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Employees with Aided Hearing Impairment: An Interdisciplinary Perspective
Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
2014 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Yrkesverksamma med hörselskada : Ett tvärvetenskapligt perspektiv (Swedish)
Abstract [en]

In Sweden 13% of the general adult population (16-84 years), with or without hearing aids (HAs), report that they have difficulties following a conversation when more than two people are involved. This means that more than one million people in Sweden (9 500 000 inhabitants in total) report subjective hearing difficulties. Observations further indicate that that people with hearing impairment (HI) have an unfavorable position in the labor market. Individuals with HI report poorer health more frequently and estimate their own health to be worse than their normally-hearing peers. Increased unemployment, early health-related retirement and sick leaves are also more common for people with hearing loss compared to the population at large.

The focus of the present thesis is employees with mild-moderate aided HI in the labor market. The research project had three general aims: 1) to develop knowledge about how HI interacts with cognitive abilities, and different types of work-related sound environments and workrelated tasks, 2) develop tests and assessment methods that allow for the analysis and assessment of perceived problems in clinical settings and 3) to develop knowledge that enables the possibility to provide recommendations of room acoustics and work-related tasks for employees with HI. Four studies were carried out. The studies presented in papers I-III are quantitative laboratory studies focusing on health related quality of life, cognition and effort and disturbance perceived in different types of occupational noise (daycare, office and traffic). Paper IV is a qualitative interview study aiming at exploring the conceptions of working life among employees with mild-moderate aided HI.

The results from papers I-IV clearly demonstrate that noise has negative effects on employees with mild-moderate aided HI. In addition to generating significantly greater effort and disturbance, it is further reported from the participants that noise at work in combination with a HI has an impact on daily life. This includes a sense of exposure during work hours, physical and mental fatigue after work, and withdrawal from social situations in the work environment and leisure activities. None of the participants with HI performed significantly worse on the visual working tasks employed in this project compared to their normallyhearing peers. This thesis shows that employees with HI objectively perform the employed  working tasks at a level similar to a well-matched normally-hearing control group. Instead, the findings of this thesis indicates that working in a noisy environment with a HI occurs at the expense of this group reporting significantly worse results on subjective measurements, including greater effort and disturbance, and lower physical health status. Interviews with these participants further confirm that these effects are indeed mostly due to noise at the workplace which could have a negative impact both physically, mentally and socially during and after work hours.

The main findings of this thesis demonstrate that there is a need for extensive services for employees with HI even after a HA fitting. This thesis therefore emphasizes the importance of identifying the need for assistive listening devices, examining the room acoustics of the individual’s work setting and providing the workplace with information about the consequences of having a HI in order to facilitate communication at work. The latter is especially important as colleagues showing support and employers making adjustments at the workplace (technically or acoustically) are facilitating factors that would benefit both employees with HI and those with normal hearing. Additional research should focus on including and comparing other types of cognitive tests, work-related noises and working tasks. More research is also needed to unravel the complex area of research between factors such as cognitive processes, hearing and effort.

Abstract [sv]

Tidigare forskning har visat att yrkesverksamma hörselskadade oftast har en mindre gynnsam position på arbetsmarknaden. Statistik visar att gruppen upplever en högre grad av trötthet och en lägre grad av arbetstillfredställelse. Avhandlingen har tre övergripande syften: 1) att utveckla ny teoretisk kunskap om hur hörselnedsättning samspelar med kognitiva förmågor, arbetsrelaterad ljudmiljö och typ av arbetsuppgifter, och 2) utveckla test- och utredningsmetoder ger möjlighet till analys och diagnos av upplevda problem samt 3) utveckla kunskap som ger möjlighet till åtgärd och anpassning av ljudmiljöer och arbetsuppgifter på arbetsplatser för hörselskadade. Projektets resultat visar på att yrkesverksamma med hörselnedsättning rapporterar en lägre fysisk hälsostatus och att en högre grad av upplevd ansträngning samt störning kan upplevas när de utför olika arbetsuppgifter i buller. Detta beror bland annat på att de kognitiva förmågorna blir mer belastade i en bullrig miljö och att hörselskadade är mer känsliga för höga bullernivåer. Djupintervjuer med gruppen visar även på att fysisk trötthet upplevs även efter jobbet som i sin tur kan leda till psykosociala konsekvenser för individen. Denna avhandling visar att de negativa effekterna av buller redan ses vid en lätt-måttlig hörselnedsättning hos en grupp som redan använder hörapparater. Från ett kliniskt perspektiv innebär det att dagens rehabiliteringsåtgärder bör vara mer omfattande än endast hörapparaturprovning för denna grupp. Tekniska hjälpmedel (FM-system, streamers, hörslinga, etc.) är viktiga för yrkesverksamma med hörselskada och information om konsekvenserna av att leva med en hörselnedsättning bör nås ut till arbetsgivare och kollegor för att underlätta kommunikation på jobbet.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2014. , p. 59
Series
Linköping Studies in Arts and Sciences, ISSN 0282-9800 ; 629Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 65
Keywords [en]
Hearing impairment, cognitive skills, noise, labor market
Keywords [sv]
Hörselnedsättning, kognitiva förmågor, buller, arbetsmarknad
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-110375DOI: 10.3384/diss.diva-110375ISBN: 978-91-7519-240-6 (print)OAI: oai:DiVA.org:liu-110375DiVA, id: diva2:744999
Public defence
2014-10-03, I:101, Hus I, Campus Valla, Linköpings universitet, Linköping, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2014-09-09 Created: 2014-09-09 Last updated: 2019-11-18Bibliographically approved
List of papers
1. Quality of life, effort and disturbance perceived in noise: A comparison between employees with aided hearing impairment and normal hearing
Open this publication in new window or tab >>Quality of life, effort and disturbance perceived in noise: A comparison between employees with aided hearing impairment and normal hearing
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2013 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 52, no 9, p. 642-649Article in journal (Refereed) Published
Abstract [en]

