title: Conceptual model for quality of life among adults with congenital or early deafness.
abstract: BACKGROUND
  A conceptual model of health-related quality of life (QoL) is needed to describe key themes that impact perceived QoL in adults with congenital or early deafness.
  
  
  OBJECTIVE
  To revise University of Washington Center for Disability Policy and Research's conceptual model of health promotion and QoL, with suggestions for applying the model to improving programs or services that target deaf adults with early deafness.
  
  
  METHODS
  Purposive and theoretical sampling of 35 adults who were born or became deaf early was planned in a 1-year study. In-depth semi-structured interviews probed deaf adult participants' perceptions about quality of life as a deaf individual. Data saturation was reached at the 17th interview with 2 additional interviews for validation, resulting in a total sample of 19 deaf adults. Coding and thematic analysis were conducted to develop the conceptual model.
  
  
  RESULTS
  Our conceptual model delineates the relationships between health status (self-acceptance, coping with limitations), intrinsic (functional communication skills, navigating barriers/self-advocacy, resilience) and extrinsic (acceptance by others, access to information, educating others) factors in their influence on deaf adult quality of life outcomes at home, college, work, and in the community.
  
  
  CONCLUSIONS
  Findings demonstrate the need for the programs and services to consider not only factors intrinsic to the deaf individual but also extrinsic factors in enhancing perceived quality of life outcomes among people with a range of functional hearing and language preferences, including American Sign Language.
authors.affiliation: Chester F. Carlson Center for Imaging Sciences, Rochester Institute of Technology, 76-3270, 54 Lomb Memorial Drive, Rochester, New York 14623, USA. Electronic address: poorna.kushalnagar@mail.rit.edu.
authors.forename: Poorna
authors.initials: P
authors.lastname: Kushalnagar
authors.affiliation: Department of Family Medicine, University of Michigan, USA; Department of Public Health Sciences, University of Rochester, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: McKee
authors.affiliation: Department of Public Health Sciences, University of Rochester, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Smith
authors.affiliation: National Technical Institute for the Deaf, Rochester Institute of Technology, USA.
authors.forename: Melinda
authors.initials: M
authors.lastname: Hopper
authors.affiliation: National Technical Institute for the Deaf, Rochester Institute of Technology, USA.
authors.forename: Denise
authors.initials: D
authors.lastname: Kavin
authors.affiliation: Department of Audiology and Speech Pathology, University of Arkansas at Little Rock, University of Arkansas for Medical Sciences, USA.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Atcherson
mesh_terms: D022126:Access to Information; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D003638:Deafness / Q000523:psychology; D004651:Employment; D005260:Female; D006304:Health Status; D034381:Hearing Loss; D006801:Humans; D008297:Male; D008875:Middle Aged; D019986:Persons with Hearing Disabilities / Q000523:psychology; D011788:Quality of Life; D012111:Residence Characteristics; D012813:Sign Language; D012931:Social Environment; D014495:Universities; D055815:Young Adult
keywords: Cochlear implant; Deaf or hearing loss; Hearing aid; Quality of life; Sign language