PDF My Health, My Faith, My Culture: A guide for healthcare practitioners

My Health, My Faith, My Culture: A guide for healthcare practitioners

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They may be atheists, agnostics, or believers. It is clear that religious beliefs are important to the lives of many physicians. Medicine is a secular vocation for some, while some physicians attest to a sense of being "called" by God to the profession of medicine. For example, the opening line from the Oath of Maimonides, a scholar of Torah and a physician incorporates this concept: In a much earlier time in the history of the world, the priest and the medicine man were one and the same in most cultures, until the development of scientific medicine led to a division between the professions.

After Descartes and the French Revolution it was said that the body belongs to the physician and the soul to the priest. In our current culture of medicine, some physicians wonder whether, when and how to express themselves to patients regarding their own faith. The general consensus is that physicians should take their cues from the patient, with care not to impose their own beliefs. In one study reported in the Southern Medical Journal in , physicians from a variety of religious backgrounds reported they would be comfortable discussing their beliefs if asked about them by patients Olive, The study shows that physicians with spiritual beliefs that are important to them integrate their beliefs into their interactions with patients in a variety of ways.

These interactions were more likely in the face of a serious or life-threatening illness and religious discussions did not take place with the majority of their patients ibid. Some physicians find a number of reasons to avoid discussions revolving around the spiritual beliefs, needs and interests of their patients. Reasons for not opening this subject include the scarcity of time in office visits, lack of familiarity with the subject matter of spirituality, or the lack of knowledge and experience with the varieties of religious expressions in our pluralistic culture.

Many admit to having had no training in managing such discussions. Others are wary of violating ethical and professional boundaries by appearing to impose their views on patients. Nonreligious physicians have expressed anxiety that a religious patient may ask them to pray.

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On another level, it could be argued that each community must find its own way to peace, but this seminar missed an important opportunity to establish a meaningful dialogue which might have benefited both. I was raised in an upper middle class household. The patient and family do the vast majority of talking and eventually become tearful, which is a healthy response. Ratings and Reviews 0 0 star ratings 0 reviews. This approach is likely to resonate with her brother, because he, like everyone, has a profound need to be heard and understood. Health care professionals ought not to neglect their own psychological and spiritual well-being. Health professionals should be aware of cultural and religious factors that help provide culturally competent and appropriate promotion and education of health services to the Islamic population.

In such instances, one could invite the patient to speak the prayer while the physician joins in reverent silence. On the other hand, some physicians regularly incorporate spiritual history taking into the bio-psycho-social-spiritual interview, and others find opportunities where sharing their own beliefs or praying with a particular patient in special circumstances has a unique value to that patient.

These and a myriad of other questions have religious and spiritual significance for a wide spectrum of our society and deserve a sensitive dialogue with physicians who attend to patients facing these troubling issues. Often, such questions are initiated in doctor-patient discussions and may trigger a referral to the chaplain.

The UW School of Medicine was an early leader among medical schools in addressing the topic of patient-spirituality. In an elective course, originating in Spring, , "Spirituality in Health Care," the range of topics goes beyond simply teaching spiritual history taking. Students are encouraged to practice self-care in order to remain healthy as providers for others, and to give intentional consideration to their deep values and their own spirituality as components of their spiritual well-being.

The purpose of this interdisciplinary course is to provide an opportunity for interactive learning about relationships between spirituality, ethics and health care.

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Some of the goals of the class are as follows:. Until recently, there were all too few medical schools that offered formal courses in spirituality in medicine for medical students and residents.

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The patient's chosen or birth faith should always play an integral part in their care . This helpful guide enables healthcare practitioners to rise to the challenge of. My Health, My Faith, My Culture: A Guide for Healthcare Practitioners [Sue Timmins] on www.farmersmarketmusic.com *FREE* shipping on qualifying offers.

This situation is changing. With regard to spirituality and cultural issues, before graduation students will have demonstrated to the satisfaction of the faculty:. Beyond the four years of medical school, residency programs, particularly those with a primary care focus and a palliative care focus, are incorporating education in spirituality training residents.

Christina Puchalski combined efforts as co-directors of this conference for several years. Patients facing serious illness, accident, or death often experience a crisis of meaning. Some patients are profoundly comforted by their spiritual beliefs. Others may encounter religious struggle or negative ways of coping with illness.

