1
|
Hillier KAW, Longworth ZL, Vatanparast H. Healthcare professionals knowledge, attitude, practices, and perspectives providing care to Muslims in Western countries who fast during Ramadan: a scoping review. Appl Physiol Nutr Metab 2024; 49:415-427. [PMID: 38128071 DOI: 10.1139/apnm-2023-0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
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.
Collapse
Affiliation(s)
- Katherine A W Hillier
- University of Saskatchewan, College of Pharmacy and Nutrition, Saskatoon, SK, Canada
| | - Zoe L Longworth
- University of Saskatchewan, College of Pharmacy and Nutrition, Saskatoon, SK, Canada
| | - Hassan Vatanparast
- University of Saskatchewan, College of Pharmacy and Nutrition, Saskatoon, SK, Canada
- University of Saskatchewan, School of Public Health, Saskatoon, SK, Canada
| |
Collapse
|
2
|
Alaeddine C, Schreiber J, Amin MEK. Ramadan fasting intentions among pregnant women in Lebanon. J Egypt Public Health Assoc 2024; 99:1. [PMID: 38228944 DOI: 10.1186/s42506-023-00148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 12/05/2023] [Indexed: 01/18/2024]
Abstract
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.
Collapse
Affiliation(s)
- Chaza Alaeddine
- Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
| | - Jim Schreiber
- School of Nursing, Duquesne University, Pittsburgh, USA
| | - Mohamed E K Amin
- Faculty of Pharmacy, Alamein International University, El Alamein, Egypt.
| |
Collapse
|
3
|
Zagloul M, Mohammed B, Abufares N, Sandozi A, Farhan S, Anwer S, Tumusiime S, Bojang M. Review of Muslim Patient Needs and Its Implications on Healthcare Delivery. J Prim Care Community Health 2024; 15:21501319241228740. [PMID: 38270090 PMCID: PMC10812098 DOI: 10.1177/21501319241228740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND In the rapidly changing environment of healthcare, striving toward health equity and providing patient-centered care is imperative to the patient's experience. To achieve these goals, a comprehensive understanding of the diverse patient populations seeking these services, their needs, and the multitude of religious, cultural, and structural elements that impact their well-being is required. Muslim patients represent a considerable demographic, both in number and complexity of religious and cultural beliefs and practices. This scoping review examines the intersection of religion and cultural values with healthcare delivery in the context of the Muslim patient experience. OBJECTIVES The objective of this review is to identify key concepts and challenges that impact the Muslim patient experience. SEARCH METHODS The research databases Cochrane Library, OVID Medline, and PubMED were used to conduct a comprehensive systemic review of original, empirical peer-reviewed publications with the following search terms: "Muslim healthcare," "Muslim patient," and "Muslim experience." SELECTION CRITERIA Inclusion and exclusion criteria were used to narrow down articles to those that addressed Muslim patient needs and their healthcare experience. RESULTS A total of 21 articles met the criteria of this scoping review. Five central topics were identified during thematic analysis: Ramadan and Fasting, Barriers in the Patient-Physician Relationship, Trauma and Perceived Discrimination, Mental Health Awareness and Stigma, and Awareness of Advanced Care Planning. CONCLUSION This scoping review demonstrates that in order to provide patient-centered care addressing the unique needs of Muslim patients, religious and cultural values need to be explored under the frameworks of cultural humility and structural competency.
Collapse
Affiliation(s)
- Maie Zagloul
- Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | - Afsar Sandozi
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Sarah Farhan
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Saba Anwer
- Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | |
Collapse
|
4
|
Obaideen K, Abu Shihab KH, Madkour MI, Faris ME. Seven decades of Ramadan intermittent fasting research: Bibliometrics analysis, global trends, and future directions. Diabetes Metab Syndr 2022; 16:102566. [PMID: 35872466 DOI: 10.1016/j.dsx.2022.102566] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/28/2022] [Accepted: 07/03/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS There is a large body of research focused on various aspects related to Ramadan intermittent fasting (RIF) and human health and disease. This study aimed to quantify the bibliometric data of RIF medical research over the past seven decades and explore these variables qualitatively via text mining analysis. METHODS We used the Scopus search engine to identify published articles related to RIF from inception to December 31, 2021. All types of research articles were included. Scientometric and bibliometric measures were determined using Excel, Biblioshiny, and VOSviewer. This study proposed a bibliometric and text mining method to qualitatively and quantitatively recognize the RIF research trend. RESULTS The Scopus search returned 1915 relevant articles. Most citations pertained to publications from the last two decades, and most publications were original research articles. These publications had received around 27,000 citations, and the 20 most prolific publishing journals had an average h-index of 112.25. More than one-third of all medical publications were in open-access journals. There was a 13-fold increase in medical research on RIF over the past few decades. We identified the 10 most prolific publishing countries, institutes, journals, and authors. We also identified five scientific hotspots of RIF scientific literature, which were: diabetes, metabolic health, public health, physiology, and maternity. CONCLUSION This is the first comprehensive bibliometric analysis of medical research related to RIF. The research gaps identified will shape future research directions and foster collaborative research activities toward enhanced medical nutrition research revolving around RIF.
