Exploring the Professional Quality of Life of South African Audiologists

Abstract

Background: South African audiologists are faced with challenges in their clinical practices which are unique to the South African context, exacerbated by the significant increases in patient caseloads whilst practising in resource-deprived healthcare facilities. There appears to be sparse research regarding South African audiologists' professional quality of life and its association with various demographic variables, and unexplored research regarding the influence of resilience on South African audiologists’ professional quality of life (ProQOL), especially in South Africa. Purpose: To explore the professional quality of life of South African audiologists working in various clinical settings. Objectives included: 1.) To measure and describe the level of compassion satisfaction, compassion fatigue, burnout and secondary traumatic stress among South African audiologists, 2.) To determine the association of the professional quality of life variables among South African audiologists (compassion satisfaction vs compassion fatigue, compassion satisfaction vs burnout, compassion satisfaction vs secondary traumatic stress, compassion fatigue vs burnout, compassion fatigue vs secondary traumatic stress, burnout vs secondary traumatic stress), 3.) To determine the association between the professional quality of life of South African audiologists and other variables such as demographic variables, 4.) To explore the influence of resilience on South African audiologists’ professional quality of life, 5.) To explore the perceptions of available resources to improve their professional quality of life, and 6.) To explore strategies that South African audiologists may use to improve their professional quality of life. Participants: A non-probability purposive sampling strategy was used to select participants. The participants included South African audiologists who are registered with the Health Professions Council of South Africa (HPCSA) and practising in any setting. Methods: A two-phase explanatory sequential mixed methods research design was utilised. In the first phase, the quantitative cross-sectional survey design was employed using the ProQOL scale to collect data. The ProQOL was distributed online using REDCap, while the qualitative explanatory aspect was conducted in the second phase using online semi-structured interviews. In the first phase, Data was analysed using SPSS version 29, with descriptive statistics used to summarise the sample and professional quality of life subscales, while inferential tests, including Pearson’s correlations and independent t-tests, explored associations between variables. Normality was assessed using skewness, kurtosis, and histograms, and missing data were imputed based on the most frequent responses for similar items. Braun and Clarke’s reflexive thematic analysis was used to analyse the qualitative aspect of the research. The process of mixing the data occurred at the interpretation stage where the results from both approaches were compared to identify patterns, correlations or contradictions. Results: A total of 73 South African audiologists participated in the quantitative phase (Phase 1) of the study, while 15 audiologists took part in the qualitative phase (Phase 2). The findings revealed that audiologists experience moderate levels of compassion satisfaction (M = 40.18, SD = 7.25) and relatively low burnout rates (M = 24.01, SD = 6.75), though the long-term effects of work-related stress remain unclear. Resilience emerged as a protective factor, with audiologists who demonstrated higher resilience (M = 3.81, SD = 0.91) reporting better emotional regulation, adaptability, and access to support systems. However, workplace challenges such as limited access to mental health resources, high caseloads, and insufficient institutional support negatively impacted professional well-being. Burnout and compassion satisfaction showed a strong negative correlation (r = -0.733, p < 0.001), highlighting the inverse relationship between job fulfilment and emotional exhaustion. Compassion fatigue was strongly correlated with burnout (r = 0.863, p < 0.001) and secondary traumatic stress (r = 0.846, p < 0.001), reinforcing the interconnected nature of these stressors. Unexpectedly, a weak correlation was found between secondary traumatic stress and compassion satisfaction (r = -0.223, p = 0.057), suggesting that exposure to patient trauma does not necessarily diminish job fulfilment. These findings underscore the role of both organisational and personal resources in shaping audiologists' professional quality of life. Conclusion: Current findings highlight the importance of professional quality of life among South African audiologists, emphasising the balance between compassion satisfaction and the challenges of burnout and compassion fatigue. Resilience emerges as a key protective factor, underscoring the need for institutional interventions to enhance workplace support and well-being. Findings suggest that targeted strategies, such as mentorship programmes and stress management initiatives, could mitigate professional stressors and improve career sustainability. The study also calls for future research to explore long-term resilience-building interventions and systemic workplace improvements, ensuring a more supportive environment for audiologists in South Africa.