Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-25T16:45:54.353Z Has data issue: false hasContentIssue false

Caring for terminally ill Muslim patients: Lived experiences of non-Muslim nurses

Published online by Cambridge University Press:  20 April 2016

Gassan Abudari*
Affiliation:
King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Hassan Hazeim
Affiliation:
King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Gilda Ginete
Affiliation:
King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
*
Address correspondence and reprint requests to: Gassan Abudari, P.O. Box: 3354, Riyadh 11211, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. E-mail: gabudari@kfshrc.edu.sa.

Abstract

Objective:

The nursing profession demands knowledge, awareness, and experience regarding the ethnic, religious, cultural, and social constructs involved in patient care. Non-Muslim nurses must have theoretical and empirical insights into treatment methods and caring for terminally ill Muslim patients. In particular, non-Muslim nurses should acquire knowledge of Islamic rules and regulations. They should also be familiar with the unique religious and sociocultural practices that pertain to healthcare practices. Our study aimed to explore non-Muslim nurses' experiences in caring for terminally ill Muslim patients and their families regarding physical, social, cultural, spiritual, and religious practices. The study also sought to investigate the context or situations that influence these experiences as described by the nurses.

Method:

In this qualitative descriptive study, 10 nurses working in medical, oncology, and oncology/palliative care units in a tertiary care hospital in Saudi Arabia were interviewed. A modified Stevick–Colaizzi–Keen method was employed for data analysis.

Results:

Three main themes constituted the nurses' lived experiences: family matters, end-of-life practices, and nurse challenges. Cultural values, religious practices, and a family approach to the process of care influenced nurses' experiences. Issues related to an absence of palliative care integration and the unavailability of members in the interdisciplinary team also influenced their experiences. Nurses showed a lack of cultural knowledge of some practices due to a lack of awareness of cultural diversity and the unavailability of formal cultural education.

Significance of Results:

