Cultural Assessment of a Muslim Woman

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Description of the Person and Cultural Heritage

Sarah Hassan is a 38-year old American-Afghani woman hospitalized at a university hospital in Fremont, California, with high blood pressure. She is married and has three children, a 13-year old daughter and two sons aged 11 and 9. Omar Hassan, her husband, is 42 years and works as a truck driver in a freight company while Sarah is a housewife. Omar and Sarah are cousins. They were forced into marriage at the age of 18 and 14 respectively. They moved to the US from a village near Kabul, Afghanistan, as refugees 13 years ago. Their daughter was born in Afghanistan before they moved to the US. They reside in a three-bedroom apartment in Fremont. In this assessment, a face-to-face interview was conducted to obtain information about Sarah’s social and cultural background based on the Giger-Davidhizar Model.

U.S. Census Data Related to the History of the Person’s Ethnic Group in the United States

Sarah belongs to one of the ethnic groups that have migrated from Afghanistan. Her ethnic group, the Pashtu, is the second-largest American-Afghani group after the Afghani Persians in the US. The Pashtu group makes up about 30% of the estimated population of 300,000 Afghanis in Fremont.

Assessment of Communication Factors

Dialect distinction is evident in the family because the children speak English fluently while the parents have a heavy influence on their mother tongue. In addition, Sarah uses body language when communicating with her nurses, probably because she is not a good speaker of English. Her voice is generally soft and low, with signs of shyness, especially when talking to health workers. She says that she will be well and return to her domestic chores.

Assessment of Space Factors

The term ‘space’ is used in reference to intimacy and distance techniques used when a patient communicates both verbally and nonverbally with other people (Lowe & Archibald, 2011). Every form of communication must take place in the context of space. Sarah communicates within her private space (Higginbottom et al., 2012). She gets in touch with female relatives and her children to show that she is well. She also talks to other women in the facility, especially the nurses who are close to her. However, she does not contact male visitors because her culture does not allow males to communicate emotionally with females unless they are married. By keeping close proximity with Sarah, the American Afghanis visiting her in the hospital seek to build trust and encourage her.

Assessment of Social Organization Factors

It was observed that the Afghani families and friends visiting Sarah at the health facility are sensitive to family structure and organization, religious beliefs and values as well as the role assignments. It appears that these factors dictate how the Afghanis and their families use health services. Sarah’s husband, who is the senior male person in the family, acts as her spokesperson and often involves nurses and other professionals in making health-related decisions. However, interviewing Sarah reveals that at home, the care of patients is delegated to women. They also tend to include families and friends from other Arab and Muslim cultures, especially the Iraqis, Iranians, Saudi Arabians, and those from other Middle East nations residing in Fremont.

Assessment of Time Factors

Giger and Davidhizar (2012) reveal that understanding of time differs among cultural settings or groups. Groups that appear to be oriented to the future are inclined to follow preservative measures when they are dealing with health issues. In contrast, individuals who follow the past do not show interest in planning for the future. Sarah and her husband seem to be future-oriented. They have plans to care for the family. For example, they have a health insurance plan, especially because Omar is already a naturalized American citizen and Sarah has obtained a permanent residence. She says that the husband works hard to meet the family needs, pay school fees and hopefully purchase a house and start a small business for her. They do not plan to return to Afghanistan, but they believe that they can invest there if peace is restored. However, it was observed that the pair idealizes traditional values as well as Islamic practices when seeking health services. They are less interested in seeking preventative approaches in most cases.

Assessment of Environmental Control Factors

Although Omar does not believe in external forces, his sick wife sometimes believes that her condition is due to the will of Allah. She thinks that God is not punishing her, but using the disease to test her faith and ability to withstand temptations. She thinks that the relocation from Afghanistan to the US has some effects on her body.

Assessment of Biological Variation Factors

Public health concerns among Afghani immigrants indicate evidence of the prevalence of some diseases. Adults are prone to a number of diseases such as diabetes, coronary heart disease, and hypertension. In addition, it has been noted that the rate of consanguinity among the Afghani population in the region is high, probably reaching 50% because most people marry their cousins. Omar and his wife Sarah are cousins as well. They were forced to marry when they were teenagers, but they managed to maintain a strong relationship through time.

Identification and Discussion of any of the Student’s Recognized Pre- bias, Prejudice, Stereotyping, and Perceptions

The language barrier is a major issue in managing Sarah’s condition. It is likely to cause bias when nurses communicate with Sarah, especially because she is not fluent in English. Sarah and her husband communicate in Pashtu, but they are also excellent speakers of Dari and standard Arabic. They communicate with their children in Pashtu, but the children are good at spoken and written American English as well. Secondly, religious stereotyping is evident in this case because the family members believe that Sarah’s health problem is not due to her lifestyle, rather it is due to the will of God. Sarah insists on prayers during family and friend visits at the facility, asking Allah to speed up her healing process.

Prejudice is evident in the case of Sarah because the Afghani society does not believe that females can make their own health decisions, which means that a male must be present when such decisions are made. Sarah thinks that her husband should always be consulted when nurses want to make any decision regarding her health.

In conclusion, cultural analysis improves our understanding of an individual’s health status and the socio-cultural factors that are likely to affect health outcomes. It improves the nurse’s understanding of the best approach to use when dealing with each patient. Communication establishes a sense of commonality among people in a given area, which allows them to share cultural traditions (Dowd, Davidhizar, & Giger, 2011). It enhances the process of exchange of information when sharing feelings, ideas and experiences with individuals and groups. Both verbal and nonverbal communication is imperative in playing these roles within a given society. By focusing on the essential elements of communication, such as the sense of touch, rhythm, vocabulary, style, emotional tone, body posture and kinetics, it is possible to examine and learn the patient’s cultural background.

References

Dowd, S., Davidhizar, R., & Giger, J. N. (2011). The mystery of altruism and transcultural nursing. The health care manager, 26(1), 64–67.

Giger, J. & Davidhizar, R. (2012). Transcultural Nursing: Assessment and Intervention. Maryland Heights, MO: Mosby Year Book

Higginbottom, G., Richter, M. S., Mogale, R. S., Ortiz, L., Young, S., & Mollel, O. (2012). Identification of nursing assessment models/tools validated in clinical practice for use with diverse ethno-cultural groups: An integrative review of the literature. BioMed Central Nursing 10(2), 16.

Lowe, J., & Archibald, C. (2011). Cultural diversity: The intention of nursing. Nursing Forum, 44(1), 11-18.

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