BACKGROUND: An intensive care unit (ICU) features high mortality rates. Witnessing subsequent deaths may affect nurses psychologically and spiritually. Islam has an influence on Muslims' life and death. Nevertheless, little is known about Muslim intensive care nurses' experiences of grief in dealing with the deaths of patients.
AIM AND OBJECTIVES: This study aimed to describe the grief reactions and coping strategies of Muslim nurses in dealing with the death of patients.
DESIGN: This is a qualitative study with a phenomenological approach.
METHODS: Semi-structured individual interviews were conducted. Fourteen participants from an ICU in an Indonesian tertiary public hospital participated in this study. Data were analysed by thematic analysis. Trustworthiness was established by Lincoln and Guba's criteria.
RESULTS: The findings identified four reactions of grief, four factors influencing reactions of grief, and three coping strategies used in dealing with death in an ICU. The reactions of nurse's grief were crying, being sad, feeling disappointed, and feeling guilty. These reactions were related to several factors including the circumstances of the patient's death, nurse's expectation of patient's recovery, relationships with the patient, and the reactions of family. Coping management strategies used by nurses in dealing with their grief comprised: sharing with colleagues, avoiding dying and death situations, and engaging in spirituality.
CONCLUSIONS: The Muslim ICU nurse participants experienced their grieving through a variety of psychological reactions influenced by several factors. Personal coping strategies were revealed in dealing with their grief. However, avoiding dying and death situations affected their duty.
RELEVANCE TO CLINICAL PRACTICE: Attention to nurses' grief should be paid to maintain their psychological well-being and quality of end-of-life care. Providing formal support to enhance grief management is recommended.
This study aims to elicit the beliefs and attitudes of middle-aged and elderly Moroccan Muslim women toward dying, death, and the afterlife; to identify whether differences are observable between middle-aged and elderly participants and to document how the actual attitudes of our participants relate to normative Islamic literature. Interviews were conducted with middle-aged and elderly Moroccan women living in Belgium (n = 30) and with experts in the field (n = 15). This study reveals that the belief in an omnipotent and omniscient God and in an afterlife strongly marks the attitudes of first- and second-generation Muslims in Belgium toward life and death.
This study examined the relationships between religious coping and indices of subjective well-being among 132 Israeli-Muslims who lost a beloved person through death. Participants provided demographic and death-related information, and completed measures of religious coping, satisfaction with life, positive/negative affect. Positive correlations were observed between positive religious coping and both satisfaction with life and positive affect, and between negative religious coping and negative affect. Further, the type of death (expected vs. sudden) was found to be a significant moderator between religious coping and subjective well-being. The theoretical and practical implications of the findings are discussed.
BACKGROUND: The death of a child is regarded as one of the most devastating events for a family. Families are reliant on nurses to not only provide end-of-life care but also to support and care for grieving families in a way that is sensitive to their cultural and religious needs and preferences.
AIMS: The aim of this study was to explore the perceived impact and influence of cultural diversity on how neonatal and paediatric intensive care nurses care for Muslim families before and after the death of infants/children.
DESIGN: A qualitative descriptive approach was used in this study, conducted in Saudi Arabia.
METHODS: Semi-structured interviews were used to gather data from a convenience sample of registered nurses working in neonatal and paediatric intensive care, with experience in providing end-of-life care. Interviews were conducted between July and November, 2018. Interviews were audio-recorded and transcribed for analysis.
RESULTS: Thirteen registered nurses participated; all were born overseas, identified with various faiths and spoke English in the workplace. A respect for diversity and care of the family was prioritized yet impacted by communication challenges. Caring and respect was demonstrated by facilitating important cultural and religious practices important in the Muslim faith. Self-care was identified as important, transcending the culturally diverse nature of the nursing workforce.