Provision of culturally competent care at the end of life for Muslim patients in Saudi Arabia requires a thoughtful understanding of religious and cultural practices as well as knowledge of the role of the family throughout the care process. The introduction of a cultural care nursing delivery model that incorporates a cultural education program with Islamic teachings and practices at its core is recommended.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Abdalati, M. (2006). Islam in focus. New Delhi, India: Adam Publishers.Google Scholar
Ahern, K.J. (1999). Ten tips for reflexive bracketing. Qualitative Health Research, 9, 407411.CrossRefGoogle Scholar
Ahmed, N., Bestall, J.C., Ahmedzai, S.H., et al. (2004). Systematic review of the problems and issues of accessing specialist palliative care by patients, carers, and health and social care professionals. Palliative Medicine, 18, 525542.Google Scholar
Alamri, S.H. (2012). Knowledge of the residents at King Abdul-Aziz University Hospital (KAAUH) about palliative care. Journal of Family & Community Medicine, 19, 194.Google Scholar
Al-Doghaither, A.H. (2004). Inpatient satisfaction with physician services at King Khalid University Hospital, Riyadh, Saudi Arabia. Eastern Mediterranean Health Journal, 10, 358364.Google Scholar
Al-Hashimi, M.A. (2005). The ideal Muslim. Riyadh: International Islamic Publishing House.Google Scholar
Aljubran, A.H. (2010). The attitude towards disclosure of bad news to cancer patients in Saudi Arabia. Annals of Saudi Medicine, 30, 141144.CrossRefGoogle ScholarPubMed
Al-Mohaimeed, A.A. & Sharaf, F.K. (2013). Breaking bad news issues: A survey among physicians. Oman Medical Journal, 28, 2025.Google Scholar
Almutairi, A.F. & McCarthy, A. (2012). A multicultural nursing workforce and cultural perspectives in Saudi Arabia: An overview. The Health, 3, 7174. Available from http://www.thehealthj.com/september_2012/a_multicultural_work_force_in_KSA.pdf.Google Scholar
Almutairi, A.F., McCarthy, A. & Gardner, G.E. (2015). Understanding cultural competence in a multicultural nursing workforce: Registered nurses' experience in Saudi Arabia. Journal of Transcultural Nursing, 26, 1623.Google Scholar
al-Shahri, M.Z. & al-Khenaizan, A. (2005). Palliative care for Muslim patients. The Journal of Supportive Oncology, 3, 432436.Google Scholar
Alsirafy, S.A., Sroor, M.Y. & al-Shahri, M.Z. (2010). Referral timing of in-hospital cancer deaths to palliative care in a Saudi tertiary care hospital. Progress in Palliative Care, 18, 8588.Google Scholar
Al-Yateem, S. & Al-Yateem, N. (2014). The experience of overseas nurses caring for Muslim patients in Kingdom of Saudi Arabia and the UAE: A qualitative study. International Journal of Research in Nursing, 5, 1724.CrossRefGoogle Scholar
Al-Zahrani, A.S., El-Kashif, A.T., Haggag, R.M., et al. (2013). Pattern of cancer deaths in a Saudi tertiary care hospital. The American Journal of Hospice & Palliative Care, 30, 2124.Google Scholar
Aranda, S., Yates, P., Edwards, H., et al. (2004). Barriers to effective cancer pain management: A survey of Australian family caregivers. European Journal of Cancer Care, 13, 336343.Google Scholar
Babgi, A. (2009). Legal issues in end-of-life care: Perspectives from Saudi Arabia and the United States. The American Journal of Hospice & Palliative Care, 26, 119127.Google Scholar
Back, A.L., Anderson, W.G., Bunch, L., et al. (2008). Communication about cancer near the end of life. Cancer, 113, 18971910.Google Scholar
Bassett, C. (2002). Nurses' perceptions of care and caring. International Journal of Nursing Practice, 8, 815.Google Scholar
Beach, M.C., Price, E.G., Gary, T.L., et al. (2005). Cultural competence: A systematic review of health care provider educational interventions. Medical Care, 43, 356373.Google Scholar
Blank, R.H. (2011). End-of-life decision making across cultures. Journal of Law, Medicine & Ethics, 39, 201214.Google Scholar
Boykin, A. & Schoenhofer, S.O. (1993). Nursing as caring: A model for transforming practice. New York: National League for Nursing. Available from http://www.gutenberg.org/files/42988/42988-h/42988-h.htm.Google Scholar
Breuer, B., Fleishman, S.B., Cruciani, R.A., et al. (2011). Medical oncologists' attitudes and practice in cancer pain management: A national survey. Journal of Clinical Oncology, 29, 47694775.Google Scholar
Burnard, P. (1991). A method of analysing interview transcripts in qualitative research. Nurse Education Today, 11, 461466.Google Scholar
Burns, N. & Grove, S.K. (2010). Understanding nursing research: Building an evidence-based practice. Amsterdam: Elsevier Health Sciences.Google Scholar
Calvillo, E., Clark, L., Ballantyne, J.E., et al. (2009). Cultural competency in baccalaureate nursing education. Journal of Transcultural Nursing, 20, 137145.Google Scholar
Campinha-Bacote, J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 13, 181184; discussion 200–201.CrossRefGoogle ScholarPubMed
Cioffi, R.N. (2003). Communicating with culturally and linguistically diverse patients in an acute care setting: Nurses' experiences. International Journal of Nursing Studies, 40, 299306.Google Scholar
Creswell, J.W. & Plano Clark, V.L. (2007). Designing and conducting mixed-methods research. Thousand Oaks, CA: Sage.Google Scholar
