| Summary: | This descriptive and interpretive focused ethnographic study was used to explore the cultural understandings and experiences of Arab immigrant women in managing diabetes. The study is based on a series of in-depth interviews with seven first wave Arab immigrant women who have diabetes and live in an Arab community in the state of Iowa in the US. Five were from the Sudan; one each from Lebanon, and Palestine. The meaning-centered approaches of Kleinman, Good & Good, and Geertz, and Kleinman's explanatory model of illness were integrated into the interviews and in data analysis to identify these women's personal and social realities shaping their cultural understandings and experiences with diabetes. Data collection, transcribing, analysis, coding, and interpretation were ongoing and iterative. QSR-N'vivo-2 software assisted in analyzing patterns through inductive and deductive coding.Cultural understandings and related experiences of diabetes do not conform to the biomedical management of illness, but encompass aspects of role identity and culture (i.e. personal, social, religious) and exist in the broader context of the immigration experience. The underlying cultural understandings of diabetes through the symbolic meanings of familial roles, religion, and their life situation as immigrants are central to their responses and experiences of living with diabetes. Their sense of identity is grounded through religion and family; if religion and family allow for accommodations, the women could retain the sense of identity and thus their equanimity; reaching a sense of equanimity results in their ability to integrate and normalize diabetes into their lives. Only within the context of family and religion can the illness understandings and experiences of the Arab immigrant women be understood by the health care provider.The individualized focus of the biomedical approaches is not suitable for designing interventions with the Arab immigrant woman because it does not fit with her understanding of self and personal identity. Culturally competent therapeutic interventions should be focused on these women's immigration context, role in the family, and the importance she places on fulfilling religious obligations. The study's findings have important implications for health care research, practice, education, and policy.
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