1 Department of Otolaryngology-Head and Neck Surgery, Section Ear & Hearing and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
2 Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
Trends Hear. 2017 Jan-Dec;21:2331216517692304. doi: 10.1177/2331216517692304.
The aim of this study was to evaluate the effectiveness of a vocational enablement protocol (VEP) on need for recovery (NFR) after work as compared with usual care for employees with hearing difficulties. In a randomized controlled trial design, 136 employees with hearing impairment were randomly assigned to either the VEP or the control group. VEP is a multidisciplinary program integrating audiological and occupational care for individuals experiencing difficulties in the workplace due to hearing loss. The primary outcome measure was NFR. Secondary outcome measures were communication strategy subscales (e.g., self-acceptance and maladaptive behavior), distress, and self-efficacy. Data were collected using questionnaires at baseline and at 3, 6, 9, and 12 months follow-up. No significant difference over the complete follow-up period was found between the intervention and control group for NFR. However, we observed a significant difference for one of the secondary outcomes after 12 months. "Self-acceptance" increased significantly in the VEP group, compared with the controls. The mean difference between the two groups was small, being only 0.24 (95% CI [0.04, 0.44]) on a scale of 1 to 5. The results do not support the use of VEP if the aim is to reduce NFR after work at 12 months follow-up. It may be that NFR does not adequately capture what is covered in the VEP. Although marginal, the effect on self-acceptance was significant. This is encouraging given that positive effects on self-acceptance have rarely been shown for audiological rehabilitation programs. Suggestions for further improvement of the VEP are discussed.
本研究旨在评估职业促进协议(VEP)对听力障碍员工工作后恢复需求(NFR)的效果,与常规护理相比。采用随机对照试验设计,将 136 名听力障碍员工随机分配到 VEP 或对照组。VEP 是一项多学科计划,将听力和职业护理整合到因听力损失而在工作场所遇到困难的个体中。主要结局指标是 NFR。次要结局指标是沟通策略子量表(例如,自我接受和适应不良行为)、困扰和自我效能感。使用问卷在基线和 3、6、9 和 12 个月随访时收集数据。在整个随访期间,干预组和对照组在 NFR 方面均无显着差异。然而,我们在 12 个月后观察到一个次要结果的显着差异。与对照组相比,VEP 组的“自我接受”显着增加。两组之间的平均差异较小,仅为 0.24(95%CI [0.04, 0.44]),在 1 到 5 的量表上。如果目的是在 12 个月随访时减少工作后的 NFR,则不支持使用 VEP。可能是 NFR 不能充分涵盖 VEP 所涵盖的内容。尽管效果较小,但对自我接受的影响具有统计学意义。鉴于很少有研究表明听力康复计划对自我接受有积极影响,这令人鼓舞。讨论了进一步改进 VEP 的建议。