Health Resilience in Arabic-speaking Adult Refugees With Type 2 Diabetes: A Grounded Theory Study During the COVID-19 Pandemic

OBJECTIVES

This qualitative study aimed to describe the lived experiences of Arabic-speaking refugees in managing their type 2 diabetes mellitus (T2DM) while resettling during the COVID-19 pandemic, and to generate a grounded theory of how resilience is used to facilitate living well while facing multiple health stressors.

METHODS

A grounded theory approach was used to conceptualize the dynamic process of resilience in living well with diabetes. Five recently resettled adult refugees with T2DM (2 women and 3 men) participated in unstructured individual interviews in Arabic in New Brunswick, Canada, during the pandemic's second wave (October 2020 to March 2021). Interview data were transcribed and analyzed thematically using open, axial, and core category coding followed by member checking.

RESULTS

Participants identified self-reliance as the core driver for decision-making, actions, and interpretations in health management while experiencing unplanned instability. The process was found to be facilitated by 4 distinct constructs: knowledge seeking, positive outlook, self-care, and creativity.

CONCLUSIONS

The substantive model derived from this study supports a strengths-based approach to clinical assessment and care of refugees with T2DM, notably during disrupted access to primary and preventive services due to forced resettlement and pandemic mitigation measures. More research is needed to increase understanding of how self-reliance can be optimized in resilience-promoting interventions to facilitate diabetes management among populations in posttraumatic circumstances.

Patients' Journey Toward Engagement in Self-Management of Diabetic Foot Ulcer in Adults With Types 1 and 2 Diabetes: A Constructivist Grounded Theory Study

OBJECTIVES

Our aim in this study was to develop the first theory that could explain the processes of engagement in self-management for adults with diabetic foot ulcer (DFU).

METHODS

A constructivist grounded theory, informed by Charmaz, and symbolic interactionism were used to guide the study design.

RESULTS

The findings from 30 study participants with active DFU draw attention to the complexity that exists for individuals seeking to balance life and manage their diabetes and DFU. The categories/phases and set of associated concepts comprise the theory known as The Journey Toward Engagement in Self-Management. This theory consists of 5 phases: 1) perception of illness, 2) noticing foot changes, 3) realizing seriousness, 4) beginning to learn about self-management and 5) engaging in self-management. The theory's phases describe the processes of engagement in self-management from participants' unique experience of living and managing DFU.

CONCLUSIONS

The results show the pathways taken by participants to learn about self-management practices and how engagement in day-to-day management of DFU occurred. Engagement in self-management of an active DFU is complex and a developmental process that differs from participant to participant and changes over time. Although most participants preferred to take a more passive role in self-management of DFU (seen in phase 4), others demonstrated confidence to advance to another stage (seen in phase 5). At the advanced stage, they took an active role in self-management by expressing their needs and preferences, and were involved in their own care and decision-making related to treatment options.

Retirement Transitions among Baby Boomers: Findings from an Online Qualitative Study

ABSTRACTCanadian baby boomers began turning 65 - traditional retirement age - in 2011. How this generation perceives and experiences retirement may differ from preceding generations. In this online, grounded-theory study, 25 baby boomers who were approaching retirement or had recently retired participated in a multi-author blog about their retirement experiences and processes. We collected additional data via subsequent focus groups and participant interviews. Participants retired in several ways, including ceasing work, adopting casual or part-time work, and adopting new types of work. Findings highlighted three phases of the retirement transition: pre-retirement, characterized by both apprehension about retirement and idealization of the perfect retirement; the initial transition, which participants compared to an extended vacation, but in which they also struggled to adjust to increased amounts of free time; and mid-transition, when participants learned to balance structure and flexibility. Findings suggest that despite retirement transition challenges, many people have positive experiences with this transition.

Normalization of Neglect: A Grounded Theory of RNs' Experiences as Family Caregivers of Hospitalized Seniors

Often older people, while maintaining a level of independence, rely on family members to provide care and assistance. Caregivers who are also registered nurses (RNs) may provide a different perspective around the experience when their older relative is admitted to acute care. The aim of our research was to investigate and develop theory regarding nursing care provision as described by RNs, who were family caregivers to older adults, when that older adult was admitted to acute care. Over a six-month period in 2011, RNs meeting this criterion (n = 12) were interviewed individually. We identified two central categories: "Culture of Neglect" and "Vigil by the Bedside". The core category "Normalization of Neglect" was identified as the theory, grounded in the data the participants provided which described a culture of neglect that had normalized poor nursing care. These findings highlight the issue of neglect and abuse, and further investigation is warranted.