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–Gulf War 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-in
law, and a family friend, who speaks English and Arabic and acts as the translator, are
at her bedside.
Study Questions
1. 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. Interpret this behavior within a cultural
context.
6. Although Mrs. Ayesha is normothermic 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.
11. 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.