CONCLUSIONS: Significant challenges exist for a culturally diverse nursing workforce in providing care to a Saudi Muslim population of infants/children and families, before and after a death. Their overriding commitment to respect for others, and an openness to cultural diversity and difference, aided in overcoming the inherent challenges in providing culturally sensitive end-of-life care that meets the needs of Muslim families. These findings provide valuable insights for intensive care clinicians in other countries to address challenges associated with cultural diversity.
Context: Nursing care on the spiritual aspect is focusing on the patients' acceptance of their diseases; thus, people living with HIV (PLWH) are able to accept their diseases and are able to take the lesson. PLWH do not only deal with the condition of the disease but also by discriminative social stigma.
Aim: The aim of this study was to explore, describe, and interpret the experience of spirituality to self-acceptance in patients with HIV/AIDS.
Research Methodology: This research is a qualitative approach by descriptive phenomenology of participants involving as many as 10 people, consisting of 5 men and 5 women. All paticipants are muslim with the education level range from junior high school to university. The ages ranged from 29 to 46 years.
Results: This research identified the two themes which are: (1) being able to take the lesson from their diseases, and (2) self acceptance as people living with HIV-AIDS. There were 10 participants participated in this study. A method of in-depth interviews and observation is a help of data collection. Data analysis used was Creswell method.
Conclusion: Results of the study suggested the patients to get motivated and to develop aspects of spirituality so that it can help to ease in the process of self acceptance, asgetting closer to God through pray, read the Quran, fasting, etc.
The aim of this paper was to study the viewpoints of Sunni Islam and Hinduism on euthanasia to explore whether the Sunni tradition's belief in the hereafter and the Hindu culture's faith in reincarnation have any impact on these two religions' positions on the rejection or justification of euthanasia. Examining these two theologies' approaches demonstrated that Sunni Islam considers euthanasia suicide/homicide in light of the belief in the hereafter, whereas Hinduism can justify euthanasia through Gandhi's interpretation of ahimsa, on the condition that all methods to alleviate the patient's pain and suffering have been exhausted.
BACKGROUND: Research demonstrates that the attitudes of religious physicians toward end-of-life care treatment can differ substantially from their nonreligious colleagues. While there are various religious perspectives regarding treatment near the end of life, the attitudes of Muslim physicians in this area are largely unknown.
OBJECTIVE: This article attempts to fill in this gap by presenting American Muslim physician attitudes toward end-of-life care decision-making and by examining associations between physician religiosity and these attitudes.
METHODS: A randomized national sample of 626 Muslim physicians completed a mailed questionnaire assessing religiosity and end-of-life care attitudes. Religiosity, religious practice, and bioethics resource utilization were analyzed as predictors of quality-of-life considerations, attitudes regarding withholding and withdrawing life-sustaining treatment, and end-of-life treatment recommendations at the bivariate and multivariable level.
RESULTS: Two-hundred fifty-five (41% response rate) respondents completed surveys. Most physicians reported that religion was either very or the most important part of their life (89%). Physicians who reported consulting Islamic bioethics literature more often had higher odds of recommending active treatment over hospice care in an end-of-life case vignette. Physicians who were more religious had higher odds of viewing withdrawal of life-sustaining treatment more ethically and psychologically challenging than withholding it and had lower odds of agreeing that one should always comply with a competent patient's request to withdraw life-sustaining treatment.
DISCUSSION: Religiosity appears to impact Muslim physician attitudes toward various aspects of end-of-life health-care decision-making. Greater research is needed to evaluate how this relationship manifests itself in patient care conversations and shared clinical decision-making in the hospital.
There appears to be a great deal of discussion among non-Muslim healthcare professionals, especially nurses and physicians, about medical assistance in dying. However, the discussion of medical assistance in dying among Muslim health caregivers including physicians, social workers, spiritual caregivers, etc. remains insufficient. A thorough analysis of the content of available resources revealed that we need more literature to analyze the attitude of Muslim health caregivers towards medical assistance in dying. This article describes the general attitude towards medical assistance in dying among non-Muslim. This will allow us to observe the challenges and dilemmas faced by Muslim healthcare professionals around medical assistance in dying.