It is important for patients that their cultural, spiritual, and religious beliefs be recognized and integrated in the development of a plan of care and in decisions that are made concerning end-of-life care. Respect for patient values and beliefs requires competent communication skills in health care professionals. Residency training programs and continuing medical education programs foster continued learning after medical school.

However, there is room for improvement. New resources are available for educators such as those developed by the George Washington Institute for Spirituality and Health GWISH , including on-line materials that are easily accessible to both students and faculty. Health care professionals ought not to neglect their own psychological and spiritual well-being. Health care professionals work in an intense and stressful environment, frequently exposed to the suffering of others and to companying with the dying.

Such work requires that we stay in touch with our own feelings and that which provides meaning and value within our own lives, while working in a profession dedicated to the care of others. International Journal of Psychiatry in Medicine. Psychiatrists' viewpoints on religion and their services to religious institutions and the ministry. American Psychiatric Association, Anandarajah G, Hight E. Spirituality and Medical Practice: Association of American Medical Colleges.

Contemporary Issues in Medicine: Medical School Objectives Project, Medical School Curricula in Spirituality and Medicine. Handzo, G, HG Koenig. Whose Job is it Anyway? Southern Medical Association , Internet History Sourcebooks Project. King DE, Bushwick B. Beliefs and attitudes of hospital inpatients about faith, healing and prayer. Journal of Family Practice ; Journal of Health Care Chaplaincy.

Religion, Spirituality, and Medicine: Research Findings and Implications for Clinical Practice. Southern Medical Association , Volume 97, Number 12, Religion and family medicine: Journal of Family Practice , ; Journal of Religion, Spirituality and Aging, September Physician religious beliefs and the physician-patient relationship.

Archives of Internal Medicine, Vol, August, A Two-Year Longitudinal Study. Journal of Health Psychology, The Art of Compassionate Medicine. Hospital Physician, March The Report of the Consensus Conference. Journal of Palliative Medicine. Prospective study of religious coping among patients undergoing autologous stem cell transplantation. Journal of Behavioral Medicine. How are they Related? Journal of Religion and Health. Top Additional Readings Related Websites. General Curriculum Thomas R. Send comments to bioethx u. Spirituality and Medicine Thomas R. Religious and spiritual beliefs and practices are important in the lives of many patients, yet medical students, residents and physicians are often uncertain about whether, when, or how, to address spiritual or religious issues.

How pervasive is religiosity in the United States? Why is it important to attend to spirituality in medicine? How should I take a "spiritual history"? How can respect for persons involve a spiritual perspective? This "wholeness" includes their body, mind, and spirit. The best healthcare approach is interdisciplinary. It is important for this multidisciplinary approach to be both culturally and spiritually sensitive as a positive spirit increases the patient's ability to fight off illness and survive. The goals of learning to treat a Muslim patient should be for all healthcare professionals to be empowered with the capacity, knowledge, and skills to respond to the special needs of each patient, and as importantly, a patient's family.

Institutions seeking Joint Commission accreditation must have expertise in administrative affairs, clinical practice, policy, research, risk management, patient advocacy, cultural competence, and language access. Islam rules prohibit alcohol, non-Halal animal fats, pork, by-products of pork, and any animals that have not been slaughtered according to Islamic custom. Islam prayer times may interfere with medical care facility mealtimes, and special arrangements may need to be made.

Some Muslims may refuse all hospital food and accommodations may need to be made to allow food brought in from home. If this is not possible, provide eggs, fruits, seafood, and vegetables. Fasting means that no food or liquids including water is ingested between sunrise and sundown. It is also important to note that the Muslim calendar is not the same as the traditional calendar resulting in Ramadan landing at slightly different times of the year. This may result in significant health problems, especially for those with diabetes and in the summer months.

Patients who plan on fasting should be provided with fasting-focused diabetes education to help them avoid complications. A pre-fasting assessment of patients with diabetes is recommended so they can be made aware of the risks and strategies to avoid problems.

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Muslim patients should be encouraged to monitor their blood sugars, especially if they are taking medications such as insulin or oral hypoglycemic agents. Patients must be taught the importance of stopping the fast if blood glucose levels fall to dangerous levels and there is a risk of severe hypoglycemia. They should be instructed to end the fast if signs or symptoms of hypoglycemia develop. These patients are also at risk of developing hyperglycemia and ketoacidosis in response to fasting. During Ramadan, patients choose to fast because Ramadan is the most blessed and spiritual month of the Islamic year.

