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

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. 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. 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. 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. La présente étude qualitative visait à décrire les expériences vécues par les réfugiés arabophones dans la prise en charge de leur diabète sucré de type 2 (DST2) lorsqu’ils sont venus s’établir pendant la pandémie de COVID-19, et à créer une théorie ancrée sur la façon dont la résilience est utilisée pour favoriser le bien-vivre lorsqu’ils sont confrontés aux nombreux agents stresseurs de la santé. Nous avons utilisé la méthodologie de la théorisation ancrée pour conceptualiser le processus dynamique de la résilience pour bien vivre avec le diabète. Cinq réfugiés adultes atteints du DST2 récemment venus s’établir (2 femmes et 3 hommes) ont participé à des entretiens individuels non structurés en arabe au Nouveau-Brunswick, au Canada, durant la deuxième vague de la pandémie (octobre 2020 à mars 2021). Les données des entretiens ont fait l’objet d’une transcription et d’une analyse thématique au moyen de la codification ouverte et