Collapse
Affiliation(s)
- Khaled Obaideen
- Sustainable Energy & Power Systems Research Centre, RISE, University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates
| | - Katia H Abu Shihab
- Department of Clinical Nutrition and Dietetics, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed I Madkour
- Department of Medical Laboratory Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, University of Sharjah, Sharjah, United Arab Emirates.
| |
Collapse
|
5
|
Ben Ammar H, Ben Massoued R, Ben Hamadi A, Khelifa E, Hakiri A, El Hechmi Z. Hospitalizations in psychiatry during the month of Ramadan: A study at the Tunisian mental health hospital. Int J Soc Psychiatry 2022; 68:341-345. [PMID: 33455506 DOI: 10.1177/0020764020988888] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Muslims fast each year during the Holy Month of Ramadan. This rite has major socio-cultural consequences. The circadian rhythms, energy expenditure, body temperature and biological clock are also influenced by Ramadan fasting. The impact of fasting on patients with mental disorders has been little studied. The aim of this study was to assess the number of hospitalizations in psychiatry during Ramadan compared to the other months of the lunar year. METHOD A cross-sectional and retrospective study was conducted at Razi hospital, the psychiatric hospital in Tunis. The following data over the five lunar years (1434-1438) was checked for: The monthly and the annual number of hospitalizations in the different departments of Razi mental health hospital in Tunis as well as the monthly and annual rates of different legal modalities of admissions. RESULTS An important decrease in the number of hospitalizations during Ramadan was observed each year followed by a constant increase during the following month.Ramadan was the only lunar month to have had a consistently below-average number of admissions. There has been a significant increase in the mean number of hospitalizations per month over the years. A general trend towards an increase in the proportion of enforced hospitalizations has been noted. CONCLUSION Ramadan stands out not only on a religious but also on a social level. Our results add support to the usefulness of research on mental health and Ramadan in the psychiatric community.
Collapse
Affiliation(s)
- Hanen Ben Ammar
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Razi Hospital, Manouba, Tunisia
| | - Rihab Ben Massoued
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Razi Hospital, Manouba, Tunisia
| | - Asma Ben Hamadi
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Razi Hospital, Manouba, Tunisia
| | - Emira Khelifa
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Razi Hospital, Manouba, Tunisia
| | - Abir Hakiri
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Razi Hospital, Manouba, Tunisia
| | - Zouhaier El Hechmi
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Razi Hospital, Manouba, Tunisia
| |
Collapse
|
6
|
Litalien M, Atari DO, Obasi I. The Influence of Religiosity and Spirituality on Health in Canada: A Systematic Literature Review. JOURNAL OF RELIGION AND HEALTH 2022; 61:373-414. [PMID: 33409859 DOI: 10.1007/s10943-020-01148-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
The association between religion and health has been the subject of growing interest in academia. However, limited reviews of such studies in Canada exist. The paper systematically reviews and synthesizes existing literature on the relationship between spirituality and health in Canada. Available general databases such as: Medline; Web of Science, PubMed, Sociological abstract, Social Service Abstracts, Google scholar, Humanities International Index, JSTOR, CPI.Q Canadian Periodicals, and American Theological Library Association were searched for the period between 2000 and April 2019 inclusive. Collected data were then systematically analysed for common themes about spirituality and health in Canada. In total, 151 articles were found, but only 128 had relevance with the study objectives. Overall, the analysis showed that religion and spirituality do influence health behaviours, and well-being. However, more gender-based studies need to be conducted to tease out the differences in religion/spirituality and health across different genders, and ethnic groups in Canada.
