A qualitative study of healthcare professionals' experiences of providing maternity care for Muslim women in the UK

Healthcare professionals knowledge, attitude, practices, and perspectives providing care to Muslims in Western countries who fast during Ramadan: a scoping review

The practice of fasting during the month of Ramadan is an obligation for healthy Muslims and involves abstaining from food and drinks from dawn to dusk for 29-30 consecutive days annually. With changes in dietary and lifestyle patterns, healthcare professionals (HCPs) play a significant role in supporting Muslims health during Ramadan. In this scoping review, we employed a systematic approach to map existing literature on HCPs' knowledge, attitude, practices, and perspectives working with Muslims who fast during Ramadan in Western countries. Our aim was to identify research gaps and opportunities for improving healthcare services for Muslims during Ramadan. Literature searches were generated through multiple scientific literature databases, including Web of Science, Ovid MEDLINE, CINAHL, and Embase and reviewed following The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews guidelines. From the eight sources included in this review, it was found that HCPs' knowledge of Ramadan fasting practices vary, with many lacking adequate knowledge. While HCPs recognize potential health complications, adjustments to medications for fasting patients, especially those with diabetes, are often neglected. Challenges in care included language barriers, limited cultural training, and resource awareness. Strategies identified to address barriers include reducing language barriers, providing resources in relevant languages, and enhancing cultural competence training. Further research is required on HCPs' knowledge providing care to Muslims during Ramadan, cultural competency training impact, and diverse healthcare interventions for fasting Muslims. Addressing these gaps may enhance culturally safe care and improve patient outcomes.

Caring for Muslim Patients: A Primer for the Obstetrician Gynecologist

Studies show that Muslim American patients experience discrimination and feel uncomfortable seeking appropriate health care for various reasons. Obstetrician-gynecologists should be educated regarding Islamic perspectives on topics such as modesty, sexual health, contraception, abortion, infertility, and fasting during pregnancy. Understanding the barriers Muslim patients face and improving cultural humility will improve the quality of sexual and reproductive care delivered to Muslim patients.

Ramadan fasting intentions among pregnant women in Lebanon

BACKGROUND

According to Islam's teachings, women are religiously exempt from fasting during pregnancy if a woman is concerned about her health or that of the fetus. This study assesses the intentions of pregnant women to fast during Ramadan and evaluates the contribution of items derived from the theory of planned behavior (TPB) in predicting these intentions.

METHODS

A cross-sectional survey was carried out in Arabic on a convenience sample of 181 pregnant women in Lebanon using a mixture of in-person (46), telephone (31), and online recruitment (104) techniques from February to April 2020. An Exploratory Bayes Tree Analysis was done to examine which TPB items appeared to separate the intention to fast in the best possible way. Then, an ordinal regression was completed followed by a latent class analysis to examine specific classes of participants that could be determined based on the regression results.

RESULTS

Overall, 58% of participants had the intention to fast all days of Ramadan, 22% had the intention to fast some days and 20% did not intend to fast for any duration. A model was run with perceptions of physical ability, Islam guidance, husband's opinion importance, mother's opinion beliefs, and impact on general health as predictors (R2 = 0.74). A four-cluster model was chosen as the most parsimonious one in interpretation, where classes one and two included the groups of women who intended to fast month-long with differences in predictors. Class three represented the group of women who did not have the intention to fast and the final class represented the group of women who had the intention to fast some days of the month. The women's belief in their physical ability to fast and the opinion of the pregnant women's mothers were very important in deciding the participants' intention to fast.

CONCLUSIONS

Items derived from TPB constructs helped in producing a model predicting women's intention to fast during Ramadan. Educational messages and interventions related to fasting while pregnant may be delivered by individuals with legitimacy among pregnant women such as those viewed by the target population as powerful motherly figures in their communities.

