The term, job demands, relates to job characteristics that incur effort-related costs on the employee (Bakker & Demerouti, 2018). Such costs are described as taxes that employees inherit as charge for their involvement in the job environment (Boudrias et al., 2011). Therefore, job demands entail those aspects of a job that incur sustained efforts from an employee (Bakker & Demerouti, 2017). The more taxing job demand-related matters are, the more prolonged the mandatory level of effort that will be required from the employee (Sonnentag & Zijlstra, 2006). While job demands primarily cost energy from the employee (Bakker & Demerouti, 2014), they also have the positive effect of strengthening the motivational effect of job resources (Bakker & Demerouti, 2017). However, unmanaged job demands have the potential to take an employee beyond exhaustion towards health impairment (Bakker & Demerouti, 2017) and, ultimately, to a point of eliciting self-undermining behaviour (Bakker & Demerouti, 2014).

Consequently, job demands are noteworthy predictors of employee outcomes such as exhaustion, psychosomatic health complaints and repetitive strain injury (Bakker & Demerouti, 2014), accidents and injuries, adverse events, depression, negative work–home interference, physical ill health and unsafe behaviours (Schaufeli & Taris, 2014). While some job demands have a general application such as workload, others are unique to the context, for example, physical and/or psychological demands (Bakker & Demerouti, 2014).

South Africa’s Department of Labour (2015) classifies hearing impairment as a physical impairment incurred because of ‘partial or total loss of a bodily function’ (pp. 8, 11). ‘Normal’ hearing is typically used to refer to hearing thresholds of 20 dB or better in both ears (WHO, 2021). Hearing impairment refers to hearing acuity outside the standard range (Edwards & Crocker, 2008).

The stage of hearing loss onset can be distinguished as congenital (incurred during birth or acquired soon thereafter) or acquired (hearing loss onset at a stage later than the congenital). A case of acquired hearing loss can be further classified as either pre-lingual or post-lingual. In a case of pre-lingual onset, hearing loss occurred before the individual acquired speech and language skills; in a case of postnatal onset, the hearing loss occurred after the individual acquired speech and language skills. Hearing loss can also be categorised in terms of whether it occurred to only one ear (unilateral hearing loss) or both ears (bilateral hearing loss). Furthermore, a case of bilateral hearing loss can be categorised in terms of whether the degree of hearing loss is equal among the ears (symmetrical) or not (asymmetrical) (Centres for Disease Control and Prevention [CDC] 2021).

Degree of hearing impairment can range from mild hearing loss to total hearing loss or deafness (WHO, 2021). The WHO’s earlier framework for classifying the severity of hearing loss (WHO, 2016) suggested that hearing loss, applied to the better ear, will count as slight if it is amid the range of 26 – 40 dB; moderate if within the range of 41 – 60 dB; severe for the range of 61 – 80 dB; and profound if equivalent to or more than 81 dB. Accordingly, hard-of-hearing (HoH) refers to hearing loss ranging between mild and severe; ‘deaf’ refers to profound hearing loss (Table 1).

The WHO’s (2021) latest framework includes more subcategories and suggests that communication-related assumptions can be made about each.

Prevalence of hearing impairment is said to be constantly increasing on a global scale, with Africa being among the regions expected to experience the highest increase, to the extent of more than doubling (WHO, 2021). In South Africa, the last reported prevalence rate of hearing impairment was estimated at 3.6%, making it the third highest reported disability after vision (11%) and cognitive disability (4.2%) (Statistics South Africa, 2011). Hearing impairment among South Africans was found to be mainly prevalent in the age group of 35–39 years, and the majority of individuals with hearing impairment were found to be beyond the retirement age of 65 years. In the age groups preceding 35–39 years, only approximately 2% of South Africa’s people were found to be hearing-impaired. However, the count of South Africans with severe hearing loss was found to constitute approximately 1% of the country’s population.

