Purpose The increase of life expectancy leads to the elderly living with one or more chronic illnesses. Communication between the elderly and the health-care professional is fundamental but can be difficult. For that reason, it is common to find the patient with an accompanying family member in the doctor’s surgery. The purpose of this paper is to analyze one of the possible actions of the companion during the provision of the medical service: the co-creation of value (through its two dimensions: coproduction and value-in-use) and its effects on the satisfaction of both the companion and the elderly patient. Design/methodology/approach A model has been tested through a system of structural equations using the statistical package EQS 6.2. The sample used is made up of 1,814 informants (907 companions and 907 patients). Findings The importance of coproduction between the accompanying person and the health-care professional is shown, to obtain greater levels of satisfaction (of the companion and the patient), whereas a negative role is conferred to the dimension value-in-use. This paper shows a positive impact of the satisfaction of the companion on that of the patient. Practical implications It is necessary to have health-care professionals who play a proactive role when facilitating the participation in the appointment with the doctor so as not to leave the initiative of participation in the hands of the companions. Originality/value Chronic illnesses are an important focal point of medical attention. Good management of the relations between those involved is fundamental for the diagnosis and adherence to treatment.

BackgroundWhile chronic illnesses are a major concern of the health system worldwide, little is known about patients–physicians communication. Growing demand for patient-centered care and shared decision-making have increased the interest for patients–physicians communication. Based on previous literature, we propose a model in which the effect of information provision and attentive listening over patients’ perceptions of shared decision-making (PPSDM) is mediated by the variables self-efficacy and proactivity. Primary data were collected between April and August 2014 through an online survey of patients with haemophilia. Haemophilia is a chronic disease in which many options of treatment are available. The right option depends, to some extent, on patient’s preferences. In this context, great uncertainty exists when choosing treatment option and shared decision-making plays an essential role.ResultsA total of 181 patients with haemophilia participated in the survey. The psychometric properties of the measurement scales were evaluated by means of a confirmatory factor analysis. A structural equation model was designed. Results show that provision of information and attentive listening determine PPSDM through patients’ self-efficacy and proactivity in requesting information.ConclusionsIt is important to incorporate communication training in medical education, particularly provision of information and attentive listening. These skills help the healthcare professional to gain a deeper understanding of the patient. Furthermore, provision of information and attentive listening are fundamental in helping patients not to undervalue their personal knowledge and expertise in relation to their doctors. These strategies encourage them to adopt a more active position in requesting information. Encouraging a proactive behaviour of patients and their relatives helps them to realize the need to participate and to make them feel that they are part of the decision-making process.

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Empowerment is a widely used word within the realm of health care. This is especially true in the case of patients living with a chronic illness, who may be active participants and learn to manage their disease, irrespective of their desires or preferences. This article focuses on the empowering experience of patients with chronic conditions. We have built on earlier research that explains the factors that mediate communication between health care professionals and patients: patient participation, patient impact, meaning, health care professionals' information provision, health care professionals' emotional support, health care professionals' attentive listening, health care professionals' trust, and patient collaboration. We propose a new model for detecting types of patients who differ in the way they live their empowering experience. Using survey data from a sample of 181 patients of hemophilia, we found two types of patients: patients with an inner locus of empowerment and patients with an outer locus of empowerment. We conclude by discussing different strategies for fostering the sense of power in each of these types of patients.

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An outcome of upward social comparisons that has been largely overlooked is its effect on non-transactional behaviours (i.e., word of mouth). Previous research has identified three different emotional reactions to upward social comparisons: admiration, benign envy and malicious envy. Despite the fact that their effect on consumption has been previously analysed, it remains unclear how these reactions affect word of mouth intention. This study carries out an experimental design that demonstrates that admiration and benign envy positively influence word of mouth behaviour. However, there is no effect of malicious envy on such disposition. The results are sustained under different cultural contexts. The findings shed light on the drivers of word of mouth. They offer guidance to companies for developing more effective strategies to encourage both brand message sharing and consumer-to-consumer sharing of consumption experiences.