of patient satisfaction for designing a measurement system.
  
  
  METHODS
  The study used a systematic review method, meta-narrative review, based on the RAMESES guideline with the phases of screening evidence, appraisal evidence, data extraction and synthesis. Patient satisfaction theoretical articles were searched on the two databases MEDLINE and CINAHL. Inclusion criteria were articles published between 1980 and 2014, and English language papers only. There were 36 articles selected for the synthesis.
  
  
  RESULTS
  Results showed that most of the patient satisfaction theories and formulations are based on marketing theories and defined as how well health service fulfils patient expectations. However, review demonstrated that a relationship between expectation and satisfaction is unclear and the concept expectation itself is not distinctly theorised as well.
  
  
  CONCLUSIONS
  Researchers brought satisfaction theories from other fields to the current healthcare literature without much adaptation. Thus, there is a need to attempt to define the patient satisfaction concept from other perspectives or to learn how patients evaluate the care rather than struggling to describe it by consumerist theories.
authors.affiliation: Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, MongoliaFaculty of Economy and Business Sciences (Facoltà di Scienze Economiche e Aziendali), University of Sannio, (Università degli Studi del Sannio), Benevento, Italy eni1mn@yahoo.com.
authors.forename: Enkhjargal
authors.initials: E
authors.lastname: Batbaatar
authors.affiliation: Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, MongoliaThe Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Javkhlanbayar
authors.initials: J
authors.lastname: Dorjdagva
authors.affiliation: Department of Business Management, Ulaanbaatar University, Ulaanbaatar, Mongolia.
authors.forename: Ariunbat
authors.initials: A
authors.lastname: Luvsannyam
authors.affiliation: Faculty of Economy and Business Sciences, University of Sannio, Benevento, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Amenta
mesh_terms: D006801:Humans; D008962:Models, Theoretical; D033262:Narration; D017060:Patient Satisfaction
keywords: RAMESES guideline; conceptualisation; customer satisfaction; expectations; narrative literature review; patient satisfaction; satisfaction theory; systematic review