Question

ARAB CASE STUDY

Mrs. Ayesha Said is a 39-year-old Muslim Arab housewife and mother of six who immigrated to the United States from a rural town in southern Iraq 2 years ago. Her mother-in-law and her husband, Mr. Ahmed Said, accompanied her to the United States as participants in a post–Gulf War resettlement program, after they spent some time in a Saudi Arabian refugee camp. Their relocation was coordinated by a local international institution that provided an array of services for finding employment, establishing a household, enrolling the children in public schools, and applying for federal aid programs.

Mr. Ahmed, who completed the equivalent of high school, works in a local plastics factory. He speaks some English. He plans to attend an English-language class held at the factory for its many Iraqi employees. Mrs. Ayesha, who has very little formal schooling, spends her day cooking and caring for her children and spouse, with the assistance of her mother-in-law. She leaves their home, a three-bedroom upper flat in a poor area of the city, only when she accompanies her husband shopping or when they attend gatherings at the local Islamic center. These events are quite enjoyable because most of those using the center are also recently arrived Iraqi immigrants. She also socializes with other Iraqi women by telephone. Except for interactions with the American personnel at the institute, Mr. Ahmed and Mrs. Ayesha Said remain quite isolated from American society. They have discussed moving to Detroit because of its large Arab community.

Four of the Said children attend public elementary schools, participating in the English as a Second Language (ESL) program. Mr. Ahmed and Mrs. Ayesha are dismayed by their children’s rapid acculturation. Although Muslims do not practice holidays such as Halloween, Christmas, Valentine’s Day, and Easter, their children plead to participate in these school-related activities.

Mrs. Ayesha is being admitted to the surgical unit after a modified radical mastectomy. According to the physician’s notes, she discovered a “lump that didn’t go away” about 6 months ago while breast-feeding her youngest child. She delayed seeking care, hoping thatinshallah, the lump would vanish. Access to care was also limited by Mrs. Ayesha’s preference for a female physician and her family’s financial constraints—that is, finding a female surgeon willing to treat a patient with limited financial means. Her past medical history includes measles, dental problems, headache, and a reproductive history of seven pregnancies. One child, born prematurely, died soon after birth. As you enter the room, you see Mrs. Ayesha dozing. Her husband, mother-in-law, and a family friend, who speaks English and Arabic and acts as the translator, are at her bedside.

Study Questions

1.Describe Arab Americans with respect to religion, education, occupation, income, and English-language skills. Compare the Said family with Arab Americans as a group.

2.Assess the Said family’s risk for experiencing a stressful immigration related to their isolated lifestyle.

3.Describe the steps you would take to develop rapport with Mrs. Ayesha and her family during your initial encounter. Include nonverbal behavior and social etiquette as well as statements or questions that might block communication.

4.Identify interventions that you would employ to accommodate Mrs. Ayesha’s “shyness” and modesty.

5.You notice that, although Mrs. Ayesha is alert, her husband and sometimes her mother-in-law reply to your questions. Interpret this behavior within a cultural context.

6.Although Mrs. Ayesha is normothermic and states her pain is “little,” Mr. Ahmed insists that his wife be covered with several additional blankets and receive an injection for pain. When you attempt to reassure him of his wife’s satisfactory recovery, noting as evidence of her stable condition that you plan to “get her up” that evening, he demands to see the physician. Interpret his behavior within a cultural context.

7.Discuss Arab food preferences as well as the dietary restrictions of practicing Muslims. If you filled out Mrs. Ayesha’s menu, what would you order?

8.When you give Mrs. Ayesha and her family members discharge instructions, what teaching methods would be most effective? What content regarding recovery from a mastectomy might most Arab Americans consider “too personal”?

9.Identify typical coping strategies of Arabs. What could you do to facilitate Mrs. Ayesha’s use of these strategies?

10.Discuss predestination as it influences the Arab American’s responses to death and bereavement.

11.Discuss Islamic rulings regarding the following health matters: contraception, abortion, infertility treatment, autopsy, and organ donation and transplant.

12.Describe the Arab American’s culturally based role expectations for nurses and physicians. In what ways do the role responsibilities of Arab and American nurses differ?