Objectives: The aims were to compare health-related quality of life (HRQOL) and hearing handicap between two groups of employees with normal hearing and aided hearing impairment (HI). HRQOL was also compared to a normative population. The second aim was to compare perceived effort (PE) and disturbance after completing a task in office noise between the two study groups. Design: A Swedish version of the short form-36 (SF-36) and the hearing handicap inventory for adults (HHIA) was used to determine HRQOL and hearing handicap. The Borg-CR 10 scale was used to measure PE and disturbance. Study sample: Hearing impaired (n = 20) and normally hearing (n = 20) participants. The normative sample comprised of 597 matched respondents. Results: Hearing-impaired employees report relatively good HRQOL in relation to the normative population, but significantly lower physical functioning and higher PE than their normally-hearing peers in noise. Results from the HHIA showed mild self-perceived hearing handicap. Conclusions: The current results demonstrate that physical health status can be negatively affected even at a mild-moderate severity of HI, and that a higher PE is reported from this group when performing a task in noise, despite the regular use of hearing aids.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
Keywords
Health-related quality of life, labour market, mild-moderate hearing impairment, noise, perceived effort, self-perceived hearing handicap, work
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97237 (URN)10.3109/14992027.2013.803611 (DOI)000323108800008 ()
Note

Funding Agencies|pa AFA Insurance||

Available from: 2013-09-05 Created: 2013-09-05 Last updated: 2017-12-06
2. Cognitive skills and the effect of noise on perceived effort in employees with aided hearing impairment and normal hearing
Open this publication in new window or tab >>Cognitive skills and the effect of noise on perceived effort in employees with aided hearing impairment and normal hearing
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2014 (English)In: Noise & Health, ISSN 1463-1741, E-ISSN 1998-4030, Vol. 16, no 69, p. 79-88Article in journal (Refereed) Published
Abstract [en]

The aim of the following study was to examine the relationship between working memory capacity (WMC), executive functions (EFs) and perceived effort (PE) after completing a work-related task in quiet and in noise in employees with aided hearing impairment (HI) and normal hearing. The study sample consisted of 20 hearing-impaired and 20 normally hearing participants. Measures of hearing ability, WMC and EFs were tested prior to performing a work-related task in quiet and in simulated traffic noise. PE of the work-related task was also measured. Analysis of variance was used to analyze within-and between-group differences in cognitive skills, performance on the work-related task and PE. The presence of noise yielded a significantly higher PE for both groups. However, no significant group differences were observed in WMC, EFs, PE and performance in the work-related task. Interestingly, significant negative correlations were only found between PE in the noise condition and the ability to update information for both groups. In summary, noise generates a significantly higher PE and brings explicit processing capacity into play, irrespective of hearing. This suggest that increased PE involves other factors such as type of task that is to be performed, performance in the cognitive skill required solving the task at hand and whether noise is present. We therefore suggest that special consideration in hearing care should be made to the individuals prerequisites on these factors in the labor market.

Place, publisher, year, edition, pages
Medknow Publications, 2014
Keywords
Adverse conditions; cognitive skills; hearing impairment; labor market; normal hearing; perceived effort
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-108180 (URN)10.4103/1463-1741.132085 (DOI)000336524500003 ()
Available from: 2014-06-26 Created: 2014-06-26 Last updated: 2021-07-27
3. The impact of different background noises: Effects on cognitive performance and perceived disturbance in employees with aided hearing impairment and normal hearing
Open this publication in new window or tab >>The impact of different background noises: Effects on cognitive performance and perceived disturbance in employees with aided hearing impairment and normal hearing
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2014 (English)In: Journal of the American Academy of Audiology, Vol. 25, no 9, p. 859-868Article in journal (Refereed) Published
Abstract [en]

Background: Health care professionals frequently meet employees with hearing impairment (HI) who experience difficulties at work. There are indications that the majority of these difficulties might be related to the presence of background noise. Moreover, research has also shown that high level noise has a more detrimental effect on cognitive performance and selfrated disturbance in individuals with HI than low level noise.