Collapse
Affiliation(s)
- Manuel Litalien
- Social Welfare and Social Development, Nipissing University, 100 College Drive, Box 5002, North Bay, ON, P1B 8L7, Canada.
| | | | | |
Collapse
|
7
|
Kumar S, Diamond T. Ramadan Fasting and Maternal and Fetal Outcomes in Pregnant Women with Diabetes Mellitus: Literature Review. Front Endocrinol (Lausanne) 2022; 13:900153. [PMID: 35813638 PMCID: PMC9263982 DOI: 10.3389/fendo.2022.900153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
There is an emerging Muslim and diabetic population in the United States and other Western countries and majority of pregnant women and patients with diabetes mellitus choose to fast during Ramadan. Fasting during Ramadan in pregnant women with diabetes may represent a 'perfect storm' of metabolic disturbances including hyperglycemia, hypoglycemia and ketosis. Recent continuous and flash glucose monitoring data suggests increased glycemic variability (fasting hypo- and post-Iftar hyperglycemia) in non-pregnant patients with diabetes during Ramadan. Only five small-scale studies, predominantly focused on women with gestational diabetes mellitus in Muslim-majority nations have explored maternal glycemic outcomes during Ramadan which is associated with lower mean blood glucose levels and higher frequency of fasting hypoglycemia. Data is limited however on important clinical outcomes such as symptomatic and serious hypoglycemia requiring hospitalization. Results have been conflicting regarding maternal Ramadan fasting and association with fetal outcomes in women without diabetes. Only one recently published study reported on perinatal outcomes in pregnant women with gestational diabetes which found no effect of Ramadan exposure on mean birthweight or macrosomia frequency but lower neonatal hypoglycemia prevalence, however a significant limitation was lack of documentation of maternal fasting status. At this stage, due to paucity of data, the current medical recommendation is against Ramadan fasting for pregnant Muslim women with diabetes. Large-scale population-based studies are warranted regarding maternal and fetal outcomes in pregnant fasting women with diabetes and such studies should characterize maternal fasting status and have meaningful and consistent clinical outcomes. High-quality data derived from these studies can assist clinicians in providing more evidence-based advice to safely navigate both mother and fetus through a potentially challenging pregnancy.
Collapse
|
8
|
Hassan A, Merghany N, Ouchkat F, Regragui W, Kedah H, Hamdy SM, Abdel-Naseer M, Shehata HS, Shalaby NM, Kishk NA, Nada MAF, Hegazy MI, Farghaly M, Ahmed SM, Hussein M. Impact of Ramadan fasting on disease activity in patients with multiple sclerosis: a multicenter study. Nutr Neurosci 2021:1-10. [PMID: 34842062 DOI: 10.1080/1028415x.2021.2006955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The safety of Ramadan fasting for Muslim patients suffering from multiple sclerosis (MS) is still a matter of debate. This work aimed to study the clinical course of MS during Ramadan fasting and to clarify the predictors of relapses and symptoms exacerbation. METHODS This retrospective study included 153 Muslim patients with MS. Data related to the disease course before Ramadan were obtained from patients' files, whereas data related to the disease activity during Ramadan, were collected from patients over the two months following Ramadan. RESULTS Patients with MS who experienced relapses, exacerbation of symptoms and development of new symptoms during Ramadan had a statistically significant longer disease duration compared to those who did not experience (P < 0.001, <0.001, 0.01 respectively). Also, patients who experienced relapses, exacerbation of symptoms and development of new symptoms during Ramadan had a statistically significant higher expanded disability status scale (EDSS) compared to those who did not experience (P <0.001, <0.001,0.01, respectively). The occurrence of relapses, exacerbation of symptoms and development of new symptoms during Ramadan, were significantly higher in patients who experienced relapses in the preceding year compared to those who did not (P= 0.002, 0.002, 0.01, respectively). Binary logistic regression revealed that each score elevation of EDSS increased the odds of relapse during Ramadan by 1.02 (P-value = 0.04). Also, each month's increase in disease duration increased the odds of relapse during Ramadan by 1.87 (P-value = 0.046). CONCLUSION High EDSS and long disease duration are independent predictors of relapse during Ramadan.
