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1. Psychology is defined as the scientific study of behavior. (the
psychology majors handbook). Though I feel most TV shows
and or movies have some form of a psychological based plot,
because its so broad. However I want to focus on a TV show
called "The Good Doctor". This is a series about a doctor who is
on the Autism spectrum. Autism refers to a broad range of
conditions characterized by challenges with social skills,
repetitive behaviors, speech and nonverbal communication...
Autism is a spectrum disorder each person with autism has a
distinct set of strengths and challenges. (what is autism). this
show was my top pick because, taking a look more into
psychology as stated in the text topics of psychology study
includes relationships, the brain and the chemicals that
influence it, visual and auditory perception, human
development, the causes of normative and atypical behavior,
and much more. In the show they focus on the main character
who has autism but is so smart and they show his strengths
analyze the body and research in a different, more in depth way
that the typical doctors do. They show how he is socially
awkward and how the typical doctors may accept him and how
some don't because they feel he has a disorder and doesn't
belong in the medical field. the show touches base on his
difficulty fitting into the culture but also show how he fits in in
his own unique way.
2. The TV show that comes to mind when I think of a TV show
in which psychology played an important role is a show, I am
currently watching called Blindspot. Psychology is a big factor
in this show because a woman had her memory erased and had
herself dropped in the middle of Times Square. When found, she
had tattoos all over her body, which helped the FBI save many
lives. It turns out that she was a part of a terrorist organization
that wanted to bring the country down. With all of that being
said, when she first got to the FBI, they had a psychologist talk
to her to try and help her understand her feelings and help her
engage with the man she had grown to like. In the end, the
psychologist was also a part of the terrorist organization and
was manipulating the woman during her sessions to make her
think she liked the man so she could get close to him because
they needed him to be a part of their plan to bring down the
country. Psychology was also a big factor because growing
closer to the man she liked, who was the assistant director of
the FBI and a good person, he helped her be a better person.
With all of her memory gone he also made her think she was his
best friend who had gone missing when he was a child, when if
fact she was not this little girl at all.
3. When I think of psychology in relation to a tv show or movie,
I think of a Netflix series that I recently watched titled "YOU."
I feel that psychology definitely played a major part in the way
the main character Joe interacted with everyone that he
encountered or had some type of relationship with. The main
character is basically a sociopath that is willing to kill anyone
that he feels is toxic to whoever his girlfriend is at that time,
even going as far as killing his own girlfriends at times. Joe
lives in a distorted reality as he has rationale for everything that
he does even if it's going as far as killing someone, in which he
justifies it within himself as ridding his significant other of
someone that was not good for her. This series allows you to see
how Joe comes off as being very charming but the real him is
very dark and violent but most people never even believe that
he can be anything other than his charming self. This is a great
show to watch and I highly recommend that you all watch it
when you have time as I feel that it can open our eyes to realize
that many people live double lives and are involved with things
that we can't even imagine.
4. A great movie that comes to mind when it comes to
psychology is The Stanford Prison Experiment. In this movie a
college professor placed an ad in the paper asking for
volunteers, mainly men of a certain age group, to participate in
an experiment that would have some of them pretend to be
prisoners and some of them prison guards. The experiment was
taped and showed how the participants adapted and reacted to
their roles. During the course of I believe a week, the
participants became 100% into their roles, with one participant
having to be removed. The participants playing guards became
abusive and the prisoners submissive. After a week the
experiment was stopped. Psychology was a big factor in this
experiment because it showed how each person became the role
they were given and created rules and regulations to associate
with them.
Week_____ discussion questions
Name
Florida National University
Nursing Department
BSN Program
NUR 4636
Date
Prof. Eddie Cruz, RN MSN
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Copyright © 2013 F.A. Davis Company
Appalachians
Larry Purnell, PhD, RN, FAAN
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
OverviewHeritage from England, Wales, Scotland, Ireland,
France, and GermanyCame to the United States for religious
freedom and better economic opportunitiesPurposely isolated
themselves in the mountains to live and practice their religions
as they chose
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Overview ContinuedAppalachia includes 410 counties in 13
states and extends from southern New York to northern
Mississippi.Continuous migration from the country to the city
and vice versaHigh proportion of aging in AppalachiaFarming,
mining, textiles, service industries, etc.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Overview ContinuedHigh poverty and unemployment
ratesOriginally most educated group in America, now some of
the least educated due to isolationArea still lacks infrastructure
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
CommunicationsCarry over from Elizabethan EnglishSpellin for
spellingWarsh for washBadder for bad
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Ethic of NeutralityAvoid aggression and assertivenessDo not
interfere with others’ livesAvoid dominance over othersAvoid
arguments and seek agreementAccept without judging—use few
adjectives and adverbs, resulting in less precise description of
emotions and thoughts
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
CommunicationsSensitive about direct questions and personal
issuesSensitive to hints of criticism. A suggestion may be seen
as criticism.Cordiality precedes information sharing so “sit a
spell” and chat before doing business, which is necessary for
developing trust
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Communication ContinuedA few may avoid direct eye contact
because it can be perceived as aggression, hostility, or
impolitenessMore being than doing oriented, more relaxed
culture and being in tune with body rhythmsBe formal with
name format until told to do otherwise.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Communication ContinuedHealthcare provider must be flexible
and adaptableCome early or late for an appointment and still
expect to be seenFamily lineage is importantFormality with
respect—Miz Florence or Mr. John
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
FamilyVaried decision-making patterns but the more traditional
Appalachian family is still primarily patriarchalWomen make
decisions about health care and usually carry out the herbal
treatments and folk remediesWomen marry at a young age and
have larger families than the other white ethnic groups
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Family ContinuedChildren are accepted regardless of what they
doHands-on physical punishment is commonMotherhood
increases the status of the woman in the eyes of the
