INSTRUCTIONS FOR ASSIGNMENTS > DIVERSE POPULATIONS

1. Use Purnell Model when answering the questions.
2. The date should not appear on the title page in standard APA. On page 2, be sure the title of the paper appears no more than double space below the running head. The word

Introduction does not appear before the Introduction starts.

3. In terms of Learn and use Level 1 and Level 2 headings. Please follow APA formatting for

Level headings.

4. Reference page: please use 3 sources total. **** One being from Purnell, L., (2013).

Transcultural health care: A culturally competent approach: (4^th ed.). Philadelphia. F.A.

PLEASE INCLUDE 2 OTHER SOURCES THAT ARE NOT OLDER THAN 5 YEARS!!!! SCHOLARLY ARTICLES ARE THE BEST SOURCES. It is recommended one additional source per question or case study…. MSN people look for evidence — based practice which requires using the most current and high quality sources.

5. Formatting of references > please use APA formatting.
6. Content > The introductory paragraph should be 3-4 sentences. The first sentence can introduce what the overall assignment is about ( the completion of 2 case studies based upon Purnell Model with additional sources added). THEN, one to two sentences that explain that you will be completing case studies about families of XYZ descent and of UVW descent. The introduction tells the reader what to expect in the reading.
7. Please be careful in using “all people” of the culture. Better to use “many people” of this culture have a certain characteristic. Refrain from overgeneralizing a culture. DO NOT

DIAGNOSE.

8. Don’t be brief with answers and include strategies that meet the needs of each family to each question, if appropriate. Add “conclusion” before conclusion paragraph.

 

 

 

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—GulfWar 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 that inshallah, 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-inlaw, and a family friend, who speaks English and Arabic and acts as the translator, are at her bedside.

Study Questions

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. nterpret this behavior within a cultural context.
6. Although Mrs. Ayesha is nomothermic 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.

 

 

I l. 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.

IRANIAN CASE STUDY #1

Mustafa E., aged 46, brought his wife, Mina, aged 39, and his three children to the United

States in 1983. Their son Hamid was 12 years old; their daughter, Maryam,was I I years old; and their son Ali was 7 years old. In addition to economic difficulties imposed by the

Iran-Iraq war, they feared that Hamid would be drafted and sent to the front. Mustafa preferred not to leave Iran; he spoke no English and was afraid he would feel isolated in the United States. Mina, conversely, was somewhat eager to leave the social constraints that were becoming permanent; she had always hoped that their children, especially their daughter, would have the opportunity for more than her own ninth grade education and for a successful professional life.

 

Mustafa graduated from high school and worked in Iran’s Ministry of Education.

He held a bookkeeping job on the side, which allowed him to save money for the journey. Mina ‘s brother, who immigrated to the United States in the early 1970s, encouraged the family to go to Turkey, and he arranged for an attorney to obtain a visa for the family. They were granted a tourist visa and flew to Dallas. Mustafa quickly repaid his brotherin-law $5000 for legal fees.

Mina’s brother and his wife, an American, welcomed the family into their house, but language and cultural differences made Mustafa and Mina uncomfortable. After 2 months, they rented an apartment nearby. With the help of her brother’s acquaintances, Mina enrolled the children in school and registered herself in an adult-learning center.

Because they had a tourist visa, neither parent could get a work permit. With no knowledge of English or the local economy, Mustafa relied on the advice of everyone

around him, such as an Iranian businessman who helped him look into purchasing a business. Within a few months, he had bought a gas station• Mina began sewing and doing alterations for their small circle of Iranian acquaintances.

Whereas the children were adjusting well, Mina and Mustafa were beginning to feel the strains of social and cultural alienation. The news of war and family affairs in

Iran was getting more intense. Mustafa still showed no desire to learn more English than he needed to do the bookkeeping for the gas station and deal with customers. Deep inside, he believed that he would return home as soon as the children started college.

 

 

By 1990, Mustafa’s business had gone bankrupt and the family’s savings had dwindled. Their only sources of income were Mina’s earnings and Hamid’s part-time job while attending the local junior college. Relations at home were extremely tense, with emotions always on the edge. Mustafa had increased his smoking to three packs of cigarettes daily, and he had frequent bouts of bronchitis. Mina had lost nearly 20 pounds since their arrival in the United States, and her migraine headaches had increased, occurring almost daily, particularly since she lost her mother without having been able to visit her in Iran.

Mustafa found a bookkeeping job in an accounting firm owned by an Iranian, but his excessive smoking and occasional shortness of breath and heartburn continued. Mina made several visits to the local hospital emergency room with complaints of fatigue and sleeplessness. Mustafa and Mina had treated some of their symptoms with herbal remedies, but their problems persisted to the point at which Mustafa was admitted to the hospital with chest pain to rule out myocardial infarction. The two older children were

attending school and working, leaving the youngest son to act as cultural and language interpreter for their parents during this hospitalization.

Study Questions

1. Identify three major emotional and physiological problems commonly seen among Iranian immigrants.
2. Identify significant socioeconomic factors that limit access to health care for Iranian immigrants.
3. Identify the family spokesperson and discuss salient issues in establishing effective communication with this family.
4. How should prevention be taught to this family? What would be appropriate goals?
5. Name three major risk factors that this family experienced.
6. What mechanisms for coping with stress were predominantly used in this household?
7. Identify the family’s social support system.
8. What hospital policies and constraints might negatively or positively affect this family’s dynamics?
9. Compare and contrast the three waves of Iranian immigration in terms of educational status, reasons for migration, and occupations in the United States.
10. Explore assertiveness tactics for female Iranians in the American workforce. What are the most common health problems of Iranian immigrants? What are some implications for health-care providers?
11. Identify characteristics of a healthy Iranian diet.