Case Study: A Lebanese Immigrant Family Copes with a Terminal Diagnosis

  • Anahid KulwickiEmail author


The purpose of this case study is to inform the health care professional about some of the cultural norms, beliefs, practices of Arab immigrants in the United States towards terminal illness keeping in mind that cultural norms are dynamic and may change over time. The author of this study cautions health care professionals regarding making generalizations or stereotyping of a cultural group. The author encourages health care providers to complete a holistic patient centered health assessment of their clients and their families prior to making decisions about their care and to facilitate their understanding about the unique role of the culture in supporting Arab clients and their families experiencing terminal illness. Most importantly, health care professionals are encouraged to include social determinants of health in their health assessments of clients that may better prepare them in providing holistic, compassionate, patient centered, and culturally tailored health care.Samira, an 18-year-old female, has been complaining from extreme lethargy, loss of weight, and spiking temperature with unknown cause. Samira’s parents came to the United States with their four children from a rural area fleeing war and political unrest in their home country with the expectation that their children will have a better way of life in the United States. They immigrated to the United States as permanent residents with the sponsorship of Samira’s ailing uncle, Mr. Khalil, who is a citizen of the United States. They chose to live close to Mr. Khalil and in a community that has a large immigrant population from the Arab world.


  1. Ahmad NM (2004) Arab-American culture and health care. Accessed 15 Jan 2007
  2. Arab American Institute (2010) Demographics. Accessed 15 Nov 2010
  3. Bou Khalil R (2013) Attitudes, beliefs and perceptions regarding truth disclosure of cancer-related information in the Middle East: a review. Palliat Support Care 11(1):69–78CrossRefPubMedGoogle Scholar
  4. Chittem M, Butow P (2015) Responding to family requests for nondisclosure. The impact of the oncologist’ cultural background. J Can Res Ther 11:174–180CrossRefGoogle Scholar
  5. Doumit MA, Abu-Saad HH (2008) Lebanese cancer patients: communication and truth-telling preferences. Contemp Nurse 28:74–82CrossRefPubMedGoogle Scholar
  6. Farhat F, Othman A, El Baba G, Kattan J (2015) Revealing a cancer diagnosis to patients: attitudes of patients, families, friends, nurses, and physicians in Lebanon-results of a cross sectional study. Curr Oncol 22(4):e264–e272CrossRefPubMedPubMedCentralGoogle Scholar
  7. Hassouneh DM, Kulwicki A (2007) Mental health, discrimination, and trauma in Arab Muslim women living in the US: a pilot study. Ment Health Relig Cul 10(3):257–262CrossRefGoogle Scholar
  8. Hassouneh P, Kulwicki A (2009) Family privacy as protection village: a qualitative pilot study of mental illness in Arab-American Muslim women. In: Piedmont R, Village A (eds) Research in the social scientific study of religion. Brill, Boston, pp 195–216Google Scholar
  9. Kulwicki A (2008a) Culture and ethnicity. In: Potter P, Perry A (eds) Fundamentals in nursing, 7th edn. CV. Mosby, St. Louis, pp 106–120Google Scholar
  10. Kulwicki A (2008b) Patient education. In: Nasir LS, Abdul-Haq AK (eds) Caring for Arab patients: a biopsychosocial approach. Radcliffe Publishing, Oxford, pp 235–246Google Scholar
  11. Kulwicki A (2011) Islam’s influence on health in the family. In: Craft-Rosenberg M, Pehler S (eds) Encyclopedia of family health. Sage, Thousand Oaks, pp 676–678. CrossRefGoogle Scholar
  12. Kulwicki A, Ballout S (2013) People of Arab heritage. In: Purnell L, Paulanka B (eds) Transcultural health care, 3rd edn. F. A. Davis, PhiladelphiaGoogle Scholar
  13. Kulwicki A, Miller J, Schim S (2000) Collaborative partnership for culture care: Enhancing health services for the Arab community. J Transcult Nurs 11(1):31–39CrossRefPubMedGoogle Scholar
  14. Kulwicki A, Aswad B, Carmona T, Ballout S (2010) Barriers in the utilization of domestic violence services among Arab immigrant women: perceptions of professionals, service providers & community leaders. J Fam Viol 25(8):727–735CrossRefGoogle Scholar
  15. Lawrence P, Rozmus C (2001) Culturally sensitive care of the Muslim patient. J Transcult Nurs 12:228–233CrossRefPubMedGoogle Scholar
  16. Naji F, Hamadeh G, Hlais S, Adib S (2015) Truth disclosure to cancer patients: shifting attitudes and practices of Lebanese physicians. AJOB Empir Bioeth 6(3):41–49CrossRefGoogle Scholar
  17. Pentheny O’kelly C, Urch C, Brown E (2011) The impact of culture and religion on truth telling at end of life. Nephrol Dial Transplant 26(12):3838–3842CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Nursing, Byblos CampusLebanese American UniversityByblosLebanon

Personalised recommendations