Daaleman, T.P. & VandeCreek, L. (2000). Placing religion and spirituality in end-of-life care. The Journal of the American Medical Association, 284, 25142517.CrossRefGoogle ScholarPubMed
Dicicco-Bloom, B. & Crabtree, B.F. (2006). The qualitative research interview. Medical Education, 40, 314321.Google Scholar
Dumont, S., Turgeon, J., Allard, P., et al. (2006). Caring for a loved one with advanced cancer: Determinants of psychological distress in family caregivers. Journal of Palliative Medicine, 9, 912921.Google Scholar
Eldredge, D. (2004). Helping at the bedside: Spouses' preferences for helping critically ill patients. Research in Nursing & Health, 27, 307321.Google Scholar
Fisher, C., Lindhorst, H., Matthews, T., et al. (2008). Nursing staff attitudes and behaviours regarding family presence in the hospital setting. Journal of Advanced Nursing, 64, 615624.Google Scholar
Ghanem, H.M., Shaikh, R.M., Alia, A.M.A., et al. (2011). Pattern of referral of non-cancer patients to palliative care in the eastern province of Saudi Arabia. Indian Journal of Palliative Care, 17, 235.Google Scholar
Giger, J.N., Davidhizar, R.E. & Fordham, P. (2006). Multi-cultural and multi-ethnic considerations and advanced directives: Developing cultural competency. Journal of Cultural Diversity, 13, 39.Google ScholarPubMed
Griffith, C.H. 3rd, Wilson, J.F., Langer, S., et al. (2003). House staff nonverbal communication skills and standardized patient satisfaction. Journal of General Internal Medicine, 18, 170174.CrossRefGoogle ScholarPubMed
Halligan, P. (2006). Caring for patients of Islamic denomination: Critical care nurses' experiences in Saudi Arabia. Journal of Clinical Nursing, 15, 15651573.Google Scholar
Hasnain, R. & Rana, S. (2010). Unveiling Muslim voices: Aging parents with disabilities and their adult children and family caregivers in the United States. Topics in Geriatric Rehabilitation, 16, 4661.Google Scholar
Hebert, R.S., Dang, Q. & Schulz, R. (2006 a). Preparedness for the death of a loved one and mental health in bereaved caregivers of patients with dementia: Findings from the REACH study. Journal of Palliative Medicine, 9, 683693.Google Scholar
Hebert, R.S., Prigerson, H.G., Schulz, R., et al. (2006 b). Preparing caregivers for the death of a loved one: A theoretical framework and suggestions for future research. Journal of Palliative Medicine, 9, 11641171.Google Scholar
Hebert, R.S., Schulz, R., Copeland, V.C., et al. (2009). Preparing family caregivers for death and bereavement: Insights from caregivers of terminally ill patients. Journal of Pain and Symptom Management, 37, 312.CrossRefGoogle ScholarPubMed
Jacobsen, R., Sjögren, P., Moldrup, C., et al. (2007). Physician-related barriers to cancer pain management with opioid analgesics: A systematic review. Journal of Opioid Management, 3, 207214.Google Scholar
Kagawa-Singer, M. & Blackhall, L.J. (2001). Negotiating cross-cultural issues at the end of life: “You got to go where he lives.” The Journal of the American Medical Association, 286, 29933001.Google Scholar
Kaki, A.M. (2011). Medical students' knowledge and attitude toward cancer pain management in Saudi Arabia. Saudi Medical Journal, 32, 628632.Google Scholar
Kemp, C. (2005). Cultural issues in palliative care. Seminars in Oncology Nursing, 21, 4452.Google Scholar
Kub, J.E., Nolan, M.T., Hughes, M.T., et al. (2003). Religious importance and practices of patients with a life-threatening illness: Implications for screening protocols. Applied Nursing Research, 16, 196200.Google Scholar
Lawrence, P. & Rozmus, C. (2001). Culturally sensitive care of the Muslim patient. Journal of Transcultural Nursing, 12, 228233.Google Scholar
Lee, S.M. (2003). A review of language and other communication barriers in healthcare. Portland: Oregon Department of Health and Human Services.Google Scholar
Leininger, M. (1994). Teaching and learning transcultural nursing. In Nursing education: An international perspective. Mashaba, T.G. & Brink, H.I. (eds.), pp. 207226. Kenwyn, South Africa: Juta & Co.Google Scholar
Leininger, M. (2002). Culture care theory: A major contribution to advance transcultural nursing knowledge and practices. Journal of Transcultural Nursing, 13, 189192; discussion 200–201.CrossRefGoogle Scholar
Malloy, P., Virani, R., Kelly, K., et al. (2010). Beyond bad news: Communication skills of nurses in palliative care. Journal of Hospice & Palliative Nursing, 12, 166174.Google Scholar
Mapp, T. (2008). Understanding phenomenology: The lived experience. British Journal of Midwifery, 16, 308311.Google Scholar
Matthews, D.A., McCullough, M.E., Larson, D.B., et al. (1998). Religious commitment and health status: A review of the research and implications for family medicine. Archives of Family Medicine, 7, 118124.Google Scholar
Matzo, M. & Sherman, D.W. (2009). Palliative care nursing: Quality care to the end of life. New York: Springer Science.Google Scholar
McCance, T.V., McKenna, H.P. & Boore, J.R.P. (1999). Caring: Theoretical perspectives of relevance to nursing. Journal of Advanced Nursing, 30, 13881395.Google Scholar
McLaughlin, L.A. & Braun, K.L. (1998). Asian and Pacific Islander cultural values: Considerations for health care decision making. Health & Social Work, 23, 116126.CrossRefGoogle ScholarPubMed
