Patient expectation of a voice clinic consultation: development of the ACaPELa questionnaire by assessment of four hundred and fifty-five patients

The many forms of dysphonia present a significant management challenge. Not only may it have a negative effect on a patients' quality of life1, but in a proportion of patients it may be the presenting symptom of a head and neck malignancy. As a result, general practitioners (GPs) are advised to refer any patient with persistent dysphonia for longer than three weeks for Otorhinolaryngology assessment.
Although patients presenting with dysphonia may have been referred by their GPs to exclude a malignancy, patients themselves may have multiple expectations ranging from exclusion of serious disease to complete resolution of every facet of their vocal issues. Equally, ORL clinicians may pursue management on what they perceive are the most relevant clinical issues. Given these uncertainties there is likely to be a mismatch of referral, expectation and subsequent management.
If it is possible to identify the patients' expectations of the outpatient consultation then it may be possible to not only tailor their consultation more effectively but also ensure that their management is optimised. The aim of the study was to assess patients' expectations of the consultation at a specialist voice clinic and identify a series of questions which would reflect these expectations.