Anahid Kulwicki

Collaborative Partnership for Culture Care: Enhancing Health Services for the Arab Community

The purpose of this study was to discover perceptions, experiences, and patterns of health care behavior among Arab Americans in an urban Midwestern area of the United States and then to discover perceptions and experiences of health care providers related to culturally competent care. The goal of the study was to generate findings that would provide the basis for implementing system-wide changes to include culturally competent care. A qualitative focus group methodology was used to discover the care patterns and perceptions of Arab Americans and the local health care providers. The nurse researchers conducted 10 focus groups. Six themes were identified, including the unique caring behaviors of Arab families, the complexity of the health care system to Arab Americans, communication gaps, the diversity of perceptions of cultural competency, obstacles to accessibility of care, and workforce diversity issues.

Predictors of Arab American Adolescent Tobacco Use

This study examined personal, psychosocial, sociocultural, and environmental predictors in tobacco use for 1,671 Arab American adolescents. Cigarette smoking in the past 30 days was 6.9%. This increased from 1% at age 14 to 14% at age 18. Twenty-nine percent of the youths reported having ever smoked cigarettes. Experimentation with narghile was 27%; it increased from 23% at 14 years to 40% at 18 years. All trends were significant (p < .001). Logistic regression analyses found 11 predictors for having smoked a cigarette in the past 30 days and 9 and 7 predictors, respectively, for having ever smoked a cigarette or the narghile. Tobacco use by friends and family members was the strongest predictor of cigarette and narghile smoking. Narghile use supported cigarette smoking.

Barriers in the Utilization of Domestic Violence Services Among Arab Immigrant Women: Perceptions of Professionals, Service Providers & Community Leaders

Ten focus group discussions were conducted with Arab American community leaders who had experience with victims of violence in the Arab American population and issues related to domestic violence. Community leaders were selected from an array of backgrounds, ranging from health and human service providers, legal and law enforcement service providers, religious and grass roots community organizations. Focus group discussions explored the role of personal resources, family, religion, culture and social support system in the utilization of domestic violence services by Arab immigrants experiencing domestic violence. In addition, issues related to personal, socio-cultural and institutional barriers in domestic violence service utilization were addressed along with identifying culturally competent policy strategies in reducing barriers for service utilization by Arab immigrants experiencing domestic violence.

Students' knowledge, attitudes, and beliefs about AIDS: A cross-cultural study.

This exploratory, comparative study was conducted to assess and compare the knowledge, attitudes, and beliefs toward AIDS between a group of Jordanian and a group of American students. A convenience sample consisting of 126 senior BSN (bachelor’s of nursing) students, 63 from a university in Jordan and 63 from a university in Michigan, was selected for this study. A self-administered structured questionnaire was utilized. The questionnaire consisted of three parts: knowledge, attitudes, and beliefs toward AIDS in both cultures. Descriptive and inferential statistical analyses were used. The results indicated that the American students’ responses concerning knowledge of HIV/AIDS were significantly greater (M = 73%) in comparison with Jordanian students’ (M = 52%). The American students also reported more positive attitudes toward AIDS than those of their Jordanian counterparts. In terms of prevention of the spread of HIV/AIDS, more American students (82.5%) approved of the use of condoms as a precautionary measure toward the spread of the disease when compared to Jordanian students.

“A model of mother-child Adjustment in Arab Muslim Immigrants to the US”

We examined the mother-child adjustment and child behavior problems in Arab Muslim immigrant families residing in the U.S.A. The sample of 635 mother-child dyads was comprised of mothers who emigrated from 1989 or later and had at least one early adolescent child between the ages of 11 and 15 years old who was also willing to participate. Arabic speaking research assistants collected the data from the mothers and children using established measures of maternal and child stressors, coping, and social support; maternal distress; parent-child relationship; and child behavior problems. A structural equation model (SEM) was specified a priori with 17 predicted pathways. With a few exceptions, the final SEM model was highly consistent with the proposed model and had a good fit to the data. The model accounted for 67% of the variance in child behavior problems. Child stressors, mother-child relationship, and maternal stressors were the causal variables that contributed the most to child behavior problems. The model also accounted for 27% of the variance in mother-child relationship. Child active coping, child gender, mothers education, and maternal distress were all predictive of the mother-child relationship. Mother-child relationship also mediated the effects of maternal distress and child active coping on child behavior problems. These findings indicate that immigrant mothers contribute greatly to adolescent adjustment, both as a source of risk and protection. These findings also suggest that intervening with immigrant mothers to reduce their stress and strengthening the parent-child relationship are two important areas for promoting adolescent adjustment.

