title: Vocational rehabilitation services for people with hearing difficulties: a systematic review of the literature.
abstract: OBJECTIVE
  The goal of this review was to list and summarize work-related health programs for employees with hearing difficulties and to summarize the statistical evidence of the effectiveness of these programs.
  
  
  METHODS
  A systematic review was performed by searching the PubMed, EMBASE, PsycINFO, CINAHL, and The Cochrane Library databases for relevant citations. From 2313 unique citations retrieved from the search strategy, we included nine programs that met all inclusion criteria. The authors assessed the methodological quality of studies which evaluated the program's effectiveness, using the Downs and Black checklist.
  
  
  RESULTS
  Nine vocational rehabilitation programs for people with hearing difficulties were described. The programs differed in procedure, duration, setting, and content. In four studies, the effectiveness of the program was explored statistically. Measurements showed an improvement in general health (SF-36), communication strategies, and the degree of work readiness, but none of these studies included a control group, a power calculation, nor adjusted for confounding. Hence, the methodological quality to provide evidence of effectiveness was assessed as poor.
  
  
  CONCLUSIONS
  Existing vocational programs for employees with hearing difficulties provide relevant information to demonstrate how to implement the appropriate content of the programs. Future research is required to improve the strength of evidence of the effectiveness of vocational rehabilitation for workers with hearing difficulties.
authors.affiliation: Department ENT/Audiology and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands Department of Public and Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Arjenne H M
authors.initials: AH
authors.lastname: Gussenhoven
authors.forename: Elise P
authors.initials: EP
authors.lastname: Jansma
authors.forename: S Theo
authors.initials: ST
authors.lastname: Goverts
authors.forename: Joost M
authors.initials: JM
authors.lastname: Festen
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Anema
authors.forename: Sophia E
authors.initials: SE
authors.lastname: Kramer
mesh_terms: D006801:Humans; D019986:Persons with Hearing Disabilities / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational
keywords: Hearing impairment; effectiveness; methodology; occupation; program; vocational rehabilitation; work