Purpose: To examine the impact of different types of background noise on cognitive performance and perceived disturbance (PD) in employees with aided HI and normal hearing.

Research Design: A mixed factorial design was conducted to examine the effect of noise under four experimental conditions.

Study Sample: Forty participants (21 men and 19 women) were recruited to take part in the study .The study sample consisted of employees with HI (n =20) and normal hearing (n = 20). The group with HI had a mild-moderate sensorineural HI and they were all frequent hearing aid users.

Intervention: The current study was conducted by employing four general work-related tasks (mental arithmetic, orthographic decoding, phonological decoding and serial recall) in four different background conditions: (1) quiet, (2) office noise at 56 dBA, (3) daycare noise at 73.5 dBA and (4) traffic noise at 72.5 dBA. Reaction time (RT) and the proportion of correct answers in the working tasks were used as outcome measures of cognitive performance. The Borg CR-10 scale was used to assess PD.

Data Collection and Analysis: Data collection occurred on two separate sessions, completed within four weeks of each other. All tasks and experimental conditions were employed in a counterbalanced order. Two-way analysis of variance (ANOVA) was performed to analyze the results. To examine interaction effects, pairwise t-tests were used. Pearson’s correlation coefficients between RT and proportion of correct answers, and cognitive performance and PD were also calculated to  examine the possible correlation between the different variables.

Results: No significant between or within-group differences in cognitive performance were observed across the four background conditions. Ratings of PD showed that both groups rated PD according to noise level, where higher noise level generated a higher PD. The present findings also demonstrate that the group with HI was more disturbed by higher than lower levels of noise (i.e. traffic and daycare setting compared to the office setting). This pattern was observed consistently throughout four working tasks where the group with HI reported a significantly greater PD in the daycare and traffic setting compared to the office noise.

Conclusions: The present results demonstrate that background noise does not impair cognitive performance in non-auditory tasks in employees with HI and normal hearing, but that PD is affected to a greater extent in employees with HI during higher level of background noise exposure. In addition, this study also supports previous studies regarding the detrimental effects high level noise has on employees with HI. We therefore emphasize the need of both self-rated and cognitive measurements in hearing care and occupational health services for both employees with normal hearing and HI.

Place, publisher, year, edition, pages
American Academy of Audiology, 2014
Keywords
Cognitive performance: labor market; hearing impairment; noise; perceived disturbance; work
National Category
Peace and Conflict Studies Other Social Sciences not elsewhere specified Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-110365 (URN)10.3766/jaaa.25.9.8 (DOI)000344907000008 ()
Available from: 2014-09-09 Created: 2014-09-09 Last updated: 2025-02-20Bibliographically approved
4. Conceptions of working life among employees with mild-moderate aided hearing impairment: A phenomenographic study
Open this publication in new window or tab >>Conceptions of working life among employees with mild-moderate aided hearing impairment: A phenomenographic study
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2015 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 54, no 11, p. 873-880Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim was to explore the conceptions of working life among employees with mild-moderate aided hearing impairment (HI). Design: This study has a descriptive design, in which data was collected by means of semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. The text was analysed in accordance with the phenomenographic approach. Study sample: Fifteen participants with mild-moderate aided HI were recruited to the current study. Results: The analysis of the interviews resulted in four main categories describing the participants conceptions of working life: (1) diffiiculties in daily work, (2) communication strategies, (3) facilitating factors in work environment, and (4) impact on daily life. The four identified descriptive categories show that the effects of HI on the lives of working adults generate far-reaching psychosocial consequences for the individual. Conclusions: This study demonstrates that difficulties and impact of having a HI interact with strategies used by the individual and contextual facilitators made in the work environment. We argue that there is a need for extensive services in aural rehabilitation for this population. This includes identifying the need of assistive listening devices, teaching the individual with HI about communication strategies and informing stakeholders about the consequence of having a HI.

Place, publisher, year, edition, pages
Taylor & Francis, 2015
Keywords
Conceptions; employees; fatigue; hearing impairment; labor market; noise; phenomenography; withdrawal
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-123811 (URN)10.3109/14992027.2015.1060640 (DOI)000366449600012 ()26140299 (PubMedID)
Note

Funding Agencies|AFA Insurance.

The previous status of this article was Manuscript and the working title was Being part of the labor market: conceptions among employees with aided hearing impairment.

Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2018-01-10

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