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The purpose of this research is to develop and empirically test a model to examine the major factors affecting patients' satisfaction that depict and estimate the relationships between service quality, patient's emotions, expectations and involvement.

The approach was tested using structural equation modeling, with a sample of 317 patients from six Portuguese public healthcare centres, using a revised SERVQUAL scale for service quality evaluation and an adapted DESII scale for assessing patient emotions.

The scales used to evaluate service quality and emotional experience appears valid. The results support process complexity that leads to health service satisfaction, which involves diverse phenomena within the cognitive and emotional domain, revealing that all the predictors have a significant effect on satisfaction.

The emotions inventory, although showing good internal consistency, might be enlarged to other typologies in further research – needed to confirm these findings.

Patient's satisfaction mechanisms are important for improving service quality.

The research shows empirical evidence about the effect of both patient's emotions and service quality on satisfaction with healthcare services. Findings also provide a model that includes valid and reliable measures.

This paper aims to deepen the concept of service quality in digital libraries based on the analysis of the Digital Library Service Quality Model (adapted from Zeithaml, Parasuraman and Malhotra) and a multiple‐item scale (dlQUAL scale) created to evaluate the quality and performance of service delivered by the Portuguese Digital Library Consortium as part of the Digital Library Integrated Evaluation Programme.

The Digital Library Service Quality Model makes it possible to assess gaps between different levels based on a multiple‐item scale to evaluate service quality, which was designed as a web survey. Considering the strategical groups (users, LIS professionals, library managers and top managers), the research team developed four different web‐survey versions to evaluate the different gaps. In the first step of this study, they looked for measures validity.

The scale proved good psychometric proprieties. This study also showed the usefulness of the Digital Library Service Quality Model to evaluate and analyze digital libraries' service quality.

The scale is valid and useful to evaluate digital libraries' service quality and it can provide valuable performance information to digital libraries' decision‐makers. Moreover, the Digital Library Service Quality Model is a useful instrument to check the critical points that are related to organizational deficiencies. If these gaps are regularly monitored, it is possible to implement adequate correction measures and improve service quality.

This paper presents a Library Service Quality Model specifically designed to evaluate digital libraries.