English abstract
Background: Health is considered to be a fundamental human right internationally. Many
disciplines including nursing, medicine, psychology and sociology have attempted to define
health. However, many definitions, including the historical definition offered by the World
Health Organization do not take into consideration understandings of disease at the molecular,
individual, and societal levels. Most, if not all, definitions have been derived from organizations
or academic perspectives, while few have been developed from the perspective of the public.
Aim: This study was conducted to explain, describe, analyze and interpret the perceptions of
health and illness from the perspective of a sample of Omani men who have T2DM.
Methodology: A qualitative thematic analysis was done using Grounded Theory techniques and
informed by Symbolic Interactionism. Participants were recruited from a tertiary Polyclinic in
one city in Oman and interviewed face-to-face in Arabic. An Arabic demographic questionnaire
designed for the study was administered before the interview which was based on a semi-structured interview guide. Audiotapes were transcribed in Arabic and translated to English.
Transcripts were checked for accuracy and all identifiers were removed. Then the transcripts
were coded and analyzed based on the six steps as described by Braun and Clarke (2006). Data
analysis was influenced by Symbolic Interactionism throughout each step of the process.
Results: Four main themes with multiple subthemes were identified. We entitled Theme 1,
Perceptions and definitions of health, and it had five subthemes including: Definitions of overall
health; impressions of mental health, stress and emotions; health is primarily experienced as
physical; health is something you do; and health is understood in relation to illness. Theme 2 was
titled Factors that facilitate or impede participants' T2DM self-management, had five subthemes
including: Health is a personal experience (my own), actual and expected social support; the lack
of positive cultural / community influences on health; fear as a motivator and as a stressor; and
avoiding knowing about illness. Theme 3 was titled, Personal experiences with healthcare
systems and it had no subthemes. Theme 4 was named, The dynamics between perceptions of
health and self-care actions, and it had 3 subthemes including: Struggling with craving control,
rationalization for less health maintenance (stress at work and no time to exercise), and culture
influenced health beliefs and attitudes about health maintenance.
Conclusions: This study was limited to participants with uncontrolled diabetes. Despite this, they
all verbalized appreciation of health and its importance to their life. Health is a multifaceted
concept that needs to be looked at from different perspectives; it is not solely a responsibility of
individuals or healthcare settings independently. The involvement of individuals, clinics, as well
as government organizations, sites of teaching, and social settings could help strengthen the
health of communities while reducing the burden of chronic illness for people, young and old
