Experiences with healthcare for unilateral vocal fold paralysis: A qualitative study of the patient's perspective

Unilateral vocal fold paralysis (UVFP) frequently causes severe dysphonia, which necessitates multidisciplinary treatment. Literature on outcomes of interventions has primarily focused on vocal fold motility or instrumental vocal outcomes, but the perspectives of patients about the treatment process have not yet been investigated. The purpose of the study was therefore to explore patient experiences with healthcare for UVFP.

Twenty-four adults with UVFP (age range: 39 - 84 years) participated in the study. Semi-structured interviews were conducted, transcribed, and analyzed with the software program NVivo. An inductive thematic approach was used to code and analyze the interviews.

Three themes were identified through the qualitative analyses: (1) the healthcare professional (HCP), (2) experiences with treatment, and (3) patient support. The laryngologist and speech-language pathologist (SLP) were crucial HCPs during treatment, and patients relied heavily on their advice, so they expected them to be knowledgeable about UVFP and empathic towards their patients. Voice therapy was mostly a positive experience due to the collaborative therapeutic relationship with the SLP, even though it did not yield sufficient voice improvements. Medialization surgery was a relief for some participants, while others expected more or felt too vulnerable to undergo surgery. Sources of patient support included personal connections such as relatives and fellow patients, but participants expressed a need for increased support and guidance from the healthcare system.

Overall, participants were satisfied with the care that they had received, but certain barriers and needs within UVFP healthcare were identified. The findings from the current study can help guide the development of initiatives to better support patients and HCPs and improve patient-centered care in UVFP.