Part II: Evaluation of professional functioning 97 Introduction Hearing loss in the working population affects work functioning (Backenroth-Ohsako et al., 2003; Granberg & Gustafsson, 2021). It causes hearing and communication difficulties, for exampleduring group-meetings or innoisy/reverberantworkplaces. In an attempt to overcome these difficulties, different coping strategies can be used (Barker et al., 2017;Christensen&Gupta, 2017). Employeeswithhearing loss oftenput extra effort and concentration when listening, use assistive listening devices, inform their colleagues about the hearing loss, or withdraw from difficult working situations. Although some of these strategies might be effective to reduce the hearing and communication difficulties at the workplace, not all of the difficulties can be compensated for (Jennings & Shaw, 2008).The benefit of assistive listening devices is smaller in noisy environments (Lesica, 2018) and it can be demanding and fatiguing to continuously put extra effort and concentrationwhen listening at work (Holman et al., 2021a).Moreover, communication difficulties can result in the inability to complete work tasks, making mistakes in work (Granberg & Gustafsson, 2021), and feelings of stress, frustration, and incompetency (Hasson et al., 2011; Hua et al., 2015; Tye-Murray et al., 2009). A great amount of evidence regarding the impact of hearing loss on the employment status has recently been summarized in a systematic review (Shan et al., 2020) and a scoping review (Granberg & Gustafsson, 2021). Compared to those with normal hearing, employees with hearing loss are more likely to earn less, to take more sick leave, to become unemployed or partly unemployed, and to take earlier retirement. Therefore, there lies great social and economic importance in good rehabilitation services for employees with hearing loss. It is increasingly acknowledged that aural rehabilitation services for employees with hearing loss require a multidimensional approach, because of the interplay between hearing loss, personal factors, and work characteristics (Granberg & Gustafsson, 2021; Zuriekat et al., 2021). However, the focus of current practices is often on technical interventions, rather than on perceptual training or counselling services on how to cope with hearing loss at work (Granberg &Gustafsson, 2021; Zuriekat et al., 2021). A reason might be that rehabilitation services for employees with hearing loss are not standardized and poorly documented (Granberg & Gustafsson, 2021; Gussenhoven et al., 2013). For example, it is unclear what interventions can best be provided individually or in a group-setting, what the duration and intensity of counselling should be, and what tools should be used to describe and evaluate the effects of rehabilitation services on work functioning in employees with hearing loss.
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