Collapse
Affiliation(s)
- Amr Hassan
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nahla Merghany
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Fatima Ouchkat
- Department of Neurology and Neurogenetics, Hospital of Specialties, University Mohammed V - Souissi Rabat, Rabat, Morocco
| | - Wafa Regragui
- Department of Neurology and Neurogenetics, Hospital of Specialties, University Mohammed V - Souissi Rabat, Rabat, Morocco
| | - Hanaa Kedah
- Neurology Department, Hera Hospital, Makkah, KSA
| | - Sherif M Hamdy
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maged Abdel-Naseer
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hatem S Shehata
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nevin M Shalaby
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nirmeen A Kishk
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona A F Nada
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed I Hegazy
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa Farghaly
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sandra M Ahmed
- Neurology Department-Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona Hussein
- Neurology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| |
Collapse
|
9
|
The pandemic’s effect on discharge against medical advice from the emergency department. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.907496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
10
|
Amin MEK, Abdelmageed A, Farhat MJ. Communicating with Clinicians on Fasting during Ramadan: The Patients' Perspective. JOURNAL OF RELIGION AND HEALTH 2021; 60:922-940. [PMID: 31485879 DOI: 10.1007/s10943-019-00910-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Caring for millions of Muslim patients who decide to fast during Ramadan can be challenging for clinicians. Using a theory-guided approach, this study explores Muslim patients' perspectives on factors influencing communication with clinicians in relation to fasting during Ramadan. Semi-structured interviews were conducted with a sample of patients in Egypt (9) and the USA (8). Participants were purposefully sampled to assure variance in age, gender, education, decision to fast and ethnicity. Data emerging from narratives were mapped to constructs within the Linguistic Model of Patient Participation in Care (LMOPPC). Using framework analysis, iterative sampling and analysis continued until saturation. Drawing on LMOPPC, participants' narratives were mapped and clustered into patient participation and quality of care; predisposing factors (perceptions about fasting and its significance including sense of spiritual benefit when fasting and sense of guilt when not fasting, prior experiences including prior conversations with clinicians on fasting and experience of fasting while sick, patients' personality and locus of control, belief in the legitimacy of participation, motivations and perception of need to communicate with clinicians about fasting, provider verbal and nonverbal responses, and provider-patient rapport); and enabling factors (knowledge about the topic and repertoire of communicative skills, presence of companions during appointment, and timing of appointments). The LMOPPC framework provided insight into patients' perspectives on barriers and facilitators for communication with clinicians about fasting during Ramadan. It is important for stakeholders to consider those issues when implementing interventions aiming to adopt a concordant approach in providing care for this group of patients.
Collapse
Affiliation(s)
| | - Ahmed Abdelmageed
- College of Pharmacy, Natural and Health Sciences, Manchester University, 10627 Diebold Rd., Fort Wayne, IN, 46845, USA
| | - Marwa J Farhat
- College of Pharmacy, Natural and Health Sciences, Manchester University, 10627 Diebold Rd., Fort Wayne, IN, 46845, USA
| |
Collapse
|
11
|
Alshehri AM, Barner JC, Wong SL, Ibrahim KR, Qureshi S. Perceptions among Muslims regarding fasting, medication use and provider engagement during Ramadan in the United States. Int J Health Plann Manage 2021; 36:945-957. [PMID: 33711183 DOI: 10.1002/hpm.3147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/29/2021] [Accepted: 02/19/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Muslims with chronic diseases tend to fast during Ramadan, although Islam allows them not to fast. Therefore, understanding their perceptions and how they manage their health, especially as a minority population, is very important. OBJECTIVE To examine Muslims' (1) perceptions of fasting exemptions, (2) medication usage behaviour, (3) perceptions of relationships with healthcare providers and (4) factors impacting health management during Ramadan. METHOD This was a qualitative study employing four focus groups (two groups of women and two groups of men). Adult Muslims (aged 18 years or more) with chronic diseases were invited to participate. Participants were asked open-ended questions about their fasting ability, medication usage behaviours, healthcare access and collaboration with providers during Ramadan. Trained researchers conducted the focus groups interviews in both English and Arabic. Each focus group was recorded, and three investigators independently transcribed the data and extracted themes and categories. Coding terminology issues were resolved through discussion. RESULTS Twenty-five Muslims with chronic diseases (e.g., diabetes, hypertension, renal failure and anaemia) participated. The most prominent themes/subthemes were as follows: (1) fasting exemption (e.g., uncontrolled medical conditions), (2) fasting nonexemption (e.g., controlled medical conditions), (3) nonoral medication use during Ramadan, (4) healthcare provider involvement during Ramadan, and (5) factors impacting health management during Ramadan. CONCLUSION Muslim patients perceive fasting as an important religious practice, so they tend to self-modify their medication-taking behaviours. Educating pharmacists and other healthcare providers about Muslim culture, especially their strong desire to fast, may lead to Muslims better managing their medications and viewing pharmacists and other healthcare providers as knowledgeable healthcare providers.