Factors Influencing Utilization of Assistive Devices by Tibetan Seniors on the Qinghai-Tibet Plateau: Based on Research Strategy of Triangulation

PURPOSE

To investigate the current situation of assistive device (AD) usage among seniors in Tibet, China, and explore its influencing factors.

METHODS

A mixed-methods design was used. Cognition, attitude, behavior, and preference toward ADs were assessed by a self-designed questionnaire. Additionally, participants responded to the open-ended questions. Anderson's behavior model analyzed the impacts of the prerequisite factors, enabling factors, and demand factors influencing the utilization of ADs by Tibetan seniors.

RESULTS

Of the 211 Tibetan seniors, 149 (70.6%) Tibetan seniors expressed the willingness to utilize ADs. Binary Logistic regression analysis showed that one prerequisite factor: age; one enabling factor: care situation, and one demand factor: dysfunctional condition were factors influencing the utilization of ADs. Qualitative comments described: psychological, physical environment, and social support factors were the main influencing factors.

CONCLUSION

This study presents the current situation to utilize ADs by Tibetan seniors on the Qinghai-Tibet Plateau, incorporates Anderson's behavioral model for quantitative analysis, and combines qualitative research to explore the facilitating and hindering factors, to provide reference and basis for the development of ADs for seniors and policy formulation. The sample size of this study is relatively small and limited to ethnic groups, and we plan to increase the sample size and include more ethnic groups in the future study.

Can mental healthcare for Muslim patients be person-centred without consideration of religious identity? A concurrent analysis

BACKGROUND

Muslims constitute the largest, fastest growing religious minority in the UK. Globally, nurses are legally, morally and ethically obliged to provide non-discriminatory, person-centred, culturally sensitive care. This obligation includes supporting people with their religious needs where appropriate, but there is evidence this is not always happening, particularly for Muslims in mental health care.

AIMS

This paper reviewed primary research to address the question: Can mental healthcare for Muslims be person-centred without consideration of religious identity?

METHODS

Narrative synthesis and concurrent analysis. Searches were conducted post 2000 in MEDLINE, CINAHL, SAGE, PsychINFO and ASA with terms: 'Muslim', 'Islam* ', 'mental health', 'nurs* ', 'person-cent* ', 'religio* '. Narrative data were analysed for commonalities and themes.

FINDINGS

Seven studies of sufficient quality were analysed. Unconscious religious bias was the overarching theme linking the findings that healthcare staff felt ill-prepared and lacked necessary knowledge and experience to work with diverse patient groups. Unconscious racial bias contributed to limited cultural/ religious competence in treatment and care.

CONCLUSION

Religious identity is core for Muslim patients, so this group may not be receiving the person-centred care they deserve. Nurses need cultural and religious competence to deliver person-centred, holistic care to diverse patient populations, yet the importance of religious practice can be overlooked by staff, with harmful consequences for patient's mental and spiritual welfare. This paper introduces a welcome pack that could help staff support the religious observance of those Muslim patients/service-users wishing to practice their faith during their stay in health services.

Religious practices of Muslim women in the UK during maternity: evidence-based professional practice recommendations

Background

Muslim women commonly observe certain religious practices during their maternity journey and research in this area suggests that more could be done from a service provision perspective to support Muslim women in the UK through this significant life event.

Aim

This study identifies Muslim women’s religious practices during maternity, needs and challenges of religious practice while engaging with maternity services, and support needs from healthcare professionals.

Method

Qualitative mixed method study; that includes eight longitudinal interviews with first-time pregnant Muslim women, five focus groups with 23 Muslim mothers experiencing childbirth in last three years in UK, and 12 one-to-one interviews with Health care Professionals (HCPs) with previous experience working with Minority Ethnic groups. Participants recruited from local Muslim community groups and Maternity Care Provider, North West Coast, England. Data analysed using thematic analysis.

Result

Qualitative findings indicate common religious practices that Muslim women exercise at different stages of their maternity journey. These practices can be divided into two categories of common religious practices for Muslim women that 1) require only healthcare professionals’ awareness of these practices and 2) require awareness and active involvement of healthcare professionals. Findings highlight key recommendations for healthcare professionals when addressing Muslim women’s religious needs in the UK.

