Patient Satisfaction in Medicine and Dentistry: A 2 Need to Advance to a Patient-Reported Outcome 3 Measures (PROMs) Culture in Surgical Sciences 4

: There is little understanding of patients' experiences and perceptions with satisfaction by 14 health professionals such as medical and dental clinicians. Furthermore, patient satisfaction is not 15 well understood. The objective of this article is to better understand patients' satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. Patient satisfaction's multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of the treatment influence participant satisfaction at different stages of the intervention's process. An improved understanding of the basis for managing patients' expectations with information reiteratively and 21 efficiently may ultimately reduce patients' potential for negative feelings toward the medical and dental treatment experience. The consumerist method may misrepresent the concept of satisfaction in health service.


28
It has been pointed out that early reports on patient-reported outcome measures (PROMs) 29 focused on general patient satisfaction, which may not serve to adequately assess the range of impacts   The quality of healthcare provision can be improved by detecting its current problems [8], and

74
The following sections will depict satisfaction measurements and satisfaction theories.

82
Two decades ago, a review of dental patient satisfaction evidenced that the common dimensions

83
(also known as "domains" or "determinants") contained in patient-satisfaction surveys were 84 concerned with operator perceived skills, interpersonal aspects, convenience, finances, and the

155
The theoretical basis of such consumer satisfaction is the user's satisfaction theory [35,36]. The

176
In contrast, assimilation theory recognizes that consumers seek to avoid dissatisfaction by negative disconfirmation, and consumers may have more than one mechanism to accomplish this.

180
They may lower their expectations enough to match their experienced product performance ( Figure   181 3). Or the dissatisfaction that consumers experience from a disagreement between their expectations 182 and perceived performance of a product (Figure 4a) could be reduced by belittling the meaning of 183 the initial dissatisfaction (Figure 4b).
184 Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 11 September 2020 doi:10.20944/preprints202009.0254.v1 The tolerance level concept proposes that customers are prepared to accede to a range of 185 performance outcomes from the service or product, provided the range can be realistically estimated

186
[42]. The next section will provide specific theories that have been adapted to concepts of patient 187 satisfaction in professional health settings.                 satisfaction directly. Once self-actualization is achieved (Figure 6), the patient is considered to be 295 pleased with the healthcare service. When all of a patient's psychophysical needs are met, then the 296 concluding need of the hierarchy is achieved (Figure 6).

297
Clinicians are thought to facilitate this process by understanding their patients' needs, each with 298 their own characteristics, pathologies, and healthcare experiences. In other words, needs will differ 299 substantially from patient to patient [60].

300
To further understand how patient satisfaction is developed, researchers contrasted two 301 theories, Maslow's hierarchy of needs[59] and the hierarchy of patient needs, which was based on a 302 normative model using the theory of caregiver motivation [60]. The hierarchy of patient needs 303 catalogues patient outcomes in four categories, building from a base focused on physical needs, as 304 shown in Figure 6 [60]. With that understanding, thereafter, some items of Maslow's hierarchy of 305 needs were seen to be parallel to the hierarchy of patient needs (Figure 6). Moreover, self-306 actualization was considered the most significant determinant of enthusiasm and is only achieved 307 once all other human needs are met (Figure 6). By the same token, patient satisfaction is a critical 308 goal for clinicians and is only achieved once all patient outcomes are fulfilled (Figure 6) [60].  has also been recognized that expectations are situation-specific.

326
Most of the patient-satisfaction theories and models described here, except for the health quality

333
The concept of "expectation" is dynamic and multidimensional, influenced by patients' 334 characteristics, including their belief system, preceding experiences, and pre-treatment situation [49].

335
Subsequently, it has been recognized that using expectations to elucidate satisfaction is problematic 336 (Figure 7) [26].

399
Conflicts of Interest: The authors declare no conflict of interest. Neither the AAED nor the AAIDF had a role in 400 the design, or interpretation of data or any role in the decision to submit results of the study for publication.