Hearing impairment has often been referred to as an ‘invisible disability’, not just because of the lack of visible symptoms, but for reasons including that it has long been overlooked by policymakers. The extent to which hearing loss impacts a person’s life depends significantly on contextual factors, such as attention towards communication needs and environmental factors. Management thereof through effective rehabilitative interventions will require attention to particular needs. However, relevant depth of insight may be lacking, thereby restricting the intervention that can be provided towards persons with hearing impairment (WHO, 2021).

A definition of EwHI was not found in the literature. However, a classification was developed by integrating the above description of hearing impairment (CDC, 2021; Edwards & Crocker, 2008; WHO, 2015) into the definition of an employee provided by section 200A(1) of South Africa’s Labour Relations Act (No. 66 of 1995: LRA). Section 200A(1) states that, until an opposing case is proven, an individual who works for or renders service to another party is regarded as an employee, notwithstanding the form of the employment contract.

In light of the discussion above, the term EwHI therefore refers to an individual with a hearing impairment who works for or renders a service to another party, irrespective of the type of employment contract.

In addition to the introductory discussion about the health impairment trend among EwHIs, international studies also suggest disengagement and self-undermining behaviour among EwHIs. Employees experiencing hearing loss are said to be more likely to occupy jobs that do not require high levels of skill (Hogan, O’Loughlin, Davis, & Kendig, 2009); however, Tye-Murray, Spry and Mauzé’s (2009) findings included EwHIs reporting to believe to have lost their competitive edge. Furthermore, hearing impairment is associated with a higher risk of early retirement (Helvik, Krokstad, & Tambs, 2012; Kramer, 2008).

Literature covering EwHIs in South Africa was found to be limited. Statistics South Africa (2011) states that in South Africa persons with disabilities face barriers to entering the labour market, and those whose impairments are more severe face the most obstacles. The most prevalent barriers include insufficiency of information about disability and lack of support in work environments Furthermore, the Department of Labour (2015) reports that persons with disabilities who are employed in South Africa often remain in low-status jobs (Statistics South Africa, 2011).

South Africa’s Department of Social Development (2016) states that while significant progress has been made over the past 20 years in terms of disability consideration in the attitudinal sense, this alone has not proved sufficient. In addition, equity should also be pursued substantively. This includes disability-specific transversal interventions for addressing barriers to participation and creating more enabling environments for persons with disabilities; the ‘one-size-fits-all’ approach is not viable for developing disability policy. Novel local research is required of countries so that they can assess their own requirements and develop interventions most applicable to serving their population’s needs (WHO, 2021).

Job satisfaction among EwHIs is negatively related to on-the-job limitations (Geyer & Schroedel, 1998). Relatedly, commotion and competing speech in the work environment are experienced as complications by EwHIs (Hua, Anderzén-Carlsson, Widén, Claes, & Lyxell, 2015). Likewise, EwHIs indicate that meetings and training activities are problematic because of the experience of commotion (Punch, Hyde, & Power, 2007). Specifically, meetings, in-service training sessions and work-related social events are reported as challenging for EwHIs (Punch, 2016). Moreover, lower levels of efficiency in the dominant language spoken in the workplace are related to higher levels of stress (Van Gils, Van Den Bogaerde, & De Lange, 2010).

Furthermore, the energy and stress levels of EwHIs are negatively affected by noise, the number of people in the room and difficulty to communicate (Lund, 2015). Likewise, valid sick leave days taken are positively correlated with exposure to noise and reverberation as well as the difficulty to distinguish between sounds and effort in hearing (Kramer et al., 2006). Employees with hearing impairments are required to concentrate more when exposed to background noise that causes elevated levels of fatigue and stress (Punch, 2016).

Lower physical functioning and higher perceived effort among EwHIs experiencing conditions of increased noise levels are reported by Hua et al. (2013). In addition, higher levels of noise are found to be more stressful to EwHIs as compared to their hearing colleagues (Jahncke & Halin, 2012). Specifically, increased noise levels are associated with reduced task performance that requires the recall of semantic information, increased fatigue and higher levels of stress hormones (Jahncke & Halin, 2012). These scholars do, however, state that the results should be interpreted with caution because of the small sample size.

