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Vocal Cord Dysfunction – Questionnaire (VCD-Q)

How to complete this Questionnaire:

  • "This is a questionnaire developed to help monitor symptoms in patients with a diagnosis of Vocal cord Dysfunction, or PVFM". It is not intended for use as a diagnostic tool, though may be informative.
  • These are statements many people have used to describe their breathing symptoms and the effects of these symptoms on their lives.
  • Please select the response that indicates how much you agree with each statement
1 - 5 Rating Scale
1 = Strongly Disagree
2 = Disagree
3 = Neither Agree or Disagree
4 = Agree
5 = Strongly Agree
My Symptoms are confined to my throat/upper chest
I feel like I can’t get breath past a certain point in my throat/upper chest because of restriction
My breathlessness is usually worse when breathing in
My attacks typically come on very suddenly
I feel that there is something in my throat that I can’t clear
My attacks are associated with changes in my voice
My breathing can be noisy during attacks
I’m aware of other specific triggers that cause attacks
My symptoms are associated with an ache or itch in my throat
I am frustrated that my symptoms have not been understood correctly
I am unable to tolerate any light pressure around the neck –e.g. tight clothes or bending the neck
The attacks impact on my social life
First Name
Surname
DOB
Email
Phone number
Download File

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