communityTake great pride in being independent and doing
things for oneself
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Family ContinuedFamily rather than the individual is the
treatment unitHaving a job is more important than having a
prestigious positionConsistent with the ethic of neutrality,
alternative lifestyles are accepted, they are just not talked
aboutExtended family is the norm
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Biocultural EcologyHigh incidence of respiratory conditions
due to occupationsIncrease of parasitic infections due to lack of
modern utilities in some areasHigh incidence of cancer, otitis
media, anemia, obesity, cardiovascular disease, suicide,
accidents, SIDS, and mental illness
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
High-Risk BehaviorsTobacco is a main farming crop in some
areas of AppalachiaSmoke at a young ageAlcohol use at a young
age—binge drinkingBelieve in the mind, body, spirit connection
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Ten Steps in Seeking Health CareUse self-care practices learned
from mother or grandmotherCall mother or grandmother if
availableThen trusted female family member, neighbor, or a
nurseThen go to OTCs they saw on TVThen use a neighbor’s
prescription medicine
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Ten Steps in Seeking Health Care ContinuedPharmacist or nurse
for advicePhysician or Advanced Practice NurseThen to a
specialistThen to the closest tertiary medical centerDO NOT BE
JUDGMENTAL, if you want to keep them in the system
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
NutritionFood may be synonymous with wealthWide variety of
meats, do not trim the fat—low-fat wild game is also
eatenOrgan meats are commonBones and bone marrow used for
making saucesPreserve with salt
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Nutrition ContinuedLots of frying (using lard or bacon grease)
and picklingAnytime is the time to celebrate with food,
especially in the rural areasMany teens have particularly poor
healthStatus symbol to have instant coffee and snack foods for
some
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Nutrition ContinuedEarly introduction of solid foodsMay feed
babies teaspoons of grease to make them healthy and strongDiet
is frequently deficient in Vitamin A, iron, and calcium
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Childbearing FamilyMust eat well to have a healthy babyDo not
reach over your head when pregnant to prevent the cord from
wrapping around the neck of the fetusBeing frightened by a
snake or eating strawberries or citrus can cause the baby to be
markedUse bands around the belly and asafetida bags
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Death RitualsMust stay with the dying personFamily should not
be left aloneFunerals with personal objects at the viewing and
buried in their best clothesMay take the deceased for viewing at
homeAfter the funeral there is more food and singing and for
some a “wake” to celebrate life
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Death Rituals ContinuedFlowers are more important than
donations to charityParticularly good at working through the
grieving processFuneral directors are commonly used for
bereavementCremation is acceptable and ashes may be saved or
dispersed on the “land”
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
SpiritualityBaptist, Pentecostal, Episcopalian, Jehovah’s
Witness, Methodist, PresbyterianEach church adapts to the
communityMost are highly religious even though they do not
attend churchCommon to attend Sunday and other daysPreacher
has a calling to “preach”Ministers are trained
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Spirituality ContinuedMeaning in life comes from the family
and “living right with God,” which varies by the specific
religious sect Nature is in control—fatalismReligion and faith is
important in a hostile environment I will be there if the “creek
does not rise” or if “God is willing”—fatalism
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Healthcare PracticesGood health is due to God’s WillSelf-
reliance fosters self-care practicesFamily important for health
careMay be very ill before a decision is made to see a
professional resulting in a more compromised health
conditionDirect approaches are frowned upon
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Healthcare Practices ContinuedHerbal medicines, poultices, and
teas are commonSee Table 8–1 in the textbook; these practices
are still alive and wellFolk medicines used in conjunction with
biomedical treatments
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
BarriersFatalismSelf-relianceLack of infrastructureHealth
profession shortagesCulture of “being”Poverty and
unemploymentCare not acceptable from outsiders
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Responses to Health and IllnessTake care of our own and accept
the person as whole individualNot mentally ill, the person has
“bad nerves” or are “odd turned”Having a disability with aging
is natural and inevitable—if you live long enoughMust establish
rapport and trust
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Responses to Health and Illness ContinuedPain is something
that is to be enduredSome may be stoicalPain legitimizes not
working or fulfilling one’s responsibilitiesWithdraw into self
when illCulture of being works against rehabilitation
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Healthcare PractitionersLay and trained nurses and midwives
still provide much of the care in some parts of
AppalachiaBreckenridge Frontier Nursing Service Prefer people
known to the family and community —the insider versus
outsider concept
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Healthcare Practitioners ContinuedCulture of “being” says the
healthcare provider should not give the perception of being
rushedPhysicians may not be trusted due to outsided-ness, not
to being foreignMust ask the clients what they think is wrong
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Copyright © 2013 F.A. Davis Company
Arab American Culture
Larry Purnell, PhD, RN, FAAN
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Copyright © 2013 F.A. Davis Company
Arab Overview/HeritageArabs, coming from 22 countries, are
united by a common language, Arabic.No U.S. census category
for Arabs; they are absorbed into the White category.Most
earlier Arab immigrants in the late 1880s to 1913 were
Christians, educated, and settled in the Northeastern United
States
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Copyright © 2013 F.A. Davis Company
Arab Overview/HeritagePost-1965, Arabs in the US were
Muslims, highly educated and professional or immigrated for
higher education.Arabism, Muslim, and Islam are intricately
interwoven and share basic traditions and beliefs.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab CommunicationArabic is the official language of the Arab
world.English is a common second language among Arabs
throughout the world.Communication is highly
contextual.Conversants stand close and maintain rather intense
eye contact.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Copyright © 2013 F.A. Davis Company
Arab CommunicationFor traditional Arabs, touch is only
accepted between members of the same sex. Speech is generally
loud and expressive with repetition and gesturing.Privacy is
valued so sharing outside the immediately family is not
common.Etiquette requires handshaking upon arrival and
departure but only between same sex individuals.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Copyright © 2013 F.A. Davis Company
Arab CommunicationTitles are important and are used in
combination with the person’s first name as in Mr.
