General introduction 19 questionnaires are designed to use in individuals with a wide range of chronic diseases. However, these questionnaires do not recognize communication as a health domain, although communication restrictions are often experienced to be the most important restriction to societal involvement by adults with hearing loss (Granberg, 2015). Hearing specific questionnaires have also been developed to assess several aspects of participation. The review of Bentler and Kramer (2000) describes 33 hearing specific questionnaires, and even more questionnaires have been developed ever since (Granberg, 2015). The reported prevalence of these questionnaires is low. One of the questionnaires that is internationally used to assess the self-reported hearing ability is the Speech Spatial and Qualities of hearing scale (SSQ) (Gatehouse & Noble, 2004). This questionnaire measures the extent of listening difficulties during several daily life activities. The burden of hearing loss on work functioning can be assessed with the NFR scale that is included in the QEEW (Van Veldhoven & Broersen, 2003). The score on this scale has been shown to be a predictor of work stress, subjective health problems, and sick leave (De Croon et al., 2003; Sluiter et al., 2003). The NFR scale can therefore also be used for screening purposes. To our knowledge, there are currently no validated questionnaires measuring aspects participation that are hearing ánd work specific, For Dutch employees, the ACHW is available. Regarding the assessment of participation, this questionnaire includes six questions regarding the subjective listening effort at the workplace, such as the effort it takes to recognize sounds or to communicate in noise. The role of the occupational physician Employees with work functioning difficulties can visit an occupational physician. The role of the occupational physician for employees with hearing loss has been described in the protocol of the Dutch Board for Occupational Medicine (NVAB) entitled ‘hearing loss and tinnitus’. This protocol has been published in 2020 and states that occupational physicians should explore the difficulties inwork functioning that may have been caused by hearing loss. Occupational physicians screen the hearing function of individuals who visit them with hearing loss complaints if no hearing assessment has been performed recently.
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