BACKGROUND: Palliative care has been successfully integrated into many Muslim-majority countries, most frequently in urbanised areas with developed health care systems. Less is known as to how the concept of palliative care is perceived by Muslim populations and health workers in rural, resource-limited contexts.
AIM: This study seeks to explore whether the principles of palliative care are congruent with the perspectives of health professionals, families and communities in rural areas of the Islamic Republic of Mauritania, in West Africa.
DESIGN: A qualitative research design was employed underpinned by a constructionist paradigm. Data were collected through 31 interviews and 8 focus groups. Data were analysed using thematic analysis.
SETTING/PARTICIPANTS: A total of 76 participants were recruited from across rural Mauritania; 33 health care professionals, 12 recently bereaved family members and 31 community leaders. Data collection occurred during training events in the capital and visits to villages and rural health posts.
RESULTS: Three major themes were identified. First, there is a perceived lack of congruency between an illness which limits life and the strong belief in destiny. The second theme describes the perceived barriers to communication of issues relating to palliative care. Finally, a good death is described, framed within the interplay of religious faith and cultural practices.
CONCLUSION: The palliative care ethos is viewed positively by the majority of participants. The need to understand and respect a Muslim individual's faith does not diminish our obligation to personalise palliative care provided for them and their family.
One of the major purposes of palliative sedation is to reduce demand for euthanasia. The present paper analyzes a grievous case which demonstrates the killing of a 23-year-old son by his father due to the son's unbearable pain resulting from metastatic colorectal cancer. The article aimed to elaborate the case to figure out whether palliative sedation can be an alternative to euthanasia in a Muslim country. Nevertheless, the analysis of these two end-of-life issues revealed that the limitation of palliative sedation to an expected lifespan of less than 2 weeks as well as the Islamic view on the importance of protecting consciousness preclude reaching a conclusion that palliative sedation can be an alternative to euthanasia in this particular case. Furthermore, in such cases, the primary problem may be the lack of adequate and appropriate palliative care services, rather than the need for euthanasia or palliative sedation.
OBJECTIVE: People's views regarding autopsy vary according to their cultural and religious beliefs. This paper aims to determine the opinions towards this procedure among Muslims resident in Libya and Muslims and non-Muslims resident in the UK. Our long-term goal is to improve autopsy rates; whether conventional or through the use of post-mortem imaging.
METHODS:: 400 questionnaires were distributed to the three communities, interrogating belief about post-mortem investigations. Descriptive statistics and non-parametric statistics were used to analyse the data.
RESULTS: Of the 400 distributed questionnaires, there was a high return rate of 320 (80%). All groups felt that children should be buried sooner than adults(p < 0.001), but 77% of Libyan Muslims thought that children should be buried within 12 h of death compared to 16% of UK Muslims and only 7% of UK non-Muslims (p < 0.001). More non-Muslims were unconcerned about a negative impact of traditional autopsy on the dignity of the corpse than Muslims (p < 0.001) and more Muslims responded that autopsy has a negative emotional effect on the family (p < 0.001). Type of death altered what sort of investigations were desired. In the case of homicide, Libyan Muslims were less likely to prefer CT (p < 0.001) or MRI (p = 0.001). Sex had no effect on the results of the survey.
CONCLUSION: Post-mortem imaging is acceptable to both Muslims and non-Muslims in Libya and the UK, but Muslims have a significant preference for post-mortem imaging compared to autopsy, except in homicidal cases.
ADVANCES IN KNOWLEDGE: (1) The ability of post-mortem imaging to preserve the dignity of the corpse is independent of religion, however, significantly more Muslims feel that autopsy has a negative emotional effect on the family of the deceased. (2) A significant majority of Muslims in Libya prefer to bury children within 12 h of death, while a delay of up to a week is acceptable in UK. (3) Muslims resident in UK have an attitude closer to that of the indigenous (non-Muslim) population and therefore, educational programmes may be successful in changing attitudes of Muslims in Libya and other predominantly Muslim countries.
