Caring for Arab Patients: A Biopsychosocial Approach PDF
Preview Caring for Arab Patients: A Biopsychosocial Approach
Caring for Arab Patients Caring for Arab Patients A BIOPSYCHOSOCIAL APPROACH Edited by LAETH SARI NASIRMBBS Professor of Family Medicine, Department of Family Medicine University of Nebraska Medical Center, Omaha, NE and ARWA KAYED ABDUL-HAQMBBS, MSc (Peds), MFT Staff Physician, Children’s Hospital, Omaha, NE Volunteer Faculty, Departments of Family Medicine and Pediatrics University of Nebraska Medical Center, Omaha, NE Foreword by ALA TOUKANMB, BS (Lond), FRCP(C) Clinical Professor of Medicine and Gastroenterology Former Dean, Faculty of Medicine University of Jordan, Amman Radcliffe Publishing Oxford • New York CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2008 by Laeth S Nasir and Arwa K Abdul-Haq CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Printed on acid-free paper Version Date: 20151015 International Standard Book Number-13: 978-1-84619-182-4 (Hardback) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/ opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. 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Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Foreword vii Preface ix About the editors x List of contributors xi Introduction 1 Part 1: Culture, environment and health 1 Culture and health 5 SHERINE F HAMDY AND LAETH S NASIR 2 Globalization, health and culture 19 LAETH S NASIR 3 Gender and health 27 LAETH S NASIR AND RAEDA AL-QUTOB 4 Genetic disorders 61 GHAZI O TADMOURI Part 2: The family 5 The Arab family: formation, function and dysfunction 77 ARWA K ABDUL-HAQ 6 Child abuse and neglect 89 ADIB ESSALI 7 Domestic conflfl ict and violence 101 AISHA HAMDAN 8 Disability 117 ARWA K ABDUL-HAQ 9 Age and aging 125 ABDELRAZZAK ABYAD 10 Death and dying 141 LAETH S NASIR Part 3: Mental health 11 Approach to the patient in primary care psychiatry 155 LAETH S NASIR AND ARWA K ABDUL-HAQ 12 Anxiety and somatoform disorders 169 BRIGITTE KHOURY, MICHEL R KHOURY AND LAETH S NASIR 13 Post-traumatic stress disorder 185 EYAD EL-SARRAJ, TAYSIR DIAB AND ABDEL AZIZ THABET 14 Eating disorders 199 NASSER SHURIQUIE 15 Substance abuse 209 LAETH S NASIR 16 Depression, self-harm behavior and suicide 223 LAETH S NASIR Part 4: Patient education 17 Patient education 235 ANAHID KULWICKI Index 247 Foreword Today medical practice in the Arab world is predominantly grounded in that of the Western model. Many healthcare providers have trained in Euro-American schools, and consequently the health infrastructure in the Arab world has been molded along similar lines. Graduating students and specialists from these Arab institutions are products of this model in their own countries. On the other hand, the background culture and the inherent psychosocial dimens ion of the medical encounter remain poorly integrated factors in the health provision process. Thus the practice language is often foreign to the provider–patient exchange in the Arab world, while signs and symptoms are interpreted according to set defifinitions in Western textbooks. Many other famil- iar instances of this defifi ciency come to mind as examples. For instance, is the extended family’s often overwhelming presence alongside the patient unders tood and used to advantage? Or is it seen as a troublesome manifestation in keeping with the Western concept of limiting such a role? How does the patient (and family) comprehend illness in terms of presentation to the healthcare provider and compliance with treatment? In this regard, “late presentation” and “poor compliance” are dismissals commonly expressed by the health provider with little thought given to the psychosocial appraisal of such failures. Analysis of these common scenarios may challenge and advance comprehension of the cultural milieu of healthcare, as well as teaching and research in the Arab world. A call to highlight the cultural and psychosocial dimensions of medical prac- tice in the Arab world should lead to a process of reorientation in this direct ion, preferably based on data from local studies rather than a process of learning by trial and error. To this end the authors of this book, experts on psychosocial impact of disease from Arab and Western institutions, have presented a remarkable effort in accumulating and analysing a surprising volume of studies done on this subject but which have not been collated for this purpose previously. They tackle many aspects in the dimension of cultural inflfl uences on medical practice, includ ing issues where psychosocial factors are of primary importance in the disease setting (mental health issues), and others where these factors are a backdrop to the issue under care (culture, environment and health, the family). vii viii FOREWORD Arab health providers are likely to read this book with an interest stimulated by familiarity with the issues, while simultaneously recognizing their own lack of comprehension of the subject. It is to be hoped that, in the near future, a critical mass of these health providers will call for the inclusion of this subject matter in curricula at all levels of education for those providing care to the citizens of the Arab world – the ultimate benefificiaries of a sound scientififi c and culturally relevant basis of health provision. Ala ToukanMB, BS (Lond), FRCP(C) Clinical Professor of Medicine and Gastroenterology Former Dean, Faculty of Medicine University of Jordan, Amman January 2008 Preface Caring for Arab Patients: a biopsychosocial approachh is designed for physicians, medical students and other health professionals who work with patients in the Arab world. The fifi rst text of its kind, Caring for Arab Patientss uses a cross-disciplinary synthesis of research evidence to explore the psychosocial aspects of medical care in Arab countries. The contributors, who include distinguished scientists and academics from the region, provide fresh and authoritative analysis, clinical approaches and directions for further research. This book will be indispensable to those wishing to gain an understanding of the psychosocial dimensions of medical care in Arab countries. Laeth S Nasir and Arwa K Abdul-Haq January 2008 ix
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