Ali.Punctuality is not always valued except in cases of
professional or business meetings. Explain the importance of
timeliness in health-care appointments.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Family Roles and OrganizationTraditional Arab families
are highly patrilineal.In public, a wife’s interactions with her
husband is formal and respectful. At home, the woman may
have tremendous influence in matters pertaining to the home
and children. Gender roles are clearly defined: men are
decision-makers, protectors, and breadwinners.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Family Roles and OrganizationThe authority structure and
division of labor within Arab families are often misinterpreted,
fueling common stereotypes of the overtly dominant male and
the passive and oppressed woman. Children are dearly loved,
indulged, and included in all family activities.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Family Roles and OrganizationChildren are dearly loved,
indulged, and included in all family activities. Children are
raised not to question elders and to be obedient to older
brothers and sisters. Discipline may include physical
punishment and shaming.Adolescents are pressed to succeed
academically.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Family Roles and Organization• Adolescents are pressed
to succeed academically. Academic failure, sexual activity,
illicit drug use, and juvenile delinquency bring shame to the
family. For girls in particular, chastity and decency are
required.Family members live nearby and sometimes intermarry
with first cousins.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Family Roles and OrganizationDevout Muslim women
value modesty. Many Muslim women view the hijab, “covering
the body except for one’s face and hands,” as offering them
protection in situations in which the sexes mix. It is a
recognized symbol of Muslim identity and good moral
character. Many Americans associate the hijab with oppression
rather than protection.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Family Roles and OrganizationSons are held responsible
for supporting elderly parents. Elderly parents are almost
always cared for within the home.Homosexuality is usually
highly stigmatized. In some Arab countries, it is considered a
crime, and participants may be killed.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Workforce IssuesDiscrimination such as intimidation,
being treated suspiciously, and negative comments about their
religious practices have been reported as a major source of
stress among Arab Americans. Muslim Arabs who wish to
attend Friday prayer services and observe religious holidays
may encounter job-related conflicts.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Workforce IssuesImpassioned communication may
incorrectly be assumed that Arabs are argumentative,
confrontational, or aggressive. Criticism is often taken
personally as an affront to dignity and family honor. Whereas
such direct praise may be somewhat embarrassing for
Americans, Arabs expect and want praise when they feel they
have earned it.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Biocultural EcologyMost Arabs have dark or olive-colored
skin, but some have blonde or auburn hair, blue eyes, and fair
complexions. Infectious diseases such as tuberculosis, malaria,
trachoma, typhus, hepatitis, typhoid fever, dysentery, and
parasitic infestations are common with newer immigrants.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Biocultural EcologyGlucose-6-phosphate dehydrogenase
deficiency, sickle cell anemia, and the thalassemias are
extremely common in the eastern Mediterranean.High
consanguinity rates (roughly 30 percent of marriages in Iraq,
Jordan, Kuwait, and Saudi Arabia) occur between first cousins
and contribute to the prevalence of genetically determined
disorders in Arab countries.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Biocultural EcologySome Arabs have difficulty
metabolizing debrisoquine, antiarrhythmics, antidepressants,
beta blockers, neuroleptics, and opioid agents.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab High-Risk Health BehaviorsSmoking and nonuse of seat
belts and helmets are major issues among Arabs in the US.
Some Arab women may be at high risk for domestic violence,
especially new immigrants, because of the high rates of stress,
poverty, poor spiritual and social support, and isolation from
family members.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab High-Risk Health BehaviorsSedentary lifestyle and high
fat intake among Arab Americans place them at higher risk for
cardiovascular diseases.The rates of breast cancer screening,
mammography, and cervical Pap smears among Arab Americans
are low because of modesty.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab NutritionSpices and herbs include cinnamon, allspice,
cloves, ginger, cumin, mint, parsley, bay leaves, garlic, and
onions.Skewer cooking and slow simmering are typical modes
of preparation. All countries have rice and wheat dishes, stuffed
vegetables, nut-filled pastries, and fritters soaked in syrup.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab NutritionConsumption of blood is forbidden; Muslims are
required to cook meats and poultry until well done. Some
Muslims refuse to eat meat that is not halal (slaughtered in an
Islamic manner). Muslims are prohibited from eating pork and
pork products which includes ingredients mouthwashes,
toothpastes, alcohol-based syrups and elixirs, and gelatin coated
capsules. However, if no substitutes are available, Muslims are
permitted to use these preparations.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab NutritionGrains and legumes are often substituted for
meats; fresh fruit and juices are especially popular, and olive
oil is widely used.Food is eaten with the right hand because it is
regarded as clean. Eating and drinking at the same time is
viewed as unhealthy.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab NutritionDuring Ramadan, the Muslim month of fasting,
abstinence from eating, drinking (including water), smoking,
and marital intercourse during daylight hours is required.
Although the sick are not required to fast, many pious Muslims
insist on fasting while hospitalized. Lactose intolerance is
common among Arab Americans.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Pregnancy and Childbearing PracticesFertility practices
are influenced by traditional Bedouin values, which support
tribal dominance and beliefs that “God decides family size.”
