Cultural Competency - Multicultural Health Generalizations: Arab
Pain Management among Arabs
- Many Arabs express pain freely, especially in the presence of family members with whom they feel comfortable.
- When helping Arab patients manage their pain, it may be useful to keep in mind that:
- Pain is feared and may cause panic when it occurs.
- Coping with pain may be easier if enough information about its source and prognosis is provided.
- When the benefits of potentially painful medical procedures are understood, a higher pain tolerance may result.
- Some Arab patients may perceive intravenous fluids as an indication of the severity of the situation; thus, an explanation may be needed.
- Injections may be considered more effective than pills.
- Explaining the differences between self-medication and prescribed medication may be valuable if patients are considering self-medication.
- Arab patients may also use metaphoric symbols such as fire, iron, knives and rocks to describe pain. Inquiring about these symbols may be useful to further understand pain management among Arabs.
Source: Meleis, A. I. (1996). Arab Americans. Culture and Nursing Care: A Pocket Guide. California: University of California. P. 28
Saudi Spiritual Healing
- Spiritual healing methods are widely practiced by Saudis for the whole spectrum of disease, with particular emphasis on conditions for which no curative medicinal treatment is known.
- These include the healing of conditions such as possession by Jinn, mal-effects of evil eye, and poisonous stings.
- The common spiritual healing practices among Saudis are the ones advised according to the teachings in the Noble Qur'an and (or) Sunnah.
- The main spiritual modality of treatment is the recitation of verses of the Qur'an and specific sayings of the Prophet Mohammad.
- Zamzam water (obtained from the Zamzam well in the Holy Mosque in Makka), honey, and black cumin (Nigella seeds) are considered healing agents.
- The use of amulets is extremely rare in Saudi culture, as this practice was discouraged by the Prophet Mohammad.
- Expression of respect toward spiritual healing practices by health care providers is likely to foster a good relationship with patients and families.
Source: Al-Shahri, M. Z. (2002). Culturally Sensitive Caring for Saudi Patients.Journal of Transcultural Nursing 13, 2, 133-138.
Iraqi Traditional Medicine Practices
Some Iraqi traditional medicine practices include:
- Cumin powder dissolved in water given for stomach ache, as is green tea.
- Lemon juice or plain rice given for diarrhea.
- A heated brick, covered with a cloth and sat upon, is also used for diarrhea.
- The Karawya herb, boiled in water, is given for stomach ache, diarrhea or constipation. This herb is also believed to ease abdominal pain, especially in children.
- To treat a cough, Iraqi patients may drink a mixture of honey and lemon juice or lemon juice and orange juice.
- To treat a cold, a steam tent is constructed where the patient can be kept covered for up to twenty-four hours.
- Boiled in water, the anise seed is used for a sore throat or laryngitis.
- Ground cumin, ninia seed, shabak seed, are all ground and mixed together as a powder and placed on the gum for toothaches.
- For a dislocated shoulder, ninia and churned butter are mixed together as an ointment and applied to the shoulder.
- To treat burns, barley is burned, mixed with butter, and applied as a poultice on the burn for 48 hours.
- For a splinter, a paste of flour and sugar is placed over the splinter or over an infected pimple or cyst.
- An infected eye with pus drainage is treated by placing a cloth, boiled in tea, over the eye.
- To treat fever, a cloth is dipped in a mixture of cumin and egg yolk heated in water, and then placed over the forehead.
Source: Iraqi Refugees. http://www3.baylor.edu/~Charles_Kemp/iraqi_refugees.htm. Retrieved on 4/2/03.
Cultural Barriers to Healthcare among Arab-Americans:
- Medical care and providers:
- An Arab-American patient seeing a doctor may expect to receive medication and have relief from pain during the first visit. Such patients may need an explanation for not receiving medication or lab testing.
- When Arab-Americans suffering from mental distress seek medical care, they could be likely to present with a variety of vague complaints. Patients often expect and prefer somatic treatment. Hospitalization is resisted because such placement is viewed as abandonment.
- Privacy:
- Some patients may not disclose detailed information about themselves or their families, especially to strangers.
- Women may not want to talk about their private lives. However, they may feel more comfortable talking with female doctors.
- Sexual problems and venereal diseases can be a difficult topic for patients to discuss.
- Diet:
- Muslims might eat only Halal meat (meat from animals slaughtered according to Islamic tradition).
- During Ramadan (10/5/05-11/4/05), Islamic patients might not take medications, eat or drink from sunrise to sunset.
Source: Purnell, L. D., & Paulanka, B. J. (1998). Transcultural Health Care: A Culturally Competent Approach. Philadelphia, PA: F. A. Davis Company.
Saudi Traditional Medicine
- Even with the developmental boom of medical services in Saudi Arabia, traditional medical practices are still available in some rural and urban areas.
- The main modalities of traditional medicine include:
- cauterizing: destroying abnormal tissue by burning or scarring with a hot instrument
- herbal medicines
- dietary treatments
- chiropractic
- fracture reduction: alignment of the fractured bone fragments back to their original state
- cupping: treatment in which evacuated glass cups are applied to intact or scarified skin in order to draw blood toward or through the surface
- Traditional healers are common. These healers inherit the trade from their predecessors.
- A traditional healer sometimes orders the discontinuation of all hospital medications before accepting a patient for treatment.
- Health care providers may find it helpful to inquire about a patient's use of traditional medicine in order to increase the effectiveness of a non-contradicting treatment plan.
Source: Al-Shahri, M. Z. (2002). Culturally Sensitive Caring for Saudi Patients. Journal of Transcultural Nursing 13, 2, 133-138