13.What illnesses or conditions are Arab Americans unlikely to disclose because of Islamic prohibitions or an attached stigma?

14.Compile a health profile (strengths versus challenges) of Arab Americans by comparing beliefs, values, behaviors, and practices favoring health and those negatively influencing health.

Answer 1

1) For many Arab American descendants and the immigrants it is commonly difficult to find a easy way of adapting to a new culture . Most of the Arab Americans retain their traditional culture , language, costumes, food habits and beliefs and values.Mostly they maintain their religious norms and follow them without any hesitation. In this group of people mostly the men are educated with a degree and earn as the major income for their family.Women tend to stay at home mostly looking after the household activities whereas the men try to venture to English classes to help them to be much fluent in the native accent of English.

2) Saids family would be in a stressful immigration as Mr said need to employ himself immediately to meet the family's expenses and his wife Mrs Ayisha who is been diagnosed with the breast lump and a radical mastectomy has to further look after her health and her 4children education and cooking and also looking after her old mother in law.Initially this would be highly stressful by each and everyone in their family to suddenly cope with the new environment and the climatic conditions.

3) Upon keeping Mrs Aiysha S situation in my mind I would make an initial encounter by introducing about myself and my profession and getting a better rapport to their family by speaking well thereby assessing their barriers to communication. If possible I would arrange a female Arabic translator to help me out to solve the issues. Keeping in my mind of their familial and ethnicity I would priory arrange a flash card with pictures on them which would help them to easily speak out their problems.I would also help them to find out some Arabic families as friends which would guide them better and also to better socialize.

4) For in regards to bring Mrs aiysha out of her modesty and shyness I would initially appreciate her behavior to me and others however I would encourage her to ask me more questions regarding her home and surroundings which can help her in some means and also I would take her along with me for a shopping such that she can have a glimpse of how the environment is and no one is ashamed or here to laugh at others mistakes and would encourage her to verbalize to others in regards to shopping thereby gradually moving to other steps of life.

5) upon seeing that Mrs aiysha does not talk much but is taken over by her husband and her mother in law I acccept in seeing this as their cultural norm where the young wife should not actively participate in the initial communication with the others.

6) in this context I would explain Mr Said about his wife's current health condition and the physiological changes after the radical mastectomy and that she is hemodynamically stable in all terms . if he still persists to see for a doctor I have no means to stop them to go further to a doctor and that I would see as this behavior as a purely cultural background question and he is asking out of it.

7) Arab food preferences are mostly non vegetarian which includes mainly of high protein such as poultry and fish and lamb which should be of halal exclusively. I would see whether she has any food allergies and if diabetic and order foods high in protein which would help in reconstructing the worn out tissues after mastectomy and makes sure she does not have any loss of appetite.

8) I would think that the wound examination must be done by female observation or by her husband only and that post discharge instructions she must have with a female physician which they think could be too personal .

9) main and typical coping strategies of Arab women in this scenario would be their worrying about the future , parental expectations and the sexual life with their partner and the body image disturbance . Hence a positive reassurance must be educated to Mrs Aiysha must be told and to involve more of diversionary therapies such as meeting friends and religion and praying being the mostly used strategy.

10) in the Muslim practice of predestination; it says that a persons action is not caused by what he or she had done but rather the action written by god who already knows all occurrences with thought the framework of time.

11)in regards to contraception it is not forbidden or harmful in the Muslim act as long as it does not cause any physical or mental trauma to both the husband and the wife.Abortion on the other hand is permissible below 4months of gestation however some Muslim scholars state that this is not permissible too. it depends on the countries in which they live but if the foretis going to caus trouble with the health of the mother then abortion is the option.in regards to fertility issues Islam has no problems with dealing with medicines to aid fertility as long as treatment does not involve things that are forbidden in their religious norms.Similarly autopsy is basically forbidden in the Muslim practices as the intrusion of body and violating the beliefs about sanctity of keeping human body complete although this religious doctrine does not strictly forbid autopsy.Organ donation is an individual choice and that it must be purely decided by the individual or by their close family members or their friends.