Background: Type 2 diabetes mellitus (T2DM) requires sustained self-management and, for many people, a deeper psychological reorientation as they integrate the illness into their sense of self. Health identity transformation (HIT) refers to the cognitive, emotional, and behavioral integration through which individuals reconstruct how they understand themselves as a person living with a chronic condition. Although diabetes literature has emphasized adherence and self-management behaviors, the identity work that underpins sustainable behavior change remains underexplored. This study aims to explain the process of HIT and the conditions that shape it among adults with T2DM.
Methods: This qualitative study will use grounded theory. Adults aged 18 years or older with a T2DM diagnosis for at least one year will be purposively recruited from outpatient clinics at a tertiary hospital in Thailand. Data will be collected through semi-structured, in-depth interviews and analyzed using constant comparative methods with iterative sampling, memoing, and theoretical coding to develop an explanatory model of HIT. Ethical approval will be obtained prior to data collection.
Results: The study is expected to generate a grounded model describing stages and mechanisms of HIT in T2DM, including key facilitators (e.g., diabetes education, social support, and self-efficacy) and barriers (e.g., stigma, emotional burden, and competing life demands). The findings will identify clinically actionable leverage points for identity-based and person-centered interventions.
Conclusions: By clarifying how adults with T2DM reconstruct health identity over time, this study will provide a conceptual foundation for nursing and interdisciplinary care to support sustained self-management and more personalized chronic disease services.