Procreation is regarded as the purpose of marriage; high fertility
rates are favored.Sterility in a woman can lead to rejection and
divorce.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Pregnancy and Childbearing PracticesMany reversible
forms of birth control are undesirable but not forbidden. They
should be used when there is a threat to the mother’s life, too
frequent childbearing, risk of transmitting a genetic disease, or
financial hardship.Irreversible forms of birth control such as
vasectomy and tubal ligation are “absolutely unlawful” as is
abortion, except when the mother’s health is compromised by a
pregnancy-induced disease or her life is threatened.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Pregnancy and Childbearing PracticesUnwanted
pregnancies are dealt with by hoping for a miscarriage, “by an
act of God”, or by covertly arranging for an abortion.The
pregnant woman is indulged and her cravings satisfied, lest she
develop a birthmark in the shape of the particular food she
craves. Although pregnant women are excused from fasting
during Ramadan, some Muslim women may be determined to
fast.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Pregnancy and Childbearing PracticesLabor and delivery
are women’s affairs.During labor, women openly express pain
through facial expressions, verbalizations, and body
movements. Care for the infant includes wrapping the stomach
at birth, or as soon as possible thereafter, to prevent cold or
wind from entering the baby’s body.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Pregnancy and Childbearing PracticesThe call to prayer is
recited in the Muslim newborn’s ear.Male offspring are
preferred.Male circumcision is almost a universal practice, and
for Muslims it is a religious requirement.Mothers may be
reluctant to bathe postpartum because of beliefs that air gets
into the mother and causes illness.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Pregnancy and Childbearing PracticesMany believe
washing the breasts “thins the milk.” Breast-feeding is often
delayed until the second or third day after birth because of
beliefs that the mother requires rest, that nursing at birth causes
“colic” pain for the mother, and that “colostrum makes the baby
dumb.”Postpartum care foods, such as lentil soup, are offered to
increase milk production.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Death RitualsDeath is accepted as God’s will. Muslim
death rituals include turning the patient’s bed to face the holy
city of Mecca and reading from the Qur’an, particularly verses
stressing hope and acceptance.After death, the deceased is
washed three times by a Muslim of the same sex. The body is
then wrapped, preferably in white material, and buried as soon
as possible in a brick or cement-lined grave facing Mecca.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Death RitualsPrayers for the deceased are recited at home,
at the mosque, or at the cemetery.Women do not ordinarily
attend the burial unless the deceased is a close relative or
husband. Instead, they gather at the deceased’s home and read
the Qur’an.For women, wearing black is considered appropriate
for the entire period of mourning.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Death RitualsCremation is not practiced.Autopsy is
generally not approved because of respect for the dead and
feelings that the body should not be mutilated. Islam does allow
forensic autopsies and autopsies medical research and
instruction.Organ donation and transplantation as well as
administration of blood and blood products are acceptable.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab SpiritualityIslam is the official religion of most Arab
countries, and in Islam there is no separation of church and
state; a certain amount of religious participation is
obligatory.Islam has no priesthood. Islamic scholars or religious
sheikhs, the most learned individuals in an Islamic community,
assume the role of imam, or “leader of the prayer.” The imam
acts as a spiritual counselor.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Spirituality
The 5 major pillars or duties of Islam are Faith, shown by the
proclamation of the Unity of God by saying “There is no God
but Allah; Mohammed is the Messenger of Allah.”• Prayer,
facing Mecca, is performed at dawn, noon, midafternoon,
sunset, and nightfall.• Almsgiving to assist the poor and to
support religious organizations.• Fasting fulfills religious
obligations, wipes out previous sins, and demonstrates
appreciate the hunger of the poor. • A pilgrimage to Mecca
(hadj) once in a lifetime is encouraged if the means are
available.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab SpiritualitySchool and work schedules revolve around
Islamic holidays and weekly prayer. Because Muslims gather
for communal prayer on Friday afternoons, the work week runs
from Saturday through Thursday. Devout patients may request
that their chair or bed be turned to face Mecca and that a basin
of water be provided for ritual washing or ablution before
praying.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab SpiritualityProviding for cleanliness is particularly
important because the Muslim’s prayer is not acceptable unless
the body, clothing, and place of prayer are clean.Sometimes
illness is considered punishment for one’s sins.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PracticesGood health is considered the ability
to fulfill one’s roles.Diseases are attributed to an inadequate
diet, shifts of hot and cold, exposure of one’s stomach during
sleep, emotional or spiritual distress, and envy or the “evil
eye.”Informed consent, self-care, advance directives, and
preventive care are valued.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PracticesWomen are often reluctant to seek
care because of cultural emphasis placed on modesty. Many fear
that a diagnosed illness, such as cancer or psychiatric illness,
may bring shame and influence their marriageability.Family
members indulge the individual and assume the ill person’s
responsibilities.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PracticesCommunicating a grave diagnosis is
often viewed as cruel and tactless because it deprives clients of
hope.Most expect physicians to select treatments. The client’s
role is to cooperate.Beautiful women, healthy-looking babies,
and the rich are believed to be particularly susceptible to the
evil eye. Thus, expressions of congratulations may be
interpreted as envy.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PracticesProtection from the evil eye is
afforded by wearing amulets, such as blue beads, or figures
involving the number five; reciting the Qur’an; or invoking the
name of Allah.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PracticesMental or emotional illnesses may be
attributed to possession by evil jinn. Islamic medicine is based
on the theory of four humors and the spiritual and physical
remedies prescribed by the Prophet. Because illness is viewed
as an imbalance between the humors—black bile, blood,
phlegm, and yellow bile—and the primary attributes of dryness,
heat, cold, and moisture, therapy involves treating with the
disease’s opposite: thus, a hot disease requires a cold remedy.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PracticesAlthough methods such as cupping,
cautery, and phlebotomy may be used, treatment with special
prayers or simple foods such as dates, honey, salt, and olive oil
is preferred.Preoperative instructions are thought to cause
needless anxiety, hypochondriasis, and complications.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PracticesThe tendency of Arabs to be more
expressive with their family and more restrained in the presence
of health professionals may lead to conflicting perceptions
regarding the adequacy of pain relief. Mental illness is a major
social stigma. Psychiatric symptoms may be denied or attributed
to “bad nerves” or evil spirits.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PracticesWhen individuals suffering from
mental distress seek medical care, they are likely to present
with a variety of vague complaints, such as abdominal pain,
lassitude, anorexia, and shortness of breath. Patients often
expect and may insist on somatic treatment, at least “vitamins
and tonics.”When mental illness is accepted as a diagnosis,
treatment with medications, rather than counseling, is preferred.
Hospitalization is resisted because such placement is viewed as
abandonment.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PracticesBecause of social stigma, the
disabled are often kept from public view.Medical treatments
that require surgery, removal of causative agents, or eradication
by intravenous treatments are valued more than therapies aimed
at health promotion or disease prevention.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PractitionersMany Arabs find interacting with
a health-care professional of the opposite sex quite
embarrassing and stressful.Discomfort may be expressed by
refusal to discuss personal information and by a reluctance to
disrobe for physical assessments and hygiene.Women may
refuse to be seen by male health care providers.
*
Transcultural Health Care: A Culturally Competent Approach,
4th Edition
Arab Health-care PractitionersKnowledge held by a doctor is
thought to convey authority and power.Most clients who lack
English communication skills prefer an Arabic-speaking
physician. The authority of physicians is seldom challenged or
questioned. When treatment is successful, the physician’s skill
is recognized; adverse outcomes are attributed to God’s will.
