Cost-effectiveness of a vocational enablement protocol for employees with hearing impairment; design of a randomized controlled trialReportar como inadecuado

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BMC Public Health

, 12:151

First Online: 01 March 2012Received: 31 January 2012Accepted: 01 March 2012DOI: 10.1186-1471-2458-12-151

Cite this article as: Gussenhoven, A.H., Anema, J.R., Goverts, S.T. et al. BMC Public Health 2012 12: 151. doi:10.1186-1471-2458-12-151


BackgroundHearing impairment at the workplace, and the resulting psychosocial problems are a major health problem with substantial costs for employees, companies, and society. Therefore, it is important to develop interventions to support hearing impaired employees. The objective of this article is to describe the design of a randomized controlled trial evaluating the cost- effectiveness of a Vocational Enablement Protocol VEP compared with usual care.

Methods-DesignParticipants will be selected with the -Hearing and Distress Screener-. The study population will consist of 160 hearing impaired employees. The VEP intervention group will be compared with usual care. The VEP integrated care programme consists of a multidisciplinary assessment of auditory function, work demands, and personal characteristics. The goal of the intervention is to facilitate participation in work. The primary outcome measure of the study is -need for recovery after work-. Secondary outcome measures are coping with hearing impairment, distress, self-efficacy, psychosocial workload, job control, general health status, sick leave, work productivity, and health care use. Outcome measures will be assessed by questionnaires at baseline, and 3, 6, 9, and 12 months after baseline. The economic evaluation will be performed from both a societal and a company perspective. A process evaluation will also be performed.

DiscussionInterventions addressing occupational difficulties of hearing impaired employees are rare but highly needed. If the VEP integrated care programme proves to be cost- effective, the intervention can have an impact on the well-being of hearing impaired employees, and thereby, on the costs for the company as well for the society.

Trial registrationNetherlands Trial Register NTR: NTR2782

KeywordsHearing loss -Need for recovery after work- Economic evaluation Psychosocial problems Occupational physician Integrated care Intervention AbbreviationsASEattitude, social influence and self-efficacy

BCAbias corrected and accelerated bootstrapping


CEACcost-effectiveness acceptability curves

CPHIcommunication profile for the hearing impaired questionnaire


dB SNRdecibel signal-to-noise ratio


ENTear nose and throat

GPgeneral practitioner

GSESgeneral self-efficacy scale

HDShearing and distress screener

ICERincremental cost-effectiveness ratio

ICFinternational classification of functioning: disability and health

JCQjob content questionnaire

JDCjob demand control

MICEmultivariate imputation by chained equations method

NFRneed for recovery

NVABDutch board for occupational medicine

OHSoccupational health services

OPoccupational physician

PHSperiodical health screening

PRODISQproductivity and disease questionnaire

PSQOHpatient satisfaction with occupational health services questionnaire

SNRsignal to noise ratio

SRTspeech reception threshold

VASvisual analogue scale

VEPvocational enablement protocol

WHOWorld Health Organization

4DSQfour dimensional symptom questionnaire.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-12-151 contains supplementary material, which is available to authorized users.

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Autor: Arjenne HM Gussenhoven - Johannes R Anema - S Theo Goverts - Judith E Bosmans - Joost M Festen - Sophia E Kramer


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