Complex services, such as healthcare, struggle to realize the benefits of value co-creation due to the substantial challenges of managing such services over the long-term. Key to overcoming these challenges to value co-creation is a profound understanding of dialogue (i.e., ‘quality of discourse’ facilitating shared meaning) during service interactions. Contributing to an emerging literature, we undertake a longitudinal, ethnographic study to assess dialogue between professionals and patients through the lens of dialogic engagement (i.e., iterative mutual learning processes that bring about action through dialogue). We develop and empirically support six dialogic co-creation and co-destruction mechanisms that impact on the resolution of tensions and integration of knowledge resources between service providers and consumers. We reveal the multidimensional and dynamic nature of value created or destroyed through these mechanisms in dialogue over time. Taking healthcare as an exemplar, we offer a research agenda for developing our understanding of DE in complex services.

中文翻译：

---

价值共同创造和共同毁灭如何展开：卫生服务互动中对话参与的纵向视角

由于长期管理此类服务面临巨大挑战，复杂的服务（例如医疗保健）难以实现价值共同创造的好处。克服这些价值共创挑战的关键是对服务互动中的对话（即促进共享意义的“话语质量”）的深刻理解。为了促进新兴文献，我们进行了一项纵向的民族志研究，通过对话参与（即通过对话带来行动的迭代相互学习过程）的角度来评估专业人员和患者之间的对话。我们开发并根据经验支持六种对话共创和共破坏机制，这些机制会影响服务提供者和消费者之间的紧张局势的解决和知识资源的整合。随着时间的推移，我们揭示了通过这些机制在对话中创造或破坏的价值的多维和动态性质。以医疗保健为例，我们提供了一个研究议程，以发展我们对复杂服务中的 DE 的理解。