*

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The Good Doctor Explores Autism and Psychology in Medicine

  • 1. 1. Psychology is defined as the scientific study of behavior. (the psychology majors handbook). Though I feel most TV shows and or movies have some form of a psychological based plot, because its so broad. However I want to focus on a TV show called "The Good Doctor". This is a series about a doctor who is on the Autism spectrum. Autism refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication... Autism is a spectrum disorder each person with autism has a distinct set of strengths and challenges. (what is autism). this show was my top pick because, taking a look more into psychology as stated in the text topics of psychology study includes relationships, the brain and the chemicals that influence it, visual and auditory perception, human development, the causes of normative and atypical behavior, and much more. In the show they focus on the main character who has autism but is so smart and they show his strengths analyze the body and research in a different, more in depth way that the typical doctors do. They show how he is socially awkward and how the typical doctors may accept him and how some don't because they feel he has a disorder and doesn't belong in the medical field. the show touches base on his difficulty fitting into the culture but also show how he fits in in his own unique way. 2. The TV show that comes to mind when I think of a TV show in which psychology played an important role is a show, I am currently watching called Blindspot. Psychology is a big factor in this show because a woman had her memory erased and had herself dropped in the middle of Times Square. When found, she had tattoos all over her body, which helped the FBI save many lives. It turns out that she was a part of a terrorist organization that wanted to bring the country down. With all of that being
  • 2. said, when she first got to the FBI, they had a psychologist talk to her to try and help her understand her feelings and help her engage with the man she had grown to like. In the end, the psychologist was also a part of the terrorist organization and was manipulating the woman during her sessions to make her think she liked the man so she could get close to him because they needed him to be a part of their plan to bring down the country. Psychology was also a big factor because growing closer to the man she liked, who was the assistant director of the FBI and a good person, he helped her be a better person. With all of her memory gone he also made her think she was his best friend who had gone missing when he was a child, when if fact she was not this little girl at all. 3. When I think of psychology in relation to a tv show or movie, I think of a Netflix series that I recently watched titled "YOU." I feel that psychology definitely played a major part in the way the main character Joe interacted with everyone that he encountered or had some type of relationship with. The main character is basically a sociopath that is willing to kill anyone that he feels is toxic to whoever his girlfriend is at that time, even going as far as killing his own girlfriends at times. Joe lives in a distorted reality as he has rationale for everything that he does even if it's going as far as killing someone, in which he justifies it within himself as ridding his significant other of someone that was not good for her. This series allows you to see how Joe comes off as being very charming but the real him is very dark and violent but most people never even believe that he can be anything other than his charming self. This is a great show to watch and I highly recommend that you all watch it when you have time as I feel that it can open our eyes to realize that many people live double lives and are involved with things that we can't even imagine. 4. A great movie that comes to mind when it comes to
  • 3. psychology is The Stanford Prison Experiment. In this movie a college professor placed an ad in the paper asking for volunteers, mainly men of a certain age group, to participate in an experiment that would have some of them pretend to be prisoners and some of them prison guards. The experiment was taped and showed how the participants adapted and reacted to their roles. During the course of I believe a week, the participants became 100% into their roles, with one participant having to be removed. The participants playing guards became abusive and the prisoners submissive. After a week the experiment was stopped. Psychology was a big factor in this experiment because it showed how each person became the role they were given and created rules and regulations to associate with them. Week_____ discussion questions Name Florida National University Nursing Department BSN Program NUR 4636
  • 4. Date Prof. Eddie Cruz, RN MSN Transcultural Health Care: A Culturally Competent Approach, 4th Edition Copyright © 2013 F.A. Davis Company Appalachians Larry Purnell, PhD, RN, FAAN * Transcultural Health Care: A Culturally Competent Approach, 4th Edition OverviewHeritage from England, Wales, Scotland, Ireland, France, and GermanyCame to the United States for religious freedom and better economic opportunitiesPurposely isolated themselves in the mountains to live and practice their religions as they chose *
  • 5. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview ContinuedAppalachia includes 410 counties in 13 states and extends from southern New York to northern Mississippi.Continuous migration from the country to the city and vice versaHigh proportion of aging in AppalachiaFarming, mining, textiles, service industries, etc. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview ContinuedHigh poverty and unemployment ratesOriginally most educated group in America, now some of the least educated due to isolationArea still lacks infrastructure * Transcultural Health Care: A Culturally Competent Approach, 4th Edition CommunicationsCarry over from Elizabethan EnglishSpellin for spellingWarsh for washBadder for bad *
  • 6. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Ethic of NeutralityAvoid aggression and assertivenessDo not interfere with others’ livesAvoid dominance over othersAvoid arguments and seek agreementAccept without judging—use few adjectives and adverbs, resulting in less precise description of emotions and thoughts * Transcultural Health Care: A Culturally Competent Approach, 4th Edition CommunicationsSensitive about direct questions and personal issuesSensitive to hints of criticism. A suggestion may be seen as criticism.Cordiality precedes information sharing so “sit a spell” and chat before doing business, which is necessary for developing trust * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ContinuedA few may avoid direct eye contact because it can be perceived as aggression, hostility, or impolitenessMore being than doing oriented, more relaxed
  • 7. culture and being in tune with body rhythmsBe formal with name format until told to do otherwise. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ContinuedHealthcare provider must be flexible and adaptableCome early or late for an appointment and still expect to be seenFamily lineage is importantFormality with respect—Miz Florence or Mr. John * Transcultural Health Care: A Culturally Competent Approach, 4th Edition FamilyVaried decision-making patterns but the more traditional Appalachian family is still primarily patriarchalWomen make decisions about health care and usually carry out the herbal treatments and folk remediesWomen marry at a young age and have larger families than the other white ethnic groups * Transcultural Health Care: A Culturally Competent Approach,
  • 8. 4th Edition Family ContinuedChildren are accepted regardless of what they doHands-on physical punishment is commonMotherhood increases the status of the woman in the eyes of the communityTake great pride in being independent and doing things for oneself * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family ContinuedFamily rather than the individual is the treatment unitHaving a job is more important than having a prestigious positionConsistent with the ethic of neutrality, alternative lifestyles are accepted, they are just not talked aboutExtended family is the norm * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural EcologyHigh incidence of respiratory conditions due to occupationsIncrease of parasitic infections due to lack of modern utilities in some areasHigh incidence of cancer, otitis media, anemia, obesity, cardiovascular disease, suicide, accidents, SIDS, and mental illness
  • 9. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition High-Risk BehaviorsTobacco is a main farming crop in some areas of AppalachiaSmoke at a young ageAlcohol use at a young age—binge drinkingBelieve in the mind, body, spirit connection * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Ten Steps in Seeking Health CareUse self-care practices learned from mother or grandmotherCall mother or grandmother if availableThen trusted female family member, neighbor, or a nurseThen go to OTCs they saw on TVThen use a neighbor’s prescription medicine * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Ten Steps in Seeking Health Care ContinuedPharmacist or nurse for advicePhysician or Advanced Practice NurseThen to a
  • 10. specialistThen to the closest tertiary medical centerDO NOT BE JUDGMENTAL, if you want to keep them in the system * Transcultural Health Care: A Culturally Competent Approach, 4th Edition NutritionFood may be synonymous with wealthWide variety of meats, do not trim the fat—low-fat wild game is also eatenOrgan meats are commonBones and bone marrow used for making saucesPreserve with salt * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition ContinuedLots of frying (using lard or bacon grease) and picklingAnytime is the time to celebrate with food, especially in the rural areasMany teens have particularly poor healthStatus symbol to have instant coffee and snack foods for some * Transcultural Health Care: A Culturally Competent Approach,
  • 11. 4th Edition Nutrition ContinuedEarly introduction of solid foodsMay feed babies teaspoons of grease to make them healthy and strongDiet is frequently deficient in Vitamin A, iron, and calcium * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Childbearing FamilyMust eat well to have a healthy babyDo not reach over your head when pregnant to prevent the cord from wrapping around the neck of the fetusBeing frightened by a snake or eating strawberries or citrus can cause the baby to be markedUse bands around the belly and asafetida bags * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death RitualsMust stay with the dying personFamily should not be left aloneFunerals with personal objects at the viewing and buried in their best clothesMay take the deceased for viewing at homeAfter the funeral there is more food and singing and for some a “wake” to celebrate life *
  • 12. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals ContinuedFlowers are more important than donations to charityParticularly good at working through the grieving processFuneral directors are commonly used for bereavementCremation is acceptable and ashes may be saved or dispersed on the “land” * Transcultural Health Care: A Culturally Competent Approach, 4th Edition SpiritualityBaptist, Pentecostal, Episcopalian, Jehovah’s Witness, Methodist, PresbyterianEach church adapts to the communityMost are highly religious even though they do not attend churchCommon to attend Sunday and other daysPreacher has a calling to “preach”Ministers are trained * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Spirituality ContinuedMeaning in life comes from the family and “living right with God,” which varies by the specific
  • 13. religious sect Nature is in control—fatalismReligion and faith is important in a hostile environment I will be there if the “creek does not rise” or if “God is willing”—fatalism * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare PracticesGood health is due to God’s WillSelf- reliance fosters self-care practicesFamily important for health careMay be very ill before a decision is made to see a professional resulting in a more compromised health conditionDirect approaches are frowned upon * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices ContinuedHerbal medicines, poultices, and teas are commonSee Table 8–1 in the textbook; these practices are still alive and wellFolk medicines used in conjunction with biomedical treatments *
  • 14. Transcultural Health Care: A Culturally Competent Approach, 4th Edition BarriersFatalismSelf-relianceLack of infrastructureHealth profession shortagesCulture of “being”Poverty and unemploymentCare not acceptable from outsiders * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Responses to Health and IllnessTake care of our own and accept the person as whole individualNot mentally ill, the person has “bad nerves” or are “odd turned”Having a disability with aging is natural and inevitable—if you live long enoughMust establish rapport and trust * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Responses to Health and Illness ContinuedPain is something that is to be enduredSome may be stoicalPain legitimizes not working or fulfilling one’s responsibilitiesWithdraw into self when illCulture of being works against rehabilitation *
  • 15. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare PractitionersLay and trained nurses and midwives still provide much of the care in some parts of AppalachiaBreckenridge Frontier Nursing Service Prefer people known to the family and community —the insider versus outsider concept * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practitioners ContinuedCulture of “being” says the healthcare provider should not give the perception of being rushedPhysicians may not be trusted due to outsided-ness, not to being foreignMust ask the clients what they think is wrong * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Copyright © 2013 F.A. Davis Company
  • 16. Arab American Culture Larry Purnell, PhD, RN, FAAN * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Copyright © 2013 F.A. Davis Company Arab Overview/HeritageArabs, coming from 22 countries, are united by a common language, Arabic.No U.S. census category for Arabs; they are absorbed into the White category.Most earlier Arab immigrants in the late 1880s to 1913 were Christians, educated, and settled in the Northeastern United States * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Copyright © 2013 F.A. Davis Company Arab Overview/HeritagePost-1965, Arabs in the US were Muslims, highly educated and professional or immigrated for higher education.Arabism, Muslim, and Islam are intricately interwoven and share basic traditions and beliefs.
  • 17. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab CommunicationArabic is the official language of the Arab world.English is a common second language among Arabs throughout the world.Communication is highly contextual.Conversants stand close and maintain rather intense eye contact. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Copyright © 2013 F.A. Davis Company Arab CommunicationFor traditional Arabs, touch is only accepted between members of the same sex. Speech is generally loud and expressive with repetition and gesturing.Privacy is valued so sharing outside the immediately family is not common.Etiquette requires handshaking upon arrival and departure but only between same sex individuals. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition
  • 18. Copyright © 2013 F.A. Davis Company Arab CommunicationTitles are important and are used in combination with the person’s first name as in Mr. Ali.Punctuality is not always valued except in cases of professional or business meetings. Explain the importance of timeliness in health-care appointments. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Family Roles and OrganizationTraditional Arab families are highly patrilineal.In public, a wife’s interactions with her husband is formal and respectful. At home, the woman may have tremendous influence in matters pertaining to the home and children. Gender roles are clearly defined: men are decision-makers, protectors, and breadwinners. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Family Roles and OrganizationThe authority structure and division of labor within Arab families are often misinterpreted, fueling common stereotypes of the overtly dominant male and the passive and oppressed woman. Children are dearly loved, indulged, and included in all family activities.
  • 19. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Family Roles and OrganizationChildren are dearly loved, indulged, and included in all family activities. Children are raised not to question elders and to be obedient to older brothers and sisters. Discipline may include physical punishment and shaming.Adolescents are pressed to succeed academically. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Family Roles and Organization• Adolescents are pressed to succeed academically. Academic failure, sexual activity, illicit drug use, and juvenile delinquency bring shame to the family. For girls in particular, chastity and decency are required.Family members live nearby and sometimes intermarry with first cousins. *
  • 20. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Family Roles and OrganizationDevout Muslim women value modesty. Many Muslim women view the hijab, “covering the body except for one’s face and hands,” as offering them protection in situations in which the sexes mix. It is a recognized symbol of Muslim identity and good moral character. Many Americans associate the hijab with oppression rather than protection. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Family Roles and OrganizationSons are held responsible for supporting elderly parents. Elderly parents are almost always cared for within the home.Homosexuality is usually highly stigmatized. In some Arab countries, it is considered a crime, and participants may be killed. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Workforce IssuesDiscrimination such as intimidation, being treated suspiciously, and negative comments about their religious practices have been reported as a major source of
  • 21. stress among Arab Americans. Muslim Arabs who wish to attend Friday prayer services and observe religious holidays may encounter job-related conflicts. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Workforce IssuesImpassioned communication may incorrectly be assumed that Arabs are argumentative, confrontational, or aggressive. Criticism is often taken personally as an affront to dignity and family honor. Whereas such direct praise may be somewhat embarrassing for Americans, Arabs expect and want praise when they feel they have earned it. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Biocultural EcologyMost Arabs have dark or olive-colored skin, but some have blonde or auburn hair, blue eyes, and fair complexions. Infectious diseases such as tuberculosis, malaria, trachoma, typhus, hepatitis, typhoid fever, dysentery, and parasitic infestations are common with newer immigrants. *
  • 22. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Biocultural EcologyGlucose-6-phosphate dehydrogenase deficiency, sickle cell anemia, and the thalassemias are extremely common in the eastern Mediterranean.High consanguinity rates (roughly 30 percent of marriages in Iraq, Jordan, Kuwait, and Saudi Arabia) occur between first cousins and contribute to the prevalence of genetically determined disorders in Arab countries. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Biocultural EcologySome Arabs have difficulty metabolizing debrisoquine, antiarrhythmics, antidepressants, beta blockers, neuroleptics, and opioid agents. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab High-Risk Health BehaviorsSmoking and nonuse of seat belts and helmets are major issues among Arabs in the US.
  • 23. Some Arab women may be at high risk for domestic violence, especially new immigrants, because of the high rates of stress, poverty, poor spiritual and social support, and isolation from family members. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab High-Risk Health BehaviorsSedentary lifestyle and high fat intake among Arab Americans place them at higher risk for cardiovascular diseases.The rates of breast cancer screening, mammography, and cervical Pap smears among Arab Americans are low because of modesty. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab NutritionSpices and herbs include cinnamon, allspice, cloves, ginger, cumin, mint, parsley, bay leaves, garlic, and onions.Skewer cooking and slow simmering are typical modes of preparation. All countries have rice and wheat dishes, stuffed vegetables, nut-filled pastries, and fritters soaked in syrup. *
  • 24. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab NutritionConsumption of blood is forbidden; Muslims are required to cook meats and poultry until well done. Some Muslims refuse to eat meat that is not halal (slaughtered in an Islamic manner). Muslims are prohibited from eating pork and pork products which includes ingredients mouthwashes, toothpastes, alcohol-based syrups and elixirs, and gelatin coated capsules. However, if no substitutes are available, Muslims are permitted to use these preparations. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab NutritionGrains and legumes are often substituted for meats; fresh fruit and juices are especially popular, and olive oil is widely used.Food is eaten with the right hand because it is regarded as clean. Eating and drinking at the same time is viewed as unhealthy. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition
  • 25. Arab NutritionDuring Ramadan, the Muslim month of fasting, abstinence from eating, drinking (including water), smoking, and marital intercourse during daylight hours is required. Although the sick are not required to fast, many pious Muslims insist on fasting while hospitalized. Lactose intolerance is common among Arab Americans. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Pregnancy and Childbearing PracticesFertility practices are influenced by traditional Bedouin values, which support tribal dominance and beliefs that “God decides family size.” Procreation is regarded as the purpose of marriage; high fertility rates are favored.Sterility in a woman can lead to rejection and divorce. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Pregnancy and Childbearing PracticesMany reversible forms of birth control are undesirable but not forbidden. They should be used when there is a threat to the mother’s life, too frequent childbearing, risk of transmitting a genetic disease, or financial hardship.Irreversible forms of birth control such as vasectomy and tubal ligation are “absolutely unlawful” as is
  • 26. abortion, except when the mother’s health is compromised by a pregnancy-induced disease or her life is threatened. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Pregnancy and Childbearing PracticesUnwanted pregnancies are dealt with by hoping for a miscarriage, “by an act of God”, or by covertly arranging for an abortion.The pregnant woman is indulged and her cravings satisfied, lest she develop a birthmark in the shape of the particular food she craves. Although pregnant women are excused from fasting during Ramadan, some Muslim women may be determined to fast. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Pregnancy and Childbearing PracticesLabor and delivery are women’s affairs.During labor, women openly express pain through facial expressions, verbalizations, and body movements. Care for the infant includes wrapping the stomach at birth, or as soon as possible thereafter, to prevent cold or wind from entering the baby’s body.
  • 27. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Pregnancy and Childbearing PracticesThe call to prayer is recited in the Muslim newborn’s ear.Male offspring are preferred.Male circumcision is almost a universal practice, and for Muslims it is a religious requirement.Mothers may be reluctant to bathe postpartum because of beliefs that air gets into the mother and causes illness. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Pregnancy and Childbearing PracticesMany believe washing the breasts “thins the milk.” Breast-feeding is often delayed until the second or third day after birth because of beliefs that the mother requires rest, that nursing at birth causes “colic” pain for the mother, and that “colostrum makes the baby dumb.”Postpartum care foods, such as lentil soup, are offered to increase milk production. * Transcultural Health Care: A Culturally Competent Approach,
  • 28. 4th Edition Arab Death RitualsDeath is accepted as God’s will. Muslim death rituals include turning the patient’s bed to face the holy city of Mecca and reading from the Qur’an, particularly verses stressing hope and acceptance.After death, the deceased is washed three times by a Muslim of the same sex. The body is then wrapped, preferably in white material, and buried as soon as possible in a brick or cement-lined grave facing Mecca. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Death RitualsPrayers for the deceased are recited at home, at the mosque, or at the cemetery.Women do not ordinarily attend the burial unless the deceased is a close relative or husband. Instead, they gather at the deceased’s home and read the Qur’an.For women, wearing black is considered appropriate for the entire period of mourning. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Death RitualsCremation is not practiced.Autopsy is generally not approved because of respect for the dead and
  • 29. feelings that the body should not be mutilated. Islam does allow forensic autopsies and autopsies medical research and instruction.Organ donation and transplantation as well as administration of blood and blood products are acceptable. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab SpiritualityIslam is the official religion of most Arab countries, and in Islam there is no separation of church and state; a certain amount of religious participation is obligatory.Islam has no priesthood. Islamic scholars or religious sheikhs, the most learned individuals in an Islamic community, assume the role of imam, or “leader of the prayer.” The imam acts as a spiritual counselor. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Spirituality The 5 major pillars or duties of Islam are Faith, shown by the proclamation of the Unity of God by saying “There is no God but Allah; Mohammed is the Messenger of Allah.”• Prayer, facing Mecca, is performed at dawn, noon, midafternoon, sunset, and nightfall.• Almsgiving to assist the poor and to support religious organizations.• Fasting fulfills religious
  • 30. obligations, wipes out previous sins, and demonstrates appreciate the hunger of the poor. • A pilgrimage to Mecca (hadj) once in a lifetime is encouraged if the means are available. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab SpiritualitySchool and work schedules revolve around Islamic holidays and weekly prayer. Because Muslims gather for communal prayer on Friday afternoons, the work week runs from Saturday through Thursday. Devout patients may request that their chair or bed be turned to face Mecca and that a basin of water be provided for ritual washing or ablution before praying. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab SpiritualityProviding for cleanliness is particularly important because the Muslim’s prayer is not acceptable unless the body, clothing, and place of prayer are clean.Sometimes illness is considered punishment for one’s sins.
  • 31. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Health-care PracticesGood health is considered the ability to fulfill one’s roles.Diseases are attributed to an inadequate diet, shifts of hot and cold, exposure of one’s stomach during sleep, emotional or spiritual distress, and envy or the “evil eye.”Informed consent, self-care, advance directives, and preventive care are valued. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Health-care PracticesWomen are often reluctant to seek care because of cultural emphasis placed on modesty. Many fear that a diagnosed illness, such as cancer or psychiatric illness, may bring shame and influence their marriageability.Family members indulge the individual and assume the ill person’s responsibilities. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition
  • 32. Arab Health-care PracticesCommunicating a grave diagnosis is often viewed as cruel and tactless because it deprives clients of hope.Most expect physicians to select treatments. The client’s role is to cooperate.Beautiful women, healthy-looking babies, and the rich are believed to be particularly susceptible to the evil eye. Thus, expressions of congratulations may be interpreted as envy. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Health-care PracticesProtection from the evil eye is afforded by wearing amulets, such as blue beads, or figures involving the number five; reciting the Qur’an; or invoking the name of Allah. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Health-care PracticesMental or emotional illnesses may be attributed to possession by evil jinn. Islamic medicine is based on the theory of four humors and the spiritual and physical remedies prescribed by the Prophet. Because illness is viewed as an imbalance between the humors—black bile, blood, phlegm, and yellow bile—and the primary attributes of dryness,
  • 33. heat, cold, and moisture, therapy involves treating with the disease’s opposite: thus, a hot disease requires a cold remedy. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Health-care PracticesAlthough methods such as cupping, cautery, and phlebotomy may be used, treatment with special prayers or simple foods such as dates, honey, salt, and olive oil is preferred.Preoperative instructions are thought to cause needless anxiety, hypochondriasis, and complications. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Health-care PracticesThe tendency of Arabs to be more expressive with their family and more restrained in the presence of health professionals may lead to conflicting perceptions regarding the adequacy of pain relief. Mental illness is a major social stigma. Psychiatric symptoms may be denied or attributed to “bad nerves” or evil spirits. *
  • 34. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Health-care PracticesWhen individuals suffering from mental distress seek medical care, they are likely to present with a variety of vague complaints, such as abdominal pain, lassitude, anorexia, and shortness of breath. Patients often expect and may insist on somatic treatment, at least “vitamins and tonics.”When mental illness is accepted as a diagnosis, treatment with medications, rather than counseling, is preferred. Hospitalization is resisted because such placement is viewed as abandonment. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Health-care PracticesBecause of social stigma, the disabled are often kept from public view.Medical treatments that require surgery, removal of causative agents, or eradication by intravenous treatments are valued more than therapies aimed at health promotion or disease prevention. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition
  • 35. Arab Health-care PractitionersMany Arabs find interacting with a health-care professional of the opposite sex quite embarrassing and stressful.Discomfort may be expressed by refusal to discuss personal information and by a reluctance to disrobe for physical assessments and hygiene.Women may refuse to be seen by male health care providers. * Transcultural Health Care: A Culturally Competent Approach, 4th Edition Arab Health-care PractitionersKnowledge held by a doctor is thought to convey authority and power.Most clients who lack English communication skills prefer an Arabic-speaking physician. The authority of physicians is seldom challenged or questioned. When treatment is successful, the physician’s skill is recognized; adverse outcomes are attributed to God’s will. *