Discussion/Conclusion

This study provides evidence-based recommendations for professional practice to assist healthcare professionals in developing understanding and addressing Muslim women’s religious practice needs in the UK. Further research is required to explore the impact of these recommendations for professional practice.

Somali Refugee Women’s Cultural Beliefs and Practices Around Pregnancy and Childbirth

Introduction:

The purpose of this study was to explore the cultural beliefs and practices of resettled Somali refugee women around pregnancy and childbirth. This study took place in the Midwestern region of the United States.

Methodology:

Leininger’s theory of Culture Care Diversity and Universality served as the theoretical framework for the design of this qualitative descriptive study. Data were collected from 15 Somali refugee women through in-depth interviews.

Results:

Three major themes emerged from this study. This article focuses on one of the themes: It’s what women believe and do. This theme is reflective and indicative of the Somali refugee women cultural beliefs and practices during pregnancy, and during and after childbirth.

Discussion and Conclusion:

Somali refugee women approached, managed, and conceptualized pregnancy and childbirth in their cultural context. Western health care providers should strive to understand cultural beliefs and conceptualizations that may influence the utilization of prenatal health care.

Investigating the reasons for missing an outpatient appointment in Royal Hospital, Sultanate of Oman: Perspectives of patients and medical staff in a survey

Introduction

Missed appointments are a major health issue in the healthcare systems globally. They directly impact on the use of hospital resources, patient's health, and can lead to patient's dissatisfaction. This study was conducted to assess the reasons for missing a hospital appointment.

Methods

A survey was conducted with a randomly selected sample of patients who missed their outpatient appointment in Royal hospital, Sultanate of Oman, from March to April 2021 in six clinics. Patients were interviewed via telephone to answer a structured survey. In addition, a self‐administered survey was distributed to medical staff to explore their perspectives.

Results

Two hundred eighty patients and 52 medical staff participated in the study. Frequent patient‐reported reasons for missed appointment were transportation difficulties (11.4%), no longer needing (7.5%), or forgetting the appointment (6.8%); staff‐reported reasons were transportation (23.8%), no SMS received (16.9%), and forgetting the appointment (15.4%). Frequencies of reasons varied substantially between clinics. Family obligations were the main theme in obstetrics (odds ratio [OR] 9.48; 95% confidence interval [CI] 2.66‐33.78) and in diabetes clinic (OR 10.55; 95% CI 2.68‐38.58), where transportation issue was the main theme in Oncology clinic (OR 4.83; 95% CI 1.11‐21.02). The recommendations for improvement were mainly around improving the reminder system, the use of telephone reminders, and developing a flexible appointment scheduling system.

Conclusion

Knowing the reasons for missed appointment from patients and health professionals can help to develop effective interventions. The heterogeneity between clinics in reasons for missed appointment indicates for interventions tailored to clinic and frequent reasons.

Cultural issues on accessing mental health services in Nepali and Iranian migrants communities in the UK

Mental health in Black Asian and Minority Ethnic (BAME) communities is a rising public health concern in the UK, with key challenges around accessing mental health services. Our understanding of mental health issues in the growing Nepali and Iranian communities in the UK is very limited. Therefore, this study aims to explore the major factors affecting access to, and engagement with NHS mental health services. This study used a qualitative approach comprising in-depth interviews with seven Nepali, eight Iranians and six community mental health workers in the south of England. The data were analysed using a thematic approach. Six themes were identified: (1) stigma and fear; (2) gender; (3) language; (4) tradition and culture; (5) family involvement; and (6) lack of cultural awareness in health workers, all appearing to be major issues. This study contributes to a shared understanding of mental illness within two given cultural contexts to promote early interventions in UK mental health services. Developing cross-cultural perspectives in health care should be a priority in practice.