Cultural Awareness When Caring for Muslim Patients
During the Holy Month of Ramadan, healthcare professionals need to apply a culturally sensitive and respectful approach to the care and treatment of their Muslim patients. Clinicians who understand the Muslim world view and religious or cultural practices are better placed to provide culturally appropriate, person-focused care to Muslim patients.
When delivering high-quality care to Muslim patients, it is important to understand the influence that the Islamic faith and beliefs have on the provision of healthcare. Healthcare professionals need to be aware of the requirement for modesty and privacy, the appropriateness of touch, dietary practices and the application of medicines.
There is a great diversity of cultural, ethnic and linguistic groups within Muslim communities, each of which has its own cultural characteristics and world view of health and illness. This diversity means that caring for Muslim patients presents constant challenges to nurses and healthcare providers (Rassool, 2014).
As healthcare providers in the UAE, it is important to respect patients’ modesty and be aware of the following:
- Muslims may request a healthcare provider of the same sex;
- Physical exposure should be minimized;
- Nurses should respect the women’s privacy and maintain the Hijab throughout hospitalization;
- Men should also be covered from the navel to the knee;
- Physical contact between a healthcare worker and a patient of opposite sex is not recommended;
- Eye contact between a healthcare worker and a patient of opposite genders is also discouraged;
- Beards are a very important religious symbol. Therefore, shaving should only be done with the permission of the patient, and should only be performed by a man.
Providing Patient Care to Muslims During Ramadan and Fasting
During Ramadan, patients will likely choose to fast because Ramadan is the most blessed and spiritually-beneficial month of the Islamic year. Healthcare professionals treating patients who are abstaining from food and drink should monitor them more closely to ensure their health is not at risk. According to the Qur’an, those who are sick or on a journey, or women who are menstruating, pregnant or nursing are permitted to break the fast and make up an equal number of days later in the year. Muslims who are sick, elderly or chronically ill for whom fasting is unreasonably strenuous are also exempt, but are required to provide food to at least one underprivileged person every day during Ramadan for which he or she has missed fasting.
Although some Muslim patients are excused for health reasons, many may still wish to fast during Ramadan, including those with diabetes. The importance of monitoring blood sugars regularly should be enforced, especially if fasting patients are insulin dependent. Pre-dawn and post-evening meals should be tailored appropriately and should, for example, include carbohydrates at the pre-dawn meal so as to release energy slowly throughout the day.
For diabetic patients, the importance of “breaking the fast” should be emphasized if blood glucose levels fall, placing the individual at risk of a hypoglycemic condition. It is important for diabetes nurses to provide fasting-focused diabetes education to those with diabetes, given that structured education is well established in the management of diabetes.
Administering Medication to Muslim Patients During Ramadan
Medications to treat the sick are permissible however administering medication to fasting Muslims may create a challenge. Fasting patients may refuse treatment and it is important for the healthcare professional to explain the importance of receiving the medication to the patient if it is absolutely necessary for treatment. A respectful and informed approach to this situation is a must.
The below are further cultural considerations to be aware of as a healthcare professional in the UAE. These considerations are applicable throughout the year, and are not Ramadan specific.
- The left hand is considered unclean in many Muslim cultures. To avoid offence, the following should be done using the right hand:
- Medicine administration; and
- Handing items to the patient.
- Upon the call to prayer, nursing staff should be considerate and offer to help with the physical cleansing. Some Muslims may refuse a bed bath, and instead request to shower at least once a day. Showers are preferred as opposed to bathtubs. Special care should be made to clean the patient of any body fluids before praying.
- Prayer occurs five times a day, and patients may ask you for the direction to Mecca. It is important not to interrupt patients during prayer, which may take a few minutes. Bed ridden patients can choose to sit in the bed.
Article written by Ms Brigitte Peetz – UniTeam Academic Director/CME Educator
Peetz, B. (2014) Cultural Aspects of Nursing in the UAE. PPT presentation. Uniteam Medical Assistance. Abu Dhabi, UAE
Rassool GH (2015) Cultural competence in nursing Muslim patients. Nursing Times; 111: 14, 12-15. (online). Available from: file:///C:/Users/user/Desktop/Cultural%20competence%20in%20nursing%20Muslim%20patients%20_%20Practice%20_%20Nursing%20Times.htm <Accessed: 30.05.2016>
Taheri, N. (2016) Clinical Pearl: Ramadan – Reminder to Health Care Practitioners (online). Available from: https://ethnomed.org/cross-cultural-health/religion/ramadan-practitioners<Accessed: 30.05.2016>