# data[].attributes.body
Background

While I was doing my research and speaking with an Arab American friend of mine, I found that there are several countries that are Arab culture countries.
There are also different religions other than just Muslim within the Arab culture.  Although the Arab culture is a Male dominating culture, not all of the countries are the same.  For example, since we're discussing healthcare specifically, the hospitals are run differently depending on if it is  Public hospital or a private hospital.
Even though the country is a Male dominant culture, the Male does't actually have a say so with the healthcare decisions.  The physician has all of the control over what is going to done and when.  There are no consent forms signed.  There is also no living will or a DNR type of form.  My friend Karima who is the CEO of a hospital in Detroit Michigan, which is where the largest Arab American community in the United States is, stated that the only thing the Male figure in the family usually will control the gender of the physician.  They do like females to see female physicians and males to see a male physician, however if the husband doesn't like the female physician or doesn't trust her then his wife or daughter will see a different physician.  She was also telling me that a lot of males don't always feel that a female should be a physician because she doesn't know as much as a Male does and that is the reason for the mistrust.  When it comes the children as a whole, the parents have the say so of their health at home but nothing to do with it at the hospital.
If there is an emergency situation and you have to be rushed to the emergency room and your clothes have to come off, then they do cut them off just as in the United States.  When you're admitted to the hospital or going to checked checked out at the hospital, Karima was saying that they are supposed to knock before entering but because its it's such controlling environment over there she wouldn't be surprised if they just barge right in unannounced.

# data[].attributes.headline
Why do Muslim Women dress the way they do?

# data[].attributes.subject
Why do Muslim Women dress the way they do?

# data[].attributes.body
The Muslim culture believes that the left hand is unclean. Any patient care or anything handed to the patient should be done with the right hand. Muslim and Arab clients do not expect healthcare professionals to tell them or remind them of terminal illness. They believe that God has the power to create life and cause death.

# data[].attributes.body
Before beginning care it is important that the healthcare worker knock and obtain permission to enter the room by the patient. When caring for an Arab patient it is best for the clinician and patient to be the same gender. If this is not possible, a family member should stay in the room during the procedure and even for communication purposes. Female patients may avoid eye contact or shaking hands with male healthcare workers as a sign of modesty. The healthcare team should also remember that if any clothing should be removed during any procedure it should be as little as possible and they should obtain permission before doing so. They should also tell the patient everything they are doing before they do it, especially if they are of a different gender.

# data[].attributes.body
Arab Americans utilize primary care prevention measures, such as finding a PCP. This culture chooses a Primary Care Physician that will be aware and sensitive of their cultural beliefs.

# data[].attributes.body
Immunizations and Vaccines are generally well accepted as preventative treatment.

# data[].attributes.body
Different cultures have different meanings for words, behaviors and gestures. The culture that someone is raised in shapes the way they think and behave and can become a communication barrier to different cultures.

# data[].attributes.body
Arab Americans will often keep any birth defect or disability private. They may not seek treatment for a child born with a disability and may go as far as to ignore the defect or disability exists at all.

# data[].attributes.body
Temporary birth control is sometimes tolerated. The morning after pill is an unacceptable form of treatment along with IUD's. (intrauterine device)

# data[].attributes.body
Smoking also a serious concern of the Arab American community.

# data[].attributes.body
Arab Americans may not allow a their spouse to be evaluated or assessed by a provider of the opposite sex. Arab American females may refuse to disrobe for the assessment.

# data[].attributes.body
Healthcare workers should inquire and identify if the patient is participating in fasting to  make a treatment plan that include their fasting choices.
Healthcare workers should also inquire about their specific diet restrictions and be aware of he Arab Americans' kosher diet restrictions or choices.

# data[].attributes.body
Arab Americans suffer from high rates of obesity.

Metropolitan Los Angeles, Detroit, and New York are home to one-third of the Arab American population.In 2003 a study was conducted on 5th graders in a city of Michigan where 40% of the population was Arab American. The study revealed 28% of Arab-American 5th graders were overweight while 17% were obese.

In the middle-east alone, 75% of the region is obese. Making them the second highest region in the world for obesity

Healthcare workers should educate patients of the Arab American communities about proper dieting and daily exercise.

Encourage patients to eat foods that promote.

Obesity is directly linked to diabetes, hypertension and cardiovascular disease. Healthcare workers should make sure patients know the risks that they are taking.

Healthcare workers should monitor blood pressure, blood glucose and other labs that would show signs of illness due to obesity.

# data[].attributes.body
Hookah smoking is a particularly concern as it originated in the middle east.
“A single session of hookah smoking may be equivalent to more than a packet of cigarettes, and the inhaled toxic compounds may be even greater,” said Professor Gordon Ferns, head of the Department of Medical Education Brighton and Sussex Medical School.”

Educate about the dangers of smoking and all the complications that come with it.

Monitor patients in the Arab American Communities for signs of cancer, heart disease, lung disease, and other health problems that can result due to smoking.

With Hookah, educate our patients on the risk of communicable infectious disease like herpes, tuberculosis, hepatitis, influenza, and H. pylori.