OBJECTIVE: To describe the meaning of the lived experiences of grief of Muslim nurses caring for patients who died in an intensive care unit.
METHODOLOGY: Gadamerian philosophy was used to underpin the hermeneutic phenomenological approach followed to analyse and interpret the lived experiences of nurses who cared for patients who died in intensive care units. Fourteen nurses met the inclusion criteria. They were asked to illustrate their experiences of grief using graphic representation. This was followed by face-to-face interviews during which they were asked to narrate and reflect on their experience. The graphic representation and interview transcripts were analysed using Van Manen's approach. Lincoln and Guba's criteria were followed to establish trustworthiness.
SETTING: An intensive care unit at a tertiary public hospital in West Sumatra Province, Indonesia.
FINDINGS: Five major thematic categories reflecting the five life-worlds were identified: 'empathetic understanding', 'balancing self', 'avoidance', 'anticipating the future of own death', and 'relating technologies in bargaining'.
CONCLUSION: This study provides further understanding of the meanings of the lived experience of grief among Muslim nurses in intensive care units. Nurses' grief arising from the loss of patients can affect their emotional, cognitive, spiritual, relational and professional well-being. The findings add further knowledge about the end of life in intensive care units.
This study aimed to elicit the attitudes and beliefs of middle-aged and elderly Moroccan Muslim women regarding mourning and remembrance, to identify whether differences are observable between middle-aged and elderly participants, to explore the role of religion and to document how the actual attitudes of our participants relate to normative Islamic literature. Interviews were conducted with middle-aged and elderly Moroccan women living in Belgium (n = 30) and with experts in the field (n = 15). This study reveals that the religious beliefs have a great impact on the views of Muslim women. We found striking similarities between our participants’ views and normative Islamic literature.
The objective of this review was to detail the experiences of Muslim oncology patients receiving palliative and end-of-life care and identify where gaps in the providing of culturally aware care occur. We also sought to examine ways in which providers could be better educated on the needs of Muslim patients at the end-of-life and identify barriers Muslims faced when being treated with hospice and palliative care models developed for non-Muslim populations. We conducted a search in April 2018 in the National Library of Medicine and CINAHL databases using the search terms "palliative care," "Muslim," and "cancer." Included were articles with focuses on adult Muslims with palliative and end-of-life care experiences. We then followed the PRISMA guidelines for an integrative review and used a data extraction matrix to identify 20 papers that met the inclusion criteria of the review. We identified four major themes patient experiences, patient care delivery suggestions, Muslim provider experiences, and definitions of death, present in all 20 papers of the review. Each of the included papers was categorized based on the dominant theme in the paper. This review ultimately found that the care provided to Muslim patients is subpar for the standard of culturally competent care and that the needs of Muslim patients at the end-of-life, as well as the needs of their families, are not being met. Moving forward further research on this topic is needed with a particular focus on examining the experiences of terminally ill Muslim patients receiving treatment in non-Muslim majority settings.
BACKGROUND: Patients' religious and spiritual values impact their goals and perception of illness, especially at the end of life (EOL). According to the Joint Commission, identifying spiritual beliefs may improve cultural competency and patient-centered care. However, clinicians may be uncomfortable discussing spirituality and unaware of basic religious teachings.
OBJECTIVES: To assess clinician understanding and knowledge of key Christian, Jewish, and Islamic teachings around EOL care before and after a one-hour educational intervention through video podcast.
DESIGN: After literature review and consultation with religious leaders, a pre- and post-test (10 questions per religion plus demographic questions) to assess knowledge of Christian, Jewish, and Islamic teachings and an educational video podcast were developed. The pretest was administered to healthcare providers, followed by a one-hour educational intervention through a video podcast. Next, a post-test was administered.
SUBJECTS: Seventy-three healthcare providers participated in this study.
MEASUREMENTS: Differences between pretest and post-test scores were analyzed employing paired t-test tests using SPSS software.