In contrast, Van Gils et al. (2010) reported that EwHIs do not experience significantly higher levels of stress. However, EwHIs experience significantly higher degrees of job demands than their hearing counterparts, even though the degree of job control (the level of control an individual has over his or her job, e.g., autonomy) is comparable between the two groups (Van Gils et al., 2010).

From the EwHI job demands literature review, it is clear that the typology of job demands, experienced by EwHIs, is not all represented in the mainstream body of knowledge noted either by Bakker and Demerouti (2017) or Schaufeli and Taris (2014) – namely, the physical, psychological, social or organisational job demands themes. Therefore, an EwHI-focused job demands inquiry is suggested. Furthermore, it is currently unclear how EwHIs in South Africa experience job demands because no local studies that have investigated this phenomenon could be located.

Based on the gap in the literature explained above, the present study qualitatively explored job demands from the perspective of EwHI in South Africa.

A qualitative research approach and descriptive phenomenological research design were used to explore the job demands of EwHIs. Consequently, the study sought to develop a general structure about the lived experiences unique to the EwHIs’ job demands while deriving conclusions from actual empirical samples (Finlay, 2009).

Social constructivism was employed as the paradigm through which the study is viewed. The study presupposed norm-deviant outlooks (Creswell, 2014) among EwHIs regarding workplace factors that they experience as job demands. Therefore, established assumptions and theoretical frameworks were acknowledged, but new perspectives were probed for by allowing EwHIs to describe the subjective interpretations they attach to workplace factors.

An interpretive description was used as the research strategy to guide the researchers in the exploration of the experiences of various participants in a specific social setting (Thorne, Reimer-Kirkham, & MacDonald-Emes, 1997). This strategy was deemed appropriate to explore the job demands experienced by employees with hearing impairment in South Africa. The interpretive description research strategy allows for the conception of a description encompassing the themes and patterns communicated by participants (Thorne, 2008).

Research setting: Workplaces of EwHIs in South Africa served as the research setting. In one organisation, EwHIs represented the majority of the workforce. However, in most of the organisations that participated in this study, EwHIs were in the minority. The researcher used email to make data collection arrangements with willing participants. The self-administered, open-ended qualitative questionnaire for the 5 working days’ data collection was administered in two modes: online or as a Microsoft Word document, based on a respondent’s indicated preference.

Entrée and establishing researcher roles: Following an application to the Research Ethics Committee, consent (EMSMHW16/06/10-01/05) was obtained on 01 September 2016. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Contact was established with a facilitating organisation that specialises in the training and development of hearing-impaired individuals in South Africa. This organisation is linked to EwHIs who work in a variety of organisations and sectors. The human resource (HR) manager of this facilitating organisation disseminated the invitation to participate in the study to EwHIs who fit the inclusion criteria of this study. In addition, the HR manager distributed the invitation to employees within the facilitating organisation who also fit the inclusion criteria. Written informed consent was obtained from all respondents who chose to participate in this study.

The language of the text was simplified in the event that a deaf respondent may possess a basic vocabulary (Spencer & Marschark, 2010). The questionnaires were distributed to participants individually. In addition to textual format, each question was accompanied by a link to an video clip of a South African Sign Language (SASL) translation (e.g. https://www.youtube.com/watch?v=fVXVEvMQjic). The content validity of the questionnaires and validity of the SASL interpretations were verified by an accredited interpreter throughout the development process. Reminders to return the day’s completed questionnaire were sent to the participants daily.

The researchers were responsible for coordinating the processes, obtaining permission from organisations to collect data, securing informed consent from participants, collecting and storing the data, ensuring that ethical standards were adhered to as well as organising, analysing and interpreting the data and reporting the findings.

Research participants and sampling methods: The study participants comprised EwHIs within the South African context. These participants represented various categories of hearing impairment, for example, HoH and deaf.

