Hanneke Van der Hoek-Snieders

Part I: Factors inflencing professional functioning 45 Directed acyclic graph The presence of tinnitus, age, and the educational level were not directly or indirectly associated with NFR and LE. Consequently, these factors were not included in the directed acyclic graph. Figure 2 shows the directed acyclic graph that was constructed. Four variables directly influenced the primary outcome NFR, specifically ‘feeling that something should change at work’ (r = 0.476), LE (r = 0.527), PA (r = − 0.456), and general health condition (r = 0.453). Two of these variables did also directly influence the secondary outcome measure LE, respectively, ‘feeling that something should change at work’ (r = .390) and PA (r = -.442). LE was also directly influenced by BHI (r = .318) and auditory work demands (r = .413). The hearing assessment outcomes did not significantly correlate with NFR, including BHI (r = .096, p = .109), maximum discrimination score (r = .010, p = .873), and SNR (r = .060, p = .492). All correlations between the hypothesized factors and the primary and secondary outcome are shown in Table 3. Table 3. Correlations between the hypothesized factors and the primary outcome need for recovery and the secondary outcome subjective listening effort. Need for recovery Subjective listening effort Binaural hearing impairment .099 .318 Maximum discrimination -.024 -.167 SNR in continuous noise .060 .203 Presence of tinnitus .102 .094 Work participation .154 .006 Collegial support .198 .130 Subjective listening effort .527 - Auditory work demands .226 .413 Fulfilling managerial tasks -.050 .109 Number of working hours -.152 -.071 Feeling something should change .476 .390 Communication strategies .032 .197 Personal adjustments -.456 -.442 Age -.018 .133 Gender -.186 -.133 General health condition .453 .289 Educational level .108 .124 SNR indicates Signal-to-Noise Ratio.

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