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Family physicians' approach to hoarseness: a qualitative study
Esin Özlem Atmış1, İzzet Fidancı2
1Faculty of Health Science, Department of Audiology, Bahçeşehir University, İstanbul, Türkiye.
Aim:
The aim of this study is to investigate family physicians' approaches to hoarseness (dysphonia), clinical decision-making, patients' perceptions, and structural barriers in the healthcare system using qualitative methods.
Methods:
Qualitative design was used. Research was reported in line with COREQ (32 items) and EQUATOR (SRQR) guidelines. Semi-structured telephone/internet interviews were conducted with 17 family physicians working primary care in Türkiye. Participants purposively sampled interviews were audio-recorded, transcribed, coded using thematic analysis, and developed themes.
Results:
The analysis revealed four main themes: clinical assessment and differential diagnosis, referral criteria and specialist referrals, patient perception and knowledge level, health system and structural barriers. Demographic analysis determined that veteran doctors were more sensitive to malignancy, junior doctors highlighted systemic deficits, female doctors highlighted patient behavior, while doctors who practiced in rural areas highlighted structural issues.
Conclusion:
Family physicians' handling of hoarseness is not only dependent on clinical data but also on patient opinion and the health system's conditions. For productive primary care management of hoarseness, it is recommended to (i) design guidelines and training for family physicians, (ii) increase patient education on voice hygiene and voice health, and (iii) establish health policies enhancing specialist accessibility.
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