A review of 16 cases of honour killings in Jordan in 1995

Abstract The purpose of the study was to determine the causes of death as reported in court files of the female victims of honour crimes, the Jordanian penal codes regarding crimes of honour, the evidence used in the sentencing of the defendants, the types of weapons used, the characteristics of the physical assaults on the victims and the sentencing of the offenders. A retrospective study of crimes of honour in Jordan was conducted, and the 16 homicide cases considered to be crimes of honour were reviewed. The autopsy reports of the victims provided information on the physical condition of the victims, including the type and severity of injuries. In over 60% of the honour crime cases, multiple gunshot wounds were the direct cause of death. In cases where the victim was a single pregnant female, the offender was acquitted of murder or received a reduced sentence. The majority of murders were committed by the brother of the victim and the length of sentence received by the offender varied from no sentence to life with hard labour. Offenders who received the harshest punishment were those whose victims married without the family consent.

Improving global health care through diversity

One of the major challenges facing the nursing profession is the globalization of nursing education, research, and practice. The word diversity is derived from the Latin word divertere meaning being different or having differences. Diversity in nursing practice means providing competent care to clients from different cultures, conducting research in multi-cultural settings, and implementing educational programs to diverse populations. Key principles and practices that provide a framework for diverse relationships in nursing practice, research, and education must be driven by a professional commitment in building a global community that is inclusive, respectful, and dedicated to global health care for all. Through international collaborations and individual and collective partnerships, nurses can build bridges between and among national health care systems, strengthen the international health care infrastructure, broaden health care delivery systems, and improve the quality of health care for all.

Smoking behavior in pregnant Arab Americans

ObjectivesTo determine the smoking behavior in pregnant Arab American women who attended a Women, Infant and Children (WIC) program at a local county public health clinic and compare the incidence of smoking behaviors of pregnant Arab American women with pregnant women who were not Arab Americans. Design and MethodsData were extracted from a computer database that contained information from health history charts of pregnant Arab and non-Arab American women. The study sample was 830 women, 823 of whom were Arab American participants enrolled in the WIC program in Michigan. ResultsApproximately 6% of pregnant Arab Americans smoked during pregnancy. The prevalence of smoking behavior among pregnant Arab American women was similar to that of smoking behaviors of Hispanics and Asian Americans in the United States. ConclusionAlthough smoking behavior is a serious problem among Arab American immigrants in general and in the Arab world in particular, cultural factors that support healthy behavior during pregnancy in the Arab culture seem to limit the use of tobacco in pregnant women. Nurses who care for Arab American pregnant women can use this information to better inform their care of these patients.

Functional and psychosocial status of Haitians who became users of lower extremity prostheses as a result of the 2010 earthquake.

ABSTRACT The January 12, 2010 earthquake devastated Port-au-Prince, the capital of the Republic of Haiti, and its surroundings. Among the 300,000 injured people, 1200 to 1500 people underwent traumatic/surgical amputations. The purpose of this study was to describe the functional and psychosocial impact on prostheses users who had a traumatic lower-limb amputation after the earthquake of 2010 in Haiti. We recruited 140 participants in collaboration with a large health care organization in Port-au-Prince from October 2011 to May 2012. The participants underwent an evaluation of physical impairments and completed questionnaires translated into Haitian Creole. The Trinity Amputation and Prosthesis Experience Scales (TAPES) and the Locomotor Capabilities Index (LCI) were used in this study. The questionnaires were administered verbally in Haitian Creole by a trained staff. We conducted descriptive statistics and t-tests using SPSS for data analysis. The participants had a mean (SD) age of 34.9 (12.0) years; 51.4% were women; 48.6% were transfemoral amputees. The mean (SD) scores of TAPES general adjustment (3.65 [0.59]) and adjust to limitation (3.67 [0.86]) were higher than the score for the social adjustment (2.58 [0.49]). The LCI showed that more than 90% of the subjects were physically independent in self-care; fewer were independent in walking on uneven ground or inclement weather (69%). The relatively poor social adjustment is consistent with the literature that describes limited acceptance of people with physical disabilities in Haitian society. Prostheses users in Haiti would benefit from a health delivery infrastructure that also addresses the psychosocial reintegration of individuals with physical disabilities.