Hearing loss (HL) among working-age adults in the UK is becoming more prevalent. Workers with HL face communication challenges that impact their career prospects, work performance, psychosocial wellbeing and financial security, leading to economic costs to wider society. Most of the available literature on workers with HL is focused on some aspects of the adversities they encounter. It is very deficient in examining the multidimensionality of the impact and the vital role of supportive audiology care in mitigating the impact of HL on work life. The available research concerning workers' experiences with HL and their healthcare is severely lacking in the United Kingdom (UK), and most of the international studies were conducted in previous decades, when work practices, disability legislation, and audiology services were rather different from today. This thesis gathers the experiences and views of audiologists and workers with HL to better understand the impact of HL on workers in the workplace. It explores the state of UK audiology care for workers with HL and identifies the factors that help or hinder effective support.
Three qualitative studies were conducted. Study 1 gathered interview data from 25 audiologists working either in the National Health Service (NHS) or independent health services, and Study 2 interviewed 24 workers with HL. The perspectives of both groups were then triangulated, and the issues around coping that came out strongly from Study 2 were further analysed in Study 3. The interviews were all thematically analysed for Studies 1-3. From the triangulated perspectives of audiologists and workers, supported by previous literature, a conceptual framework is developed, offering an unprecedented demonstration of the multidimensionality of the challenges affecting workers with HL and the issues that were perceived to be influencing workers’ experiences and wellbeing. HL can affect every aspect of a worker's working life, from career choices to day-to-day struggles and career progress. They experience stress, fatigue and difficulties adapting to different work situations, and a sense of being not sufficiently well supported by employers and colleagues and audiology services.
Key findings include the acknowledgement by audiologists in Study 1 that workers with HL have specific needs that often go unmet due to lack of resources, lack of funding, and lack of knowledge and training on how to support this demographic. The workers in Study 2 expressed uncertainty about who to approach for support and perceived a gap in audiological care for working adults, especially by the NHS. The triangulation of their perspectives showed that the audiologists and the workers mostly agreed that there were important issues in audiology care for the working population, such as better access to services, more effective patient-audiologist interaction, and more advanced technological support aside from hearing aid provision. However, the triangulation showed some misalignment of perspectives between the two groups. For example, the audiologists believed that workers were most in need of appointments outside of working hours, whereas the workers were much more concerned about inordinately long waits for appointments and overly-convoluted referral pathways and how these affected their jobs.
Study 3 identified the coping strategies used by workers’ with HL in the workplace, such as disclosure of HL, use of basic and advanced hearing technologies and withdrawal. Unlike previous research, this research found that factors related to coping In work life with HL include self management skills and better support from audiology services. Overall, this thesis shows that audiology services should make more effort to identify workers' needs and provide better support aside from standard hearing aid provision. Audiologists need to be supported by services and the health system to make effective improvements. Workers with HL need to take an active role in their care, while being supported by audiology services, healthcare provision and employers. This research can be used to develop higher standards of care for workers with HL and improve audiology services. Further research is needed to understand the factors influencing the quality of audiologic rehabilitation of workers with HL and how to implement timely, practical and effective positive changes to service delivery. <br/