Table 4

Themes and examples of participants’ quotations

ThemesExamples of participants’ quotations
1. Decision-making process
“We are [Arabic-speaking migrants] are known to have the ‘wait and see’ mentality. I knew something was wrong with me. But I did nothing about it. I was feeling a bit of blurry eyes when I woke up in the morning and sometimes I was feeling thirsty. It didn't occur to me that I might be diabetic.” ASP-31
“I felt tired and had leg cramps, but I ignored these symptoms for a long time. One must not run to see a doctor unless he is very sick. You know it's quite different for us [men]; we have not to appear very cautious about screening and check-ups. To do so it's not very manly.” ASP-44
“I felt tired and unwell, so I thought I better go to my GP and have a check-up. He did few tests and I was told I have diabetes.” ESP-92
“I felt tired, and kept going to toilet, I suspected that I have diabetes…I went to my GP and after few tests I was informed that I have diabetes.” ESP-76
“I don't think it's a good practice for one to ‘self-diagnose’, doctors know better. In fact they are the experts. So I see it as no brainer if one feels sick to go to GP immediately to get examined.” ESP-69
2. Barriers and enablers to access of healthcare services
2a. Influence of significant other(s)“In our culture it's a very common practice for people to share their stories and life experiences and involve those we trust. This sharing is part of social bonding…prior making any key decisions, we [Arabic-speaking migrants] often ask our close friends or a senior family member about what is the best course of action including health-related decisions. I remember when I first had symptoms like feeling tired, lack of energy, and losing weight I talked with my mother in law and she advised me that all these symptoms are because of stress and I shouldn't be worry. She even advised me to use certain herbal treatment to boost my energy levels and increase immunity…after a long time, and when the symptoms get worse I went to a doctor, and he told me that I have diabetes.” ASP-13 “I had some symptoms and I suspected it could be diabetes. My husband encouraged me to see our GP and have a check-up. He rang GP practice and organised an appointment. GP did few tests and he told me that I have diabetes.” ESP-71
“I knew something was wrong with me. I kept going to toilet and I was very tired most of the time. I had a chat with my best friend about these symptoms and his advice at the time was just get some rest and he told me not to worry. I didn't want to go to a doctor just for a check-up. If a man start to be worried or concerned about his health, then he will be perceived as being ‘soft’ or ‘feminine’. I can't imagine myself saying to my wife, for example, that tonight I'm going to see a doctor for a check-up as I'm feeling tired and generally unwell!! She would laugh at me…” ASP-16
2b. Religious and sociocultural beliefs“I knew I had some symptoms, and I should have gone to see a doctor. But, I preferred not to. I was afraid of being ‘officially’ told I have diabetes, because then I would be responsible for my own health. I preferred not to know, and hoped that these symptoms to go away.” ASP-6
“For us [Arabic-speaking migrants] diabetes is such a big thing that sometimes one would prefer to suffer rather than being told to have diabetes. People in our community consider diabetes to bring lots of other diseases with it and it severely diminishes one's health status. I suspected that I have diabetes, but I just delayed going to doctor! I basically I was just buying more time!…Now I knew better, I wish time goes back and acted more quickly.” ASP-38
“I had symptoms for quite some time, and I ignored them. I don't see the point of running to see a doctor and get examined. In this life time, Allah [God] determines everything…I was meant to have diabetes. So what is the big fuss about going for check-ups or have blood tests we will die when we suppose to not earlier and not before!” ASP-3
“Having an illness, in my case it's diabetes, and to experience physical suffering is not a bad thing! Having an illness and suffering is a ‘sign’ of being close to Allah (God)…the closer the person the more challenges/he will experience!”ASP-13
“I have diabetes now for many years. My health is generally weak! I'm happy to put up with physical suffering by being ill. The closer the person to Allah [God] the more challenges he experience. Suffering through illness is a way of living in a state of remembrance to Allah.” ASP-5
2c. Perception of healthcare providers“I like [Dr-XY an Arabic-speaking GP], he really understands me. I can talk to him about my ‘real’ concerns, life situations, and problems. I never felt that he judged me. I feel safe with him, maybe because he speaks the same language and have the same cultural background. When he goes overseas, I don't see any other doctor, even if I needed to!” ASP-15
“I don't like to come here [diabetes outpatient clinic], doctors here are strict. I usually feel anxious prior seeing specialists. They demand more things to do, and sometimes suggest increasing doses of my diabetes pills or adding insulin.” ASP-17
“I trust my GP more [compared with specialist], I can talk to her without the need for an interpreter, she gets me. I came here [diabetes outpatient clinic] just because I had to.” ASP-59
“I trust specialists here [diabetes outpatient clinic], they are very knowledgeable…I have received really good medical care. I have a great respect for them.” ESP-80 “My GP always looks after me. She is the best; I try to follow her instructions as much as possible. I have been seeing her for the last 15 years. If I have any health problem, symptoms or in pain I go to see her immediately.” ESP-83
2d. Knowledge about available health services“When sometimes I hear people talk about diabetes care services, I have no idea what do they mean? I just go to see my Arabic-speaking GP. Are there other medical services?” ASP-8
“It's difficult for us [Arabic-speaking migrants] to figure things out when it comes to health system. Everything is in English, it's not that easy.” ASP-5
  • ASP, Arabic-speaking participant; ESP, English-speaking participant; GP, general practitioner.