Healthcare professionals treating any Islamic patient abstaining from food and drink should monitor them more closely. Muslims who are chronically ill or elderly in whom fasting is unreasonable are also exempt, but they are required to provide food to an underprivileged person each day during Ramadan for which they missed fasting. Hospitals are becoming increasingly aware that food served to Muslims must meet dietary rules, particularly with no pork products. This includes offering medications that don't contain pork or alcohol.

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Implementing sensitivity training to better educate workers about traditions and customs helps in maintaining cultural sensitivity in food preparation. The family unit, rather than the individual, is the core of the community, and there is a strong extended family support structure. The behavior and acts of the individual or the family are greatly influenced by the spouse, children, and relatives.

The extended family is often consulted in all important decisions. For Muslims, health is a state of physical, psychological, spiritual, and social well-being and is considered the greatest blessing God has given humankind. Muslim patients receive illness with patience, prayers, and meditation. Even Muslim patients who are not actively practicing their faith may call for spiritual or religious intervention when they are facing significant challenges.

For some Muslims, spiritual values are a component of their health belief and, as such, spiritual needs may take precedence over physical needs. Medications that contain alcohol, gelatin or pork-based are forbidden. Use gelatin-free alternatives such as antibiotic liquids or halal gelatin tablets. Magnesium stearate is forbidden in tablets when derived from an animal source.

If it is an emergency, and an alternative is not readily available, the drug may be used, but this should be explained to the patient. Islam permits the use of any drug in a life-threatening situation. Fasting Muslims may create a challenge for the administration of drugs as they may refuse treatment. It is important for, healthcare professional to take the time to explain the importance a medication to the patient.

An informed and respectful approach will go a long way to helping the patient make the correct decision. Ideally, it is best if they are cared for by a clinician and nurse of the same gender. This is very important if the patient requires obstetric or gynecologic care. If gender-specific care is impossible, a female staff member or patient relative should always be present during examinations or even communications.

If a male provider is examining a patient, it is of the utmost importance for the provider to explain the steps of the physical exam to the female patient and if clothing must be removed, to be removed for as little time as possible. In many circumstances, a female patient may avoid eye contact or shaking hands with a male healthcare professional. This should not be interpreted as lack of trust or a sign of rejection, as in Muslim's this is a sign of modesty.

Muslim men and women are usually reluctant to expose their bodies for a physical exam. Request permission before uncovering any part of the body, and perform the exam sequentially, exposing as small an area as possible with each step. Touch between members of the opposite gender is prohibited except immediate family members. It is permissible to touch a patient of the opposite sex when there is a medical reason, such as completing a clinical examination or procedure. When entering a room of a Muslim patient, obtain permission before entering the room.

Muslim patients typically receive multiple visitors as there is an obligation to visit according to Islamic teachings. The number of visitors can be overwhelming, and they may not adhere to official visiting times. The staff should be sensitive to the patients need to receive visitors without compromising the clinical care of other patients. Islam requires modest dress to maintain moral and social order. For Muslim women, they are required to wear clothes that are neither transparent or shape-revealing.

They may be extremely uncomfortable in wearing hospital provided gowns. Muslim dress varies differently depending on the country of origin. Some dress in a manner that is similar to their Western counterparts although more conservative. Some Muslim women will cover their hair, arms, and legs. Strict women may choose a long wide black dress that covers their entire body, and they may wear a veil. Few simple approaches can be taken to make the Muslim patient feel more comfortable.

These include announcing the arrival of the healthcare professional allowing a female time to cover herself. If a woman is sick and needs to bathe, offer a shower instead of a bath. It is customary for Muslim women to breastfeed their newborn babies and prefer to do this in private. When the cultures of Muslims around the world are compared, there are common features found in all countries, and the variations represent the basic features of the Muslim religious tenets.

However, Muslims are not a homogeneous group, and different groups may have varying cultures even though they share the same religious practices. Often behaviors are shaped by cultural practices that are not in concordance with basic religious practices. The cultural or pre-Islamic practices observed by Muslims are given an Islamic dimension even though they are not typically part of Islamic practices.

Hospitals can't make assumptions about the needs of Muslim patients and families, so the best practice is to have Arabic and Urdu speaking staff. Hospitals should also hire Muslim chaplains to be available to patients. Muslims in certain cultures use folk remedies rooted in the passages in the Quran, Hadith, and Sunnah of the Prophet Muhammed.

