1. The Middle East: Its Vibrant Culture, Health Beliefs, and Ideas Veronika Stiles HYGDCE 487 August 4, 2008

2. Defining the Middle East Initially British term Referred to as the Near East or Southwest Asia Not an exactly defined area of the world Political concept Birthplace of three World religions: Judaism, Christianity, and Islam 1. Smith D. The State of the Middle East: An Atlas of Conflict and Resolution. Brighton, UK: Myraid Editions Limited; 2006.

3. Countries of the Middle East

4. Ethnicity, Language, and Religion The region population is 350 million 240 million are Arabs Arabic is the most spoken language Arabic is the language of Islam 90% of the population are Muslims 1. Smith D. The State of the Middle East: An Atlas of Conflict and Resolution. Brighton, UK: Myraid Editions Limited; 2006.

5. Crude Oil Power 68% of the world’s proven oil reserves Saudi Arabia reserves 23% of the world total Iraq reserves 9% of the world total Source: Energy Information Agency/Oil and Gas Journal. (c2004 The Christian Science Monitor (www.csmonitor.com)). 1. Smith D. The State of the Middle East: An Atlas of Conflict and Resolution. Brighton, UK: Myraid Editions Limited; 2006.

6. Middle Eastern Immigration to the U.S. One of the fastest growing immigrant groups in the U.S. One of the most educated immigrant groups Reasons for immigration to the U.S.: 1.Poor economy 2. Politically oppressed and corrupt 3. Religious conflicts 2. Camarota SA. Immigrants from the Middle East: A Profile for the Foreign-Born Population from Pakistan to Morocco [database on the Internet]. Washington, DC: Center for Immigration Studies. 2002 Aug; cited 2008 Aug 1. Available from: http://www.cis.org/articles/2002/back902.html

7. Middle Easterners in Michigan In the Midwest, Michigan and Illinois are leading states Michigan has the highest percentage (70%) of Arab immigrants 2. Camarota SA. Immigrants from the Middle East: A profile for the foreign-born population from Pakistan to Morocco [database on the Internet]. Washington, DC: Center for Immigration Studies. 2002 Aug; cited 2008 Aug 1. Available from: http://www.cis.org/articles/2002/back902.html

8. Gender Inequality and Health Beliefs Patriarchal society Overprotection is the male’s duty Strict sexual segregation Male doctors are preferred Male family member might stay and answer questions Modesty is very important in Islamic tradition 3. Jenko M, Moffitt SR. Transcultural nursing principles: An application to hospice care. J Hosp Palliat Nurs. 2006 Jun 16; 8 (3): 172-80. 4. Fernandez VM, Fernandez KM. Transcultural nursing: Basic concepts and case studies [database on the Internet]. Cultural Diversity in Nursing. c1997-2008 [updated 2005 Mar; cited 2008 Aug 2]. Available from: http://www.culturediversity.org/mide.htm

9. Health Related Practices Concept of an upset body balance Amulets against evil Burn incense Good personal hygiene and a healthy diet Ramadan and fasting Safe, simple home remedies from elders 3. Jenko M, Moffitt SR. Transcultural nursing principles: An application to hospice care. J Hosp Palliat Nurs. 2006 Jun 16; 8 (3): 172-80. 4. Fernandez VM, Fernandez KM. Transcultural nursing: Basic concepts and case studies [database on the Internet]. Cultural Diversity in Nursing. c1997-2008 [updated 2005 Mar; cited 2008 Aug 2]. Available from: http://www.culturediversity.org/mide.html 5. Guiley, RE. Harper’s Encyclopedia of Mystical and Paranormal Experience. New York (NY): Harper Collins; 1991: 197. 6. Jordan M. Encyclopedia of Gods. New York (NY): Facts on File Inc.; 1993: 107.

10. Health Care Professional Perceptions 4. Fernandez VM, Fernandez KM. Transcultural nursing: Basic concepts and case studies [database on the Internet]. Cultural Diversity in Nursing. c1997-2008 [updated 2005 Mar; cited 2008 Aug 2]. Available from: http://www.culturediversity.org/mide.html http://www.culturediversity.org/mide.html 7. Marrone SR. Nursing in Saudi Arabia: Leadership development of a multicultural staff. JONA. 1999 Jul-Aug; 29 (7/8): 9-11. Medical professions are not well-respected in the Middle East Its intimate nature of the physical care needs Nurses are perceived as helpers Trust modern Western medicine

11. Useful Body Language Tips Use of silence means the need for privacy Showing sole of the foot is offensive Use right hand when handing an item to Middle Easterners Respect patient’s privacy and personal space 3. Jenko M, Moffitt SR. Transcultural nursing principles: An application to hospice care. J Hosp Palliat Nurs. 2006 Jun 16; 8 (3): 172-80.

12. Dental Appointment Considerations Reluctant to disclose detailed information Anxious to receive medications Answer questions, listen carefully Follow directions Stop medications with improvement Once improved, no follow-up appointments 4. Fernandez VM, Fernandez KM. Transcultural nursing: Basic concepts and case studies [database on the Internet]. Cultural Diversity in Nursing. c1997-2008 [updated 2005 Mar; cited 2008 Aug 2]. Available from: http://www.culturediversity.org/mide.htmlhttp://www.culturediversity.org/mide.html

13. Cultural Competence Working with any culture, it is crucial A building-block approach Step 1: Knowledge of one’s own culture Step 2: Knowledge of others Step 3: A nonthreatening interaction Step 4: Tolerance 8. Willis WO. Culturally competent nursing care during the perinatal period. J Perinat Neonatal Nurs. 1999 Dec; 13 (3): 45-59.

14. Cultural Competence Step 5: Inclusion Step 6: Appreciation and Acceptance Step 7: Competence Competence = all steps blended together 8. Willis WO. Culturally competent nursing care during the perinatal period. J Perinat Neonatal Nurs. 1999 Dec; 13 (3): 45-59.