Omani Adults’ Experiences and Perceptions of Living with Heart Failure: A Classic Grounded Theory Study

Abstract

Background: Heart failure (HF) is a major public health issue, leading to high mortality and morbidity rates around the world. Despite the increasing number of people with HF in Oman, to date there is no published qualitative study from the Gulf region exploring the experiences and perceptions of people with the condition. Research question: This study aims to answer the question of: What are Omani adults’ experiences and perceptions of living with heart failure?’ Methods: Employing classic grounded theory, a sample of 21 adults with HF were recruited from secondary and tertiary hospitals in Oman. The sampling methods involved purposive sampling, followed by theoretical sampling. Semi-structured telephone interviews were used to collect data for this study between October 2020 and December 2021. Data analysis was conducted concurrently with the data collection process and included a classic grounded theory coding process, constant comparison and memo writing. Findings: Data analysis generated sub-core categories regarding the participants’ perceptions of symptoms onset and experience of diagnosis, living with heart failure: searching for hope and alternative meanings, and living with heart failure – perceived threats to the social self and gender roles. When the participants were experiencing their HF for the first time, they rationalised their symptoms as normal or familiar and were unaware that their symptoms were due to an underlying medical condition. This led to delay in seeking medical help. After a diagnosis of HF, the process of searching for hope and alternative meanings started, in which the participants tried to find hope of being cured of HF by believing that it was caused by supernatural power and/or was Allah’s (God) will. The participants perceived HF as a threat to their social selves and gender roles, which they tried to maintain despite symptoms of HF. The data led to the emergent theory of ‘negotiating continuity of the social self’. Discussion: The emerging theory involved one core category of ‘saving the social self’, which represents the participants’ main concern, and three sub-core categories that explained the participants’ experiences and perceptions of living with HF: ‘Perceptions of symptoms onset and experiencing diagnosis’; ‘Living with heart failure: searching for hope and alternative meanings’; and ‘Living with heart failure: perceived threats to the social self and gender roles’. These sub-core categories contained 14 interrelated categories and showed how the participants were trying to save their social selves throughout their experiences of living with HF. Conclusion: This study provides a novel understanding and insights into Omani adults’ experiences and perceptions of living with HF, which were found to be influenced by their Omani cultural and social expectations as well as Islamic beliefs. The study’s findings could help healthcare professionals to understand patients’ experiences and perceptions towards their lives with HF and plan comprehensive care plans that are oriented to Omani traditional and Islamic beliefs. The emerging theory could be tested in other contexts to determine its transferability to other settings.

Date of Award	7 Nov 2023
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Hannah Cooke (Supervisor) & Janice Christie (Supervisor)