RESULTS: The median score on the pretest was Christian: 6 [2–9], Jewish: 6 [4–10], and Islamic: 6 [2–8]. After the educational intervention, the median Christian, Jewish, and Islamic scores improved to 8 [4–10], 9 [6–10], and 10 [3–10], respectively (p < 0.0001). Additionally, the total pretest median score improved from 17 [10–24] to 27 [16–30].
CONCLUSIONS: A one-hour educational intervention through video podcast significantly improved understanding of Christian, Jewish, and Islamic teachings around EOL care. The video podcast enabled easy distribution of the educational session to multiple facilities and providers. Additional research is needed to determine the longitudinal outcomes and impact on patient outcomes of this intervention.
The aim of this study was to identify the needs, beliefs, and practices of Muslim family members during the end-of-life care for a family member in the intensive care unit (ICU) in Saudi Arabia. This was a phenomenological study using in-depth individual interviews to gather data. Ten family members of adult ICU patients receiving end-of-life care were interviewed. The experiences of family members during end-of-life care were reflected in four major themes: (a) the spirituality of death, (b) family's need for information, (c) being there, and (d) the ICU environment. Participants placed high value on religious practices such as prayer, and appreciated when these practices could be accommodated in the ICU. Family participants also detailed their need for frequent communication and opportunities to ask questions about the care of their critically ill loved one. Being able to spend as much time as desired in close proximity to the critically ill patient particularly as the end of life approaches was also important, with participants suggesting that visitation times should be waived. Finally, family participant suggested that changes were needed to the ICU environment to make accommodating large families easier and more comfortable particularly when they wish to spend significant time at the bedside of their loved one. Family should be prioritized as an extension of the care provided to critically ill ICU patients, particularly those approaching end of life. A model of care should be introduced to deliver supportive and holistic care during the end-of-life care journey, supported by appropriate education regarding family care at the end of life.
Families of patients who are dying have a key role in decisions regarding do-not-resuscitate orders. The objective of this study was to explore the aspects and characteristics of this decision by the families of Muslim patients with cancer. This study is a conventional content analysis. Eighteen families who met the inclusion criteria participated in this study and were selected by purposive sampling. Data collection was done by a semistructured interview (each interview was 60-110 minutes). The data analysis was performed using content analysis. The data analysis introduced 4 main categories and 8 subcategories: (a) feeling duality ("sacrifice against selfishness," and "logic against emotion"), (b) religious beliefs ("guilt" and "miracle"), (c) stigmatized ("purgatory talk" and "family rejection") and (d) decision-making mediators ("religious clergymen" and "the application of the deceased"). Maybe, since the effect of religion in Iran is more significant than other elements such as ethnicity and law, it is possible to receive help from clergymen. It seems necessary for Iran's Ministry of Health and Medical Education to plan clinical guidelines in this context.
This study aims, first, to compare normative Islamic practices toward death and dying and actual practices of Moroccan Muslim women. Second, it seeks to compare the views and practices of middle-aged and elderly women. Qualitative empirical research was conducted with 30 middle-aged and elderly Moroccan Muslim women living in Antwerp (Belgium) and with 15 experts in the field. Our study shows that religious beliefs and worldview have a great impact on Muslims' practices surrounding death and dying. More specifically, practices are strongly shaped by their eschatological beliefs. The rituals are perceived as preparations for the hereafter, entailing purification of both soul and body, and demonstrate the belief in a continued existence of the soul. We found striking similarities between our participants' views and normative Islamic views. We did not find a more secular understanding of death and dying among the middle-aged women.
La croyance après la mort
Comme dans le judaïsme et le christianisme, l’islam prône que Dieu insuffle l’âme au premier souffle de vie. À la mort, l’âme se sépare du corps : celle des fidèles retourne auprès de Dieu, celles des parjures vont en enfer. Au Jour Dernier (Jour du Compte), Dieu fera disparaître tous les êtres humains sur la Terre comme au Ciel.
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