Chapter 3 92 the follow-up time of three months was relatively short, it might also be the case that the first hearing aid users were not yet used to their hearing aid, which might have suppressed its effect on the NFR. Another explanation is that hearing aids may not always meet the expectations of first hearing aid users. In that case, managing patients expectations on what effects can realistically be expected from hearing aids might improve rehabilitation outcomes. Future studies with greater sample size and longer follow-up time should further assess this matter. Our regression analysis revealed that change in NFR and LE can best be explained by different factors. Change in NFR could best be explained by change in personal adjustments, whereas change in LE could best be explained by change in selfreported hearing ability. This finding suggests that improved hearing might result in decreased LE, but not automatically in decreased NFR. Especially interventions that affect personal adjustments may be promising to reduce NFR in employees with hearing loss. As suggested in previous studies (Backenroth-Ohsako et al., 2003; Gussenhoven et al., 2017; Van Leeuwen et al., 2021), we therefore hypothesize that greater improvement in NFR might be obtained when sensory management interventions are not provided in isolation, but combined with interventions that foster adequate coping behavior. Future research is required to assess this hypothesis, since no conclusions on causality can be drawn because of the design of this study. Some strengths and limitations should be noted for this study. Due to a programming error, one SSQ question was not included in the questionnaire. We do not expect that this has had a major impact on the SSQ spatial score, because this scale score is an average score of 7 questions. Also, since the last question was missing, this cannot have influenced the scores of other questions. This study was performed in the setting of routine clinical practice, which improves the applicability of the results. A downside of our design was that no homogeneous intervention was provided and that there was no control group.Therefore, we cannot conclude that the improvement in NFR can be attributed to (aspects of ) the aural rehabilitation. Also, the study population was too small to run subgroup analyses on patients who received the same intervention. The post hoc power analysis that was based on the effect size of NFR revealed that the 80% power was not achieved. This implies that our study might have been slightly underpowered to detect changes in the NFR. Despite this, we found a significant difference in the NFR.
RkJQdWJsaXNoZXIy MTk4NDMw