A purposive sampling was used to ensure that participants who can offer specific insights related to the phenomenon were included (Jensen & Laurie, 2016). The inclusion criteria of this sampling technique concerned having a hearing impairment – in the pre-lingual, post-lingual, unilateral, bilateral and/or HoH or deaf sense – and being employed in South Africa. The attained sample consisted of eight pre-lingually deafened employees, four post-lingually deafened employees and two employees who are HoH (N = 14). Transferability of the results was increased by using purposive sampling with specific inclusion criteria.

Data collection methods: A self-administered, open-ended questionnaire was used to collect data about EwHIs’ job demands experiences. This was the most appropriate data collection technique for the present study because the researchers are not fluent in SASL and using an interpreter could have posed an ethical risk. This decision by the researchers increased the dependability of the study.

The open-ended question for data collection during days 1–4 is presented below: firstly, the text, then the backward translation of the SASL rendition in italics. Note that the backward translation in SASL is slightly different because of a dissimilar grammatical structure as compared to that of English:

The open-ended question for the fifth day’s data collection was preceded by an individualised summary of the first four working days’ responses. Each participant therefore had a chance to check the accuracy of the data and to add additional responses if needed. This member checking strategy increased the confirmability of the study:

The fifth working day’s question aimed to include more cases of job demands, experienced by EwHIs, during a more extended period than reported in the previous four consecutive working days:

In addition, a biographical questionnaire was used to collect information about the sample. Employees with hearing impairments were asked about: the category of hearing loss (deaf or HoH), the stage of onset of the hearing impairment (pre- or post-lingual), the laterality of hearing loss (unilateral or bilateral), gender, industry and whether their workplace predominantly comprises hearing people. Data collected from the biographical questionnaire enabled the researchers to accurately describe the characteristics of the sample, which increased the transferability of the study.

Data collection was initiated as a pilot study. The pilot study indicated that the questions used to probe responses were well understood. No adjustments were required to the questionnaire. Therefore, the researcher proceeded with the main data collection phase on the same basis.

Data recording: Respondents were asked, as part of the invitation, to avoid discussing their responses with any hearing-impaired colleague until after conclusion of the data collection. For each day of the data collection process, a new questionnaire was used. The final copies of the data were transferred to a Microsoft Word file as exact copies of the source texts. This practice increased the dependability of the study. The storage location of the data remained confidential and was not publicly accessible. Data files were saved on a computer hard drive with an encrypted password.

Strategies employed to ensure data quality and integrity: The following strategies, as recommended by Anney (2014), Teddie and Tashakkori (2009) and Shenton (2004), were used to enhance the trustworthiness of the results of this study:

Credibility: this refers to the plausibility of research findings. The researchers enhanced the credibility of this study by using well-established research methods, obtaining thick descriptions of the job demands experienced by EwHI and making use of co-coders.

Transferability: this denotes the generalisability of the results of the study and the extent to which the findings can be applied to related contexts. The use of purposive sampling with inclusion criteria and by accurately describing the characteristics of the sample increased the transferability of this study.

Confirmability: this implies that strategies are put in place to ensure that results are a true reflection of the data collected. The researchers eliminated bias by allowing the respondents to inspect their individual responses after 4 days of data collection, thereby verifying the quality of the data. In addition, the researchers co-coded the data to guard against interpreter bias.

Dependability: this refers to fidelity of the findings over time. The researchers enhanced the dependability of the study by providing in-depth and clear descriptions of the respondents’ experiences and by explaining the decisions of the researchers regarding the procedures followed.

Data analysis: Data analysis was aimed at capturing job demands categories without being anchored by previously defined job demands structures or knowledge – as prior research about job demands of EwHI is not extensive. Accordingly, an inductive qualitative content analysis process, as recommended by Elo and Kyngäs (2008), was adopted to analyse the data. This decision of the researchers enhanced the credibility and transferability of the study. The phases of this process are explicated below:

Preparation: The researchers immersed themselves in the qualitative data and climate of the texts. Consequently, the responses were read through several times.

Open coding: The researchers used the brainstorming technique to derive potential labels to the texts. In addition, the researchers co-coded the data to ensure credibility and confirmability

Creating categories: The individual labels were grouped, and a structure of overarching themes, and subthemes, was established.

