Part II: Evaluation of professional functioning 77 • To examine to what extent change in the NFR can be explained by changes in subjective listening effort, personal adjustments, communication strategies, auditory work demands, and self-reported hearing ability. Methods Study design This prospective study was performed in employees with hearing loss who received aural rehabilitation at two audiological centers in the Netherlands, respectively at one location of the Amsterdam University Medical Center (UMC) and at three locations of Libra Revalidation and Audiology. Outcomes were measured by an extensive online questionnaire at baseline (T0) and three months follow-up (T1). Between T0 and T1, patients received different components of aural rehabilitation. Participants Eligible patients were referred to the audiological center of the Amsterdam UMC between 2019 and 2021 or the audiological center of Libra Revalidation and Audiology between 2020 and 2022. The inclusion criteria further required patients to be aged between 18 and 67, to visit the audiological center because of hearing complaints in the work situation, and to provide informed consent for participating in this study. Hearing complaints in the working situation could either be the reason of the referral to the audiological center or these complaints were concluded after the intake with the audiologist. Eligible patients received information about the study and were asked consent for using their responses on the baseline questionnaire (part of the routine health care process) for this study, for sending a second survey for research purposes after three months, and for accessing their patient file to extract their puretone audiometry results and the type of intervention that was applied. Patients were excluded if the reason for their referral was an auditory fitness for job assessment, because these patients visit the audiological center to ensure that they can perform their job safely and effectively rather than to reduce their LE and NFR. Patients were also excluded if the first visit at the audiological center was cancelled, if the baseline questionnaire was not filled in or was filled in after the start of the intervention, and if there was no indication for aural rehabilitation (Figure 2). The audiologist (routine clinical care) decided whether there was an indication for aural rehabilitation or not. Table 1 shows the demographic and clinical characteristics of the patients.
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