Collapse
Affiliation(s)
- Ahmed M Alshehri
- Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Alkarj, Riyadh, Saudi Arabia
| | - Jamie C Barner
- Division of Health Outcomes, University of Texas at Austin College of Pharmacy, Austin, Texas, USA
| | - Shui Ling Wong
- Pharmaceutical Services Programme, Ministry of Health Malaysia, Petaling Jaya, Selangor, Malaysia
| | - Kemi R Ibrahim
- Division of Health Outcomes, University of Texas at Austin College of Pharmacy, Austin, Texas, USA
| | - Sana Qureshi
- Pharmacy, Baylor Scott & White Health, Lakeway, Texas, USA
| |
Collapse
|
12
|
Ramadan Fasting Increases Socialization in Patients Who Underwent Sleeve Gastrectomy: An Observational Study. Obes Surg 2021; 31:2576-2582. [PMID: 33555450 DOI: 10.1007/s11695-021-05270-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 01/28/2021] [Accepted: 02/03/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE The prevalence of obesity is increasing along with the number of sleeve gastrectomies. Patients' mental health and social life, along with their physical health, should be considered. Their cultural and religious values are an important part of treatment. Fasting is an important act of worship in all religions. Ramadan fasting is one of the five pillars of Islam. In this study, we aimed to investigate the effect of Ramadan fasting on quality of life in patients who underwent sleeve gastrectomy. MATERIALS AND METHODS Data regarding the demographic characteristics, weight, the time elapsed after surgery, and the amount of liquid and solid food consumed during fasting were collected with two surveys, one of which was carried out at the beginning and the other at the end of Ramadan. In addition, the SF-36 health survey questionnaire was administered to evaluate the impact of Ramadan fasting on patients' quality of life. RESULTS Fifty-one people participated in the first survey, but the second survey included 19 of them. While the median weight of the patients was 86.52 ± 17.78 kg before fasting, the median weight after 25 days of fasting was 83.31 ± 17.06 kg. A significant decrease was observed in weight after 25 days of fasting (p < 0.001). A comparison of the SF-36 scores for quality of life revealed a significant increase in the social functioning (p = 0.032). CONCLUSION Ramadan fasting caused significant weight loss in patients who underwent sleeve gastrectomy. Besides, it did not adversely affect the quality of life, but rather increased social functioning.
Collapse
|
13
|
Adanan NIH, Adnan WAHWM, Khosla P, Karupaiah T, Daud ZAM. Exploring the experiences and perceptions of haemodialysis patients observing Ramadan fasting: a qualitative study. BMC Nephrol 2021; 22:48. [PMID: 33530941 PMCID: PMC7851908 DOI: 10.1186/s12882-021-02255-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/08/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The festival of Ramadan is a month of spiritual reflection for Muslims worldwide. During Ramadan, Muslims are required to refrain from eating and drinking during daylight hours. Although exempted from fasting, many patients undergoing maintenance haemodialysis (HD) opt to participate in this religious practice. Many studies have explored the effects of Ramadan on health outcomes, however, the exploration from patients' own point of view pertaining to this religious practice is lacking. Thus, we aimed to explore the experiences and perceptions of Muslim HD patients observing Ramadan fasting from three HD centres in Klang Valley, Malaysia. METHOD An exploratory phenomenology qualitative study was conducted whereby subjects were purposively selected based on previous experience in observing Ramadan fasting. Face-to-face in-depth interviews were conducted, and study data were analyzed thematically and iteratively coded using a constant comparison method. RESULTS Four major themes emerged from the data, namely: (i) "fasting experiences", (ii) "perceived side effects of fasting", (iii) "health-seeking behavior" and, (iv) "education and awareness needs". Patients expressed the significance of Ramadan fasting as well as the perceived impact of fasting on their health. Additionally, there is lack of health-seeking behaviour observed among patients thus, raising needs for awareness and education related to Ramadan fasting. CONCLUSIONS Findings of this study shed light on patients' experiences and perceptions regarding Ramadan fasting which warrants the needs for an effective communication between patients and health care practitioners through a structured-Ramadan specific education program.
Collapse
Affiliation(s)
- Nurul Iman Hafizah Adanan
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
| | | | - Pramod Khosla
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI, USA
| | | | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia.
- Research