Abstraction: Titles were inductively assigned to themes and subthemes – without reverting to established classifications.

Reporting: A thorough narrative discussion was provided about the data analysis process and the conceptual model that emerged.

Reporting style: The themes and subthemes that emerged from the data analysis are delineated in the results section of this study. Reporting was done in the form of a qualitative narrative, providing a rich and thick description of the job demands experienced by EwHIs in South Africa. This narrative was substantiated by direct quotations from the participants. This practice enhanced the credibility of the study.

Respondents indicated that a non-hearing-impaired person’s rate of speech can be experienced as too quick. Therefore, an HIE may find it difficult to follow what is being said and/or to respond at a reciprocal rate. This experience is illustrated in the following excerpt:

The participants shared that misunderstandings in the workplace occur often, even if the organisation has basic Sign Language capabilities. The quotation below by participant 4 illustrates this effort-inducing job demand:

The experience of having to explain a work-related issue repeatedly emerged from the data. Participants in this study found the process of repetitive explanation exhaustive. This taxing experience is substantiated by the following excerpt:

In support of this view, participant 9 explained that:

The subtheme of communication commotion was extracted from descriptions of cases where EwHIs found themselves surrounded by several instances of communication, making it difficult to follow the discussion directed at them. The following response illustrates this job demand:

Furthermore, participant 6 added the following:

The communication gap subtheme highlights the prolonged hindrances experienced by EwHIs regarding communication with task associates or clients. Participants indicated that they had to find different ways to communicate with people and this takes a great deal of effort. The following excerpt illustrates the communication gap experienced by EwHIs:

In support of this view, participant 8 said:

Participants indicated that poor task orientation is experienced as energy consuming. The following quotation by participant 4 substantiates this view.

Moreover, participant 6 added that:

The lack of motivation among subordinates is another task hindrance that takes effort from EwHIs who participated in this study. The following extract supports this statement:

This view is supported by participant 9, who shared that:

Some participants experience an inquiry from a higher authority as energy consuming. This experience is illustrated in the following quotation:

In support of this view, participant 4 stated that:

Employees with hearing impairments participating in this study indicated that being pressured by someone in a managerial position to be inventive (creative output) is draining. Participant 4 shared the following instruction to him from his manager:

Another example of creative output requiring considerable effort from an HIE is:

Interruption of the task process takes considerable effort from some participants of this study. An example of such an interruption while the HIE is performing a task is presented in the following quotation:

Some participants reported that travelling is experienced as energy depleting. The following excerpt supports this statement:

Also relating to travelling, participant 14 reported that:

One participant indicated that taking on additional work, because their subordinate did not deliver the required service, was energy consuming. The following quote conveys the point clearly:

In another case, a subordinate did not complete a task:

Some participants stated that co-workers fail to take on personal responsibility as part of the team. This behaviour of co-workers causes prolonged disappointment on the part of the participants. The following extract conveys a feeling of distress:

Some participants indicate that the lack of cooperation from management is emotionally exhausting. This point is illustrated by the following excerpt:

Participants stated that situations occur in the workplace where undue pressure is placed upon them to perform without taking their point of view or auditory disability into consideration. This view is supported by the following extract:

In addition, a quotation from participant 6 can be offered in support of the statement:

Some participants noted that unreasonable confrontation in the work environment is experienced as energy sapping. The following two instances entail EwHIs who are hastily reprimanded by an ill-informed party:

Participant 7 added:

Participants shared emotionally draining experiences where they received feedback from individuals who showed no empathy or consideration towards the realities of having a hearing impairment:

This view was supported by participant 4 who added that:

Some participants indicated that the delayed comprehension of subordinates requires prolonged effort on the part of EwHIs. Participant 5 explained this finding in the following quotation:

Participant 5 added the following:

Participants shared that the lack of perspective shown by some co-workers is another source of energy depletion. This experience is evidenced by the following response:

This view was shared by participant 7, who added the following: