course materials

1. Discussion: People of Egyptian and People of Filipino Heritage
Discussion: People of Egyptian and People of Filipino Heritage ON EgyDiscussion: People
ofptian and People of Filipino HeritagePeople of Egyptian Heritage.People of Filipino
Heritage.Read chapter 13 and 28 of the class textbook and review the attached PowerPoint
presentations. Read chapter 28 in Davis Plus Online Website. Once done, write an essay
discussing the health beliefs of both heritages and if there is any similarity in both culture
beliefs. Also, discuss how their beliefs influence the delivery of evidence-based healthcare
focusing on the nursing care.Your assignment must have a minimum of 700 words, 3
evidence-based references no older than 5 years Transcultural Health Care: A Culturally
Competent Approach, 4th Edition Filipino Americans Larry Purnell, PhD, RN, FAAN
Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent
Approach, 4th Edition Overview/Heritage ? Almost 2 million in the United States ? Literally
all speak English and Tagalog (Pilipino), and many speak Spanish and another language ?
Predominantly from Malayan ancestry with influence and mixtures from other Asian
groups, Spanish, and Arab Transcultural Health Care: A Culturally Competent Approach, 4th
Edition Overview/Heritage Continued ? Americanization of the Philippines began after the
Spanish–American War ? Immigrant Filipinos make up the majority of Filipinos in the
United States. Discussion: People of Egyptian and People of Filipino Heritage? Unrestricted
immigration in the early 1900s then very restricted in 1924 because of the Exclusionist
policies of Immigration Act of 1924 Transcultural Health Care: A Culturally Competent
Approach, 4th Edition Overview/Heritage Continued ? Immigration and Nationality Act of
1965 eliminated the quota system for the Philippines resulting in large numbers of middle
class and professionals coming to the United States ? Included relatives of Filipinos living in
the United States Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage Continued ? First group were primarily single men who were brought to
the United States to work in Alaskan canneries, farms in California, and plantations in
Hawaii and endured much discrimination ? Most were restricted from owning or leasing
land and could not become US citizens Transcultural Health Care: A Culturally Competent
Approach, 4th Edition Overview/Heritage Continued . Discussion: People of Egyptian and
People of Filipino Heritage? After WW II, many Filipino Veterans immigrated and settled on
the West Coast ? Now more women than men immigrate to the United States ? Well
educated immigrants continue to have difficulty in finding similar work in the United States
unless they are in the healthcare field Transcultural Health Care: A Culturally Competent
Approach, 4th Edition Communications ? Tagalog is the national language with English the

2. second official language ? Eight other dialects are spoken as well as Spanish ? Taglish is
common among immigrants and American born Filipinos ? Highly contextual
communication patterns Transcultural Health Care: A Culturally Competent Approach, 4th
Edition Communications Continued . Discussion: People of Egyptian and People of Filipino
Heritage? Pakikisama—smoother interpersonal relationships and sacrifice exact meaning ?
External or outsider communication and internal or one-of-us communication proceeds on
different levels Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communications Continued ? ? ? ? ? ? ? Interacting level Participating level Conforming level
Adjusting level Understanding and acceptance level Getting involved level Being one with
level Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Communications Continued ? An exclusive “we” and an inclusive “we” ? Eye contact varies
with age, education, and acculturation ? Many ways to say yes, but how do you say no?
Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications
Continued ? Respect the past, enjoy the present, and hope for the future ? Filipino time for
social events, clock time if really important events, business, and work usually ? Many
names are Spanish in origin ? One of the middle names is the mother’s maiden name
Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck
Many Filipinos speak Tag-Lish, which is a. Discussion: People of Egyptian and People of
Filipino HeritageA combination of Tagalog and English. b. The indigenous language of the
Philippines. c. The official language of the Philippines. d. A combination of Spanish and
English. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct
Answer Correct answer: A Tag-Lish is a combination of Tagalog and English. Transcultural
Health Care: A Culturally Competent Approach, 4th Edition Family Roles ? Matriarchal
before Spanish, then Patriarchal, now more egalitarian in decision making ? Gender neutral
pronouns causing confusion with he and she in English ? Respect is a dominant family value
and older children may assume the role of parent Transcultural Health Care: A Culturally
Competent Approach, 4th Edition Family Roles Continued ? Honor and care for parents or
brings shame to the family ? Nuclear family is dominant although polygamous families exist
among Moslem Filipinos ? Extended family members are important ? Education is
paramount for children and parents sacrifice so at least one child will become educated and
help the others if necessary Transcultural Health Care: A Culturally Competent Approach,
4th Edition Family Roles Continued ? Respect is shown to elders with deferential behavior ?
Grandparents become surrogate parents for their grandchildren in the United States
especially ? Advance degree brings higher social status Transcultural Health Care: A
Culturally Competent Approach, 4th Edition Family Roles Continued ? Filipino organizations
targeted to gays and lesbians ? Chastity is valued premaritally. Discussion: People of
Egyptian and People of Filipino Heritage? Single parenting becoming more common in the
United States Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology ? Varying skin tones of brown and tan with dark eyes, flat nose bridges,
and mildly flared nostrils ? Most are of smaller stature than European Americans ? More
difficult to determine age than in European Americans because of youthful face
Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural
Ecology Continued ? Endemic conditions in the Philippines include malaria, tuberculosis,

3. gastrointestinal disorders, due to parasitosis, cardiovascular related disease, cancer,
respiratory diseases, nutritional diseases, HTN, and diabetes ? Sensitive to the effects of
alcohol and require lower doses of neuroleptics Transcultural Health Care: A Culturally
Competent Approach, 4th Edition Nutrition ? Fundamental form of socialization ? Any
occasion is an occasion for food ? Wide variety of foods and prepared in a variety of ways ?
Outsiders are served western food ? Insiders are served Filipino food ? To help in the
kitchen you are really an insider Transcultural Health Care: A Culturally Competent
Approach, 4th Edition Nutrition Continued ? Rice may be served at every meal, most
common meats are fish, chicken, and pork ? Diet varies among urban and rural areas ?
Lactose intolerance among adults ? Milk in cooked desserts is tolerated well ? Salt and
vinegar are used frequently ? Moderation in food is considered important Transcultural
Health Care: A Culturally Competent Approach, 4th Edition Nutrition Continued ?
Considered polite to leave some food on your plate ? Herbs are grown in many homes to be
used for cooking and for medicinal purposes ? Newer immigrants are at risk of nutritional
deficiencies if unfamiliar with American foods Transcultural Health Care: A Culturally
Competent Approach, 4th Edition Childbearing Family ? Catholic religion influences birth
control practices —rhythm method only ? Abortion is considered a sin, carries a stigma, and
leads to back door abortions ? Pregnancy is a time for pampering and attention from entire
family ? Mother of pregnant woman has a very special role Transcultural Health Care: A
Culturally Competent Approach, 4th Edition Childbearing Family Continued ? Consult
healthcare provider plus a massage therapist for advice ? Reluctant to take any medicine
during pregnancy, even vitamins for fear of harming the fetus ? Satisfy cravings so baby will
not be marked with the craving Transcultural Health Care: A Culturally Competent
Approach, 4th Edition Childbearing Family Continued ? Should be protected from a sudden
fright for fear it will harm the fetus ? Mother rather than husband may be the coach during
birthing ? Traditional may not want to bathe but engage in sponge bath and aromatic oils ?
Soup increases lactation Transcultural Health Care: A Culturally Competent Approach, 4th
Edition Death Rituals ? Three days to week for wake after death to await for family to come
together—varies in United States because of work schedules ? Plenty of food available and
family support ,? Nine days of novenas in the home or church are common ? Ritualistic
mourning wearing black for one year Transcultural Health Care: A Culturally Competent
Approach, 4th Edition Death Rituals Continued ? Burial is the most common but cremation
is okay ? Body or ashes may be returned to the Philippines ? Open expression of emotions
and may include fainting Transcultural Health Care: A Culturally Competent Approach, 4th
Edition Spirituality ? 80% Christian with 90% of them Roman Catholic ? 5% practices Islam
? Many returning to Bathala, ancestral religion with a spiritualist guide who is usually a
woman Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Spirituality Continued ? Novenas and prayers are commonly said for the sick person ? Good
health comes to those who are in good with God and is the “Will of God” ? Many are
considered fatalistic, life is up to God, there is little one can do to change life circumstances
and the forces of nature, monsoons, tides, volcanoes, earthquakes, etc. Transcultural Health
Care: A Culturally Competent Approach, 4th Edition Healthcare Practices ? Adhere to
Western medicine and traditional practices simultaneously ? Health is the result of balance

4. and moderation and God’s Will ? Adequate sleep, rest, nutrition, and cleanliness are
important for good health ? Aromatic baths restore balance Transcultural Health Care: A
Culturally Competent Approach, 4th Edition Healthcare Practices Continued ? In the
Philippines many medicines can be purchased over-the-counter ? May hoard and share
medicine ? Many do not seek care until the illness is advanced /? Many distrust the
healthcare environment ? In the Philippines, one pays for testing before the testing is done
Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare
Practices Continued ? ? ? ? Protect oneself from wind and cold Avoid extremes of hot and
cold—balance Introduce changes gradually Pain is part of life and may be atonement for
immoral behavior and leads to stoicism ? Mental illness carries a stigma, is hereditary and
may affect one’s ability for a spouse Transcultural Health Care: A Culturally Competent
Approach, 4th Edition Healthcare Practices Continued ? Mental illness may be severe before
help is sought —take care of family member at home ? Somatization of symptoms is
common ? Important to maintain self-esteem and self-image for self and family ? Able to
enter the sick role easily Transcultural Health Care: A Culturally Competent Approach, 4th
Edition ClickerCheck Mrs. Lino, age 38 years, has been seeing a traditional Filipino healer
for her pregnancy complications. A Filipino traditional healer is a. Galang. b. Utang na loob.
c. Hilot. d. Hiya. Transcultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer Correct answer: C A hilot is a traditional Filipino healer.
2780_BC_Ch28_001-022 03/07/12 9:54 AM Page 1 Chapter 28 People of Egyptian Heritage
Afaf Ibrahim Meleis and Mahmoud Hanafi Meleis Overview, Inhabited Localities, and
Topography Overview Egypt, the country of origin of Egyptian Americans, has a landmass of
386,900 square miles (about one and a half times the size of Texas) and a population of over
82 million people, giving it a population density of over 177 per square mile. More than 95
percent of the land is barren desert, resulting in 90 percent of the population’s living on 3
percent of the total land area, in the Nile Valley and Delta (CIA World Factbook, 2011).The
Nile has been and still is significant in shaping life and living patterns in Egypt. The average
annual rate of population increase is 1.75 percent, with a birth rate of 22.94 per 1000 and
an infant mortality rate of 25.2 per 1000 (CIA World Factbook, 2011). The capital, Cairo, has
almost 11 million people, followed in population by Alexandria with 4.3 million people (CIA
World Factbook, 2011). Egypt is bordered by Libya on the west, Sudan on the south, the
Mediterranean Sea on the north, and the Red Sea and Israel on the east. The eastern region,
across the Suez Canal, is Sinai. Egypt’s climate is hot and dry most of the year. The average
daily temperature on the Mediterranean coast is 68°F with a maximum of 88°F, and in
Aswan, average temperatures are 80°F but can reach 120°F with little or no humidity. The
Mediterranean region receives most of the country’s annual rainfall (7.5 in.). The northern
summers are balmy with moderate temperatures and 80 percent humidity. Between March
and April, khamsi winds blow in from the Western Desert at up to 93 miles per hour. Except
for a few hills outside Cairo, Egypt has a flat terrain on both sides of the southern Nile valley
and the Sinai Peninsula. The Nile River, a main artery for Egypt and an orientation point for
its terrain, runs through the center of the country from south to north to the Mediterranean
Sea. The Nile—considered to be Egypt’s lifeline—provides water and supports agriculture.
Egypt is considered by many politicians, historians, and social scientists to be part of 22

5. Arabic-speaking countries in North Africa. Others write about Egypt as a Middle Eastern
country and count its population as Middle Eastern. A review of scholarly literature about
Egyptian Americans is embedded in writing that aggregates them with Arab Americans,
African Americans, and Middle Eastern Americans, as well as separates them out as
Egyptian Americans. Scholarly literature about Egyptians in the United States is limited;
therefore, the reader will find citations that reflect a broader geographic territory, which in
turn reflects how Egyptians are often connected to or embedded in many Arab, Middle
Eastern, African, and Muslim cultures. This chapter is also based on the authors’ own
experiences. Both authors are Egyptian Americans who came to the United States in the
early 1960s and observed many Egyptian Americans as they defined themselves within the
multiple identities generated by the different groupings, such as generation and length of
time away from the country of origin. Both authors have been insiders as well as outsiders
to Middle Eastern communities in the United States and globally. They have participated in
different community celebrations, experienced immigrants’ grief over the impending or
actual death of a family member, provided social and emotional support during times of
crisis, and counseled many immigrants. One of the authors has been professionally involved
with health care for this population for over 30 years as part of a project that was designed
to provide health-care services to Middle Eastern immigrants in California.Therefore, data
in this chapter are from our lived experiences in the two worlds Egyptian Americans claim
as their own—Egypt and the United States. Arab Americans are estimated to number
anywhere between 1.5 and 3.5 million (Shah, Ayash, Pharaon, & Gany, 2007). Over 80
percent of Arabs living in the United States are citizens (El-Sayed & Galea, 2009). 1
2780_BC_Ch28_001-022 03/07/12 9:54 AM Page 2 2 Aggregate Data for Cultural-Specific
Groups Egyptians reside in most states in the United States; 2.3 million of Arab Americans
reside in 10 states: 1.2 million live in California, New York, and Michigan (Arab American
Institute, 2011). New York alone has an estimated number of 405,000 Arab Americans
residents (Shah et al., 2007). Michigan has a population of 490,000 Arab Americans, and
California has the highest number of Arab Americans with a population of 715,000 (El-
Sayed & Galea, 2009). Other heavily populated states are New Jersey and Illinois.
Approximately 94 percent of Arab Americans live in major cities, with the top five being Los
Angeles, Detroit, New York, Chicago, and Washington, DC. Lebanese Americans are the
largest group of Arab Americans living in the United States, comprising 37 percent of the
total Arab American population. Egyptians comprise approximately 12 percent of the Arab
American population (Shah et al., 2007). However, Egyptian Americans are the largest Arab
American group in the State of New Jersey (Arab American Institute, 2011). Egyptian
Americans’ religious affiliations resemble those of others from the rest of the Arab
countries. The majority are Christians, and among the Christians are Orthodox (Greek and
Copts), Catholics, and Protestants. Egyptian American Muslims who are Sunni are
increasing in numbers and represent the fastest-growing religious group among Egyptian
immigrants (Salari, 2002). Ninety percent of Egyptians are Muslims, and the overwhelming
majority of these are Sunni Muslims. Egyptian Americans are diverse in other ways. They
come from urban and rural communities, upper and lower Egypt, and diverse educational
backgrounds, and they possess a wide range of cultural characteristics influenced by

6. colonialization, occupations, and a variety of immigration experiences that shaped their
responses. However, only the most common patterns of responses and experiences of
Egyptian Americans with regard to health and illness are presented in this chapter.Diversity
among Egyptians is not well depicted, and this description does not represent a universal
profile. By defining the similarities among Egyptian Americans, we hope to stimulate
interest in more systematic scholarship about this unique community and their lifestyles,
health, and health-care practices. Heritage and Residence In spite of the many attributions
of geographic belonging to Egypt, the Egyptian people have a strong sense of identity with
their country and demonstrate pride in coming from such an old civilization. Egyptian
history is inextricably connected to the Nile River and dates back to about 4000 B.C., when
the kingdoms of upper and lower Egypt were united by King Menes, who presented himself
as a god. The ancient Egyptians were the first to believe in life after death, mummify bodies,
and build elaborate tombs to preserve and protect these bodies for the afterlife. Egyptians
also developed the plow, a system of writing, and medical skills such as surgical operations.
The Arab conquest of Egypt around A.D. 641, which spread the Islamic and Arabic culture
among the Egyptians, has lasted to this day. The minority (Christian) Copts, who preserved
the African-Asiatic language of ancient Egypt, now use the Arabic language and have been
assimilated into the Arabic culture. The Ottoman Turks invaded Egypt in 1517, adding it to
their vast empire. While living under Turkish rule, Egypt enjoyed religious and cultural
stability because the Turks shared the Islamic and Arabic cultures. In the last two centuries,
Egypt experienced invasions by the French, followed by the British in 1882, who remained
in the country until 1954. In 1952, an Egyptian army group led by Lieutenant Colonel Gamal
Abdel Nasser took control of the government and removed King Farouk from power. Since
then, Egypt has been an independent state called the Arab Republic of Egypt (CIA World
Factbook, 2011). An influential part of modern Egyptian history is the Arab–Israeli
conflict.The conflict between Egypt, as part of the Arab League, and Israel ended in 1979
when the two countries signed the Camp David Accords. Anwar Sadat was the president of
Egypt at the time. Egypt continues to be involved in diplomatic efforts to arrive at peace
between Israel and its neighboring Ar …Purchase answer to see full attachment