Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Doctor of Philosophy


Health and Rehabilitation Sciences


Mary Beth Jennings

2nd Supervisor

Margaret Cheesman

Joint Supervisor


Workers who wish to remain employed should be supported in doing so, even if they are experiencing age-related disabilities, such as hearing loss. I aimed to better understand the strategies from which workers with hearing loss might benefit, and how they can be supported in adopting these strategies. To collect rich data, I recruited telepractice nurses who rely on listening to make critical decisions about triaging and health care recommendations. My first research question was: What strategies exist for making telephone speech more intelligible for health care providers and patients with hearing challenges? I performed a scoping review following the Joanna Briggs Institute’s protocol. I identified 11 types of strategies, many of which required cooperation from, and disclosure to, providers’ employers, co-workers, and clients. This led me to consider the public narrative workers associated themselves with when they disclosed. Thus, my second research question was: How do Canadian newspapers portray workers with hearing loss? Through a thematic analysis of newspapers articles on this topic, I found they are predominantly portrayed as striving cheerfully both towards functioning normally and towards differentiating themselves and their hearing loss as unique and positive. To further explore how a subset of adults with hearing loss strive to work with a hearing loss, I developed an online communication-strategies training program tailored to nurses with hearing challenges. I then used a multiple case study to answer the following research question: How do nurses with hearing challenges change in terms of their telephone performance and workplace wellbeing in response to participation in an online communication strategies training program? Results suggested that nurses engaged in a problem-solving process before adopting strategies, and that strategy adoption could positively contribute to their performance. Together, the findings from these studies suggest that strategies exist to enhance the performance of workers with hearing loss, but the process of adopting these strategies can be demanding. Organizations should take steps to proactively support their nurses, health-care providers, and potentially other workers with hearing loss in identifying communication strategies and adapting them to their unique context.