Part I: Factors inflencing professional functioning 35 and job control have also been demonstrated to be associated with NFR in hearingimpaired employees, independently of the degree of hearing loss measured with an online hearing test (Nachtegaal et al., 2009). To our knowledge, further studies examining the effect of work characteristics on NFR in hearing-impaired employees are lacking, but high auditory work demands were shown to be related to sick leave due to stress-related complaints (Kramer et al., 2006). Personal characteristics influencing NFR in the general working population include gender (Kiss et al., 2008), age (Gommans et al., 2015; Kiss et al., 2008), general health condition (Gommans et al., 2015; Van der Starre et al., 2013), educational level (DeCroonet al., 2003), and coping style (De Vries et al., 2015; Machin & Hoare, 2008). Several studies have indicated that people with hearing loss use coping strategies in their interaction with others (Backenroth-Ohsako et al., 2003; Barker et al., 2017; Hallberg & Carlsson, 1991). Also, the Communication Profile for the Hearing Impaired (CPHI) has been developed to investigate how people cope with their hearing loss (Mokkink et al., 2010).This questionnaire contains questions on the communication strategies and non-verbal strategies that are commonly used by people with hearing loss. However, the influence of hearing loss coping on NFR has not yet been examined. The evidence on factors influencing NFR in hearing-impaired employees lags behind, although the outcome NFR has potential for early identification of hearingimpaired employees being at risk for occupational diseases, and may be a valuable tool for evaluating the effects of interventions aiming to prevent these problems. It is hypothesized that hearing loss, work characteristics, and personal characteristics influence both each other and NFR. Because earlier studies do not provide a framework on how these factors interfere, NFR may not be optimally understood in employees with hearing loss. The primary aim of this study is therefore to identify hearing-related, work-related, and personal factors influencing NFR in hearingimpaired employees. To examine if the influence of hearing-related, work-related, and personal factors on NFR differs from their influence on listening effort, which is a more commonly assessed construct when assessing the functional disability of hearing-impaired employees, the secondary aim is to identify factors influencing listening effort.
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