McSherry, W., Cash, K. & Ross, L. (2004). Meaning of spirituality: Implications for nursing practice. Journal of Clinical Nursing, 13, 934941.Google Scholar
Mitchell, M., Chaboyer, W., Burmeister, E., et al. (2009). Positive effects of a nursing intervention on family-centered care in adult critical care. American Journal of Critical Care, 18, 543552; quiz 553.Google Scholar
Mobeireek, A.F., Al-Kassimi, F., Al-Zahrani, K., et al. (2008). Information disclosure and decision making: The Middle East versus the Far East and the West. Journal of Medical Ethics, 34, 225229.Google Scholar
Moustakas, C. 1994. Phenomenological research methods. Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
Mueller, P.S., Plevak, D.J. & Rummans, T.A. (2001). Religious involvement, spirituality, and medicine: Implications for clinical practice. Mayo Clinic Proceedings, 76, 12251235.Google Scholar
Mutair, A.S., Plummer, V., O'Brien, A.P., et al. (2014). Providing culturally congruent care for Saudi patients and their families. Contemporary Nurse, 46, 254258.Google Scholar
Pargament, K.I., Koenig, H.G., Tarakeshwar, N., et al. (2004). Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: A two-year longitudinal study. Journal of Health Psychology, 9, 713730.Google Scholar
Pargeon, K.L. & Hailey, B.J. (1999). Barriers to effective cancer pain management: A review of the literature. Journal of Pain and Symptom Management, 18, 358368.Google Scholar
Rashidi, A. & Rajaram, S.S. (2001). Culture care conflicts among Asian-Islamic immigrant women in U.S. hospitals. Holistic Nursing Practice, 16, 5564.Google Scholar
Rassool, G.H. (2000). The crescent and Islam: Healing, nursing and the spiritual dimension. Some considerations towards an understanding of the Islamic perspectives on caring. Journal of Advanced Nursing, 32, 14761784.Google Scholar
Ross, L. (2006). Spiritual care in nursing: An overview of the research to date. Journal of Clinical Nursing, 15, 852862.Google Scholar
Roter, D., Frankel, R., Hall, J., et al. (2006). The expression of emotion through nonverbal behavior in medical visits. Journal of General Internal Medicine, 21, 2834.Google Scholar
Saad, B., Azaizeh, H., Abu-Hijleh, G., et al. (2006). Safety of traditional Arab herbal medicine. Evidence-Based Complementary and Alternative Medicine, 3, 433439.CrossRefGoogle ScholarPubMed
Salman, K. & Zoucha, R. (2010). Considering faith within culture when caring for the terminally ill Muslim patient and family. Journal of Hospice & Palliative Nursing, 12, 156163.Google Scholar
Saroglou, V., Delpierre, V. & Dernelle, R. (2004). Values and religiosity: A meta-analysis of studies using Schwartz's model. Personality and Individual Differences, 37, 721734.Google Scholar
Searight, H.R. & Gafford, J. (2005). Cultural diversity at the end of life: Issues and guidelines for family physicians. American Family Physician, 71, 515522.Google Scholar
Shavers, V.L., Bakos, A. & Sheppard, V.B. (2010). Race, ethnicity, and pain among the U.S. adult population. Journal of Health Care for the Poor and Underserved, 21, 177220.Google Scholar
Taylor, R. (2005). Addressing barriers to cultural competence. Journal for Nurses in Staff Development, 21, 135142; quiz 143–144.Google Scholar
Tufford, L. & Newman, P. (2012). Bracketing in qualitative research. Qualitative Social Work, 11, 8096.Google Scholar
Vallurupalli, M., Lauderdale, K., Balboni, M.J., et al. (2012). The role of spirituality and religious coping in the quality of life of patients with advanced cancer receiving palliative radiation therapy. The Journal of Supportive Oncology, 10, 8187.Google Scholar
van den Branden, S. & Broeckaert, B. (2010). Necessary interventions: Muslim views on pain and symptom control in English Sunni e-Fatwas. Ethical Perspectives, 17, 626651.Google Scholar
Waldrop, D.P., Kramer, B.J., Skretny, J.A., et al. (2005). Final transitions: Family caregiving at the end of life. Journal of Palliative Medicine, 8, 623638.CrossRefGoogle ScholarPubMed
Watson, M.J. (1988). New dimensions of human caring theory. Nursing Science Quarterly, 1, 175181.Google Scholar
Wells, N., Hepworth, J.T., Murphy, B.A., et al. (2003). Improving cancer pain management through patient and family education. Journal of Pain and Symptom Management, 25, 344356.Google Scholar
Wiener, L., McConnell, D.G., Latella, L., et al. (2013). Cultural and religious considerations in pediatric palliative care. Palliative & Supportive Care, 11, 4767.Google Scholar
World Health Organization (2012). WHO definition of palliative care. Available from http://www.who.int/cancer/palliative/definition/en/.Google Scholar
Worth, A., Irshad, T., Bhopal, R., et al. (2009). Vulnerability and access to care for South Asian Sikh and Muslim patients with life-limiting illness in Scotland: Prospective longitudinal qualitative study. BMJ, 338, b183.Google Scholar
Younge, D., Moreau, P., Ezzat, A., et al. (1997). Communicating with cancer patients in Saudi Arabia. Annals of the New York Academy of Sciences, 809, 309316.CrossRefGoogle ScholarPubMed
Zeinah, G.F., Al-Kindi, S.G. & Hassan, A.A. (2013). Middle East experience in palliative care. The American Journal of Hospice & Palliative Care, 30, 9499.Google Scholar