# data[].attributes.body
Many recent Arab Americans immigrants have language barriers, although many of them may hold part-time jobs that may prevent them from getting timely access to health care when needed. In addition, many part-time jobs do not provide health insurance or provide sick leave. Many recent immigrants do not speak English fluently and that will limit their ability to seek medical care.

# data[].attributes.body
Arab Americans may refuse blood products due to the belief that it may have been donated by nonmuslems even if they are not a practicing Muslim their selves.

# data[].attributes.body
Muslims prayer is performed 5 times daily; dawn (before sunrise), midday (after the sun passes it highest), the late part of the afternoon, just after sunset, and then between sunset and midnight. They are prohibited alcohol, non-Halal animal fats, pork, by products of pork, and any animal that has not been slaughtered according to Islamic custom. During Ramadan, which is Muslim’s fasting, they do not consume food or liquids (water included) between sunrise and sundown. This even includes sex and is a month long. They believe life after death and that there is a judgement day. They also believe there is only one God, Allah, and the messenger of God is Muhammad. They see health providers as "helpers of God's will."

# data[].attributes.body
A guideline to follow (if possible) when working with a Muslim patient of the opposite gender, avoid eye and physical contact. Obtain permission prior to entering the room. During a physical exam, having a physician of the same sex is best. Also, a healthcare professional of the opposite gender may have to communicate through the spouse. Sometimes these accommodations may not be able to be met, but if possible, having a third person in the room of the same sex could possibly add comfort to the patient. If clothing should be removed, remove little as possible. Hospital gowns may be refused due to the amount of skin shown. Due to their dietary rules, refusal of hospital food may occur and if they are unable to bring food from home, provide things such like eggs, fruits, seafood, and vegetables. Medicines containing alcohol, gelatin, or are pork based is forbidden. When a Muslim is fasting, they may also refuse treatment (IV's or medications), but education on the importance of medication and being respectful could help the patient make the right choice. With this being said, “Islam permits the use of any drug in a life-threatening situation.” Be sure to apologize for cultural mistakes can make a difference.

# data[].attributes.body
Arab Americans seeking treatment for diabetes may refuse insulin due to it containing  pork products.
Medication is generally well accepted in order to treat disease and illness. However psychoactive drugs and medications that contain narcotics and alcohol should be avoided.
Circumcision in newborns is expected before being discharged from the hospital.
Mental health is taboo. No treatment for mental health such as antidepressants are looked down upon.
Although medication is accepted, they believe rest will speed the recovery best. So while staying in a noisy hospital it is important to take in this cultural belief into consideration while preparing and carrying out their treatment plan.

# data[].attributes.body
Early Arab immigrants were mostly Christians.

After 1965, Muslim Arabs began arriving in larger numbers to the US and the newer Arab immigrants tend to be Muslim.

Men – Beards are religiously symbolic and wont shave unless it is necessary. If it is for a medical purpose, another man should shave off the beard. Men are typically dressed to the knees or past the knees.

Women – They dress modestly. It is to protect from immorality and pride. They wear hijab, which is a head covering.

# data[].attributes.body
With Muslim faith being the fastest growing religion in the world, chances are as a healthcare professional, we will care for a Muslim patient.

# data[].attributes.body
There are an estimated 2- 3 million Arab Americans living in United States, including individuals who are ethnically Arab or have emigrated from one of the approximately 22 countries that make the contemporary Arab world. With Arabic people living in many different countries, Arab Americans can be from a wide variety of areas, having differs in each health care's systems.  According to a classmate's family member, a resource barrier would be that the nurse to patient ratio could differ quite a bit depending on the country.  With that, there is a huge lack of communication between the physicians and patients which can be almost non-existent. Physicians make decisions on treatments with what they think is best and do not particularly ask for permission from patients.

# data[].attributes.body
"For Muslims, health is a state of physical, psychological, spiritual, and social well-being and is considered the greatest blessing God has given humankind. Muslim patients receive illness with patience, prayers, and meditation. Even Muslim patients who are not actively practicing their faith may call for spiritual or religious intervention when they are facing significant challenges. Muslim patients believe illness, suffering, pain, and dying as a test from God, and perceive illness as a trial by which one’s sins are removed."

# data[].attributes.body
http://www.arabamericanmuseum.org/umages/IMLS_religion_exhibit/AA_religion.html
https://www.discoverislam.com/why-do-muslim-women-dress-the-way-they-do
http://www.pewresearch.org/fact-tank/2017/04/05/christians-remain-worlds-largest-religious-group-but-they-are-declining-in-europe/
https://www.ncbi.nlm.nih.gov/books/NBK499933/
https://www.bbc.co.uk/religion/religions/islam/practices/salat.shtml
Interview with Karimma Bentounsi

Health Concerns
http://www.aaiusa.org/arab-american-health-today-a-discussion-with-dr_-abdulrahman-m-el-sayed
https://renewbariatrics.com/obesity-rank-by-countries/
http://www.aaiusa.org/demographics/

Attum, B. (2019, January 19). Cultural Competence in the Care of Muslim Patients and Their Families. Retrieved March 20, 2019, from https://www.ncbi.nlm.nih.gov/books/NBK499933/