Application of the VALS and the laddering techniques at shared decision-making
Patients values are fundamental in the process of health decision-making. The use of PROMs is often difficult in routine clinical practice, which requires the search for simpler methods of determining the patients values, where psychographic segmentation and laddering are one of those.The aim of the study was to improve the process of shared-decision-making in patients with non-melanoma skin cancer using the VALS segmentation and the laddering technique.Materials and methods. An inclusive, incomparable, prospective, long-term multicenter cohort study of the use of the laddering technique and the VALS technique was conducted in 158 patients (154 (97%) with basal cell skin cancer, 4 (3%) squamous cell skin cancer; 129 (82%) patients with stage I-II diseases, 17 (11%), with IV - 12 (7%); 56 (35%) - m en, 102 (65%) - women. The results of psychographic segmentation showed: the clinical result of the procedure is important for 96% (n=152), the safety of treatment and adverse reactions - for 91% (n=143), the cosmetic result - for 46% (n=73), convenience and flexibility of the treatment schedule - f or 36% (n=57), the painlessness of the treatment procedure - f or 34% (n=54), the ability to lead a habitual lifestyle during treatment - f or 23% (n=36), the comfort of the treatment procedure - f or 14% (n=22), the financial costs associated with treatment - for 9% (n=14), preservation of organ function after treatment - for 3% (n=5). Conclusions. The method of psychographic segmentation can be adapted to the tasks of communication between the doctor and the patient. The scope of application of the VALS methodology and the laddering technique can be considered situations when a doctor is unable to use validated quality of life questionnaires due to limited resources or the absence of such questionnaires.