Folk treatments include the use of aloe, capers, chicory, dates, dill, fenugreek, pomegranate, indigo, Senna, olive, mustard, and truffles. Most of these are presumably harmless, but some may be unsafe. It is essential that all healthcare providers questions patients about what herbs or supplements they are ingesting, as well as any other nontraditional healthcare methods they are trying. Practitioners that patients who follow Islam may feel more comfortable using these supplements and remedies together with modern medicine and in conjunction with Western medical care. Healthcare practitioners should also remember that these remedies and herbs may be contraindicated or even dangerous when taken with specific prescribed modern medications.

Some Muslims use cupping to treat various disorders including headaches, nausea, vomiting, stomach ache, sprains, muscular pain, sprains, insomnia, and jaundice. Cautery is used in many cultures when conventional treatment has been unsuccessful. It is used to treat headaches, eye problems, jaundice, mental illness, and cancer. Patients should avoid ancient methods of cautery and consult an appropriate healthcare professional.

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Honey is recommended in the Quran and many Islamic medical texts for internal use or as a wound dressing. Many Muslim patients with diabetes use honey as a traditional remedy. Muslims use olive oil to prevent and treat ailments. It is a source of dietary fat in the Mediterranean diet, which has a low death rate for cardiovascular diseases compared with other cultures.

Some believed that regular olive oil consumption helps reduce inflammation, endothelial dysfunction, thrombosis, and improves carbohydrate metabolism. Some believe that this plant's oil and seeds treat a variety of gastrointestinal and respiratory complaints. Adoption is not acceptable in the Islamic religion due to loss of family name. However, the Quran provides rewards for fostering orphans.

Muslims may care for and raise children who need assistance, but they keep their family names and are made aware of their biologic parents.

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However, if a mother breastfeeds an orphan, the child is considered linked to the family, and it will have more rights. When a Muslim patient is called to prayer, be considerate and offer help with bathing. One must understand that this is not typical bathing. It is ritualistic bathing that starts with a certain sequence.

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Muslims may perceive congenital disabilities as a test of their faith in God. Arabs and Muslims tend to be private about family matters which prevents them from discussing the disability of a child. Contrary to popular belief female genital mutilation circumcision is forbidden in Islam. Islam does require males be circumcised. Islamic families prefer newborn males be circumcised before leaving the hospital. Hospitals and clinics should strive whenever possible to have female physicians and providers care for female patients, and for male providers to care for male patients.

Muslim patients will often ask for same-sex providers. Hence, hospitals should be well-prepared to meet this demand. However, most orthodox Muslims recognize that in a medical emergency, saving a patient's life takes precedence over finding a female or male professional and that having a male provider treat a female patient or a female provider treat a male patient is acceptable in an emergency situation.

Many Muslim and Arab patients do not expect health professionals to tell them or remind them of their terminal illness. Hospice care may help the Islamic family fulfill a cultural and religious obligation if the focus is on comforting the patient, rather than helping them to accept impending death. It is not uncommon for Muslim patients to not give up hope because they believe God has the power to create life and as well as cause death.

The left hand in the Muslim culture is considered unclean. To avoid offense, use the right hand for medication administration, handing objects to patients, and assisting with feeding. Mental illness is not well understood in the Islamic faith. Some may believe that depression is not possible if the Islamic tenets are being followed and may not accept the need for antidepressants, antianxiety agents, or antipsychotics. This can be a significant problem for patients who experience common illnesses such as anxiety, depression, postpartum depression, or schizophrenia.

One method of combating this is to describe these disorders similarly as a physical ailment such as high blood pressure which may break down some barriers to treatment. Prayer occurs 5 times a day, if possible, assist patients in determining the direction to Mecca. Once prayer begins, be respectful of giving the patient privacy and a place to pray. Avoid interruption, it typically only takes a few minutes. Bedridden patients may choose to remain in bed. Muslims tend to avoid discussing sexual issues. Healthcare providers must be aware of these issues so that they can approach them in a culturally sensitive manner that increases patient trust in the provider.

This is a conversation that should be done by a same-sex provider preferably alone. Some unmarried women may not agree to pelvic examinations, Papanicolaou tests, or any invasive vaginal examinations unless it is life-threatening. Although reproductive system examinations and tests are regularly performed for married or previously married women, a single woman may refuse or be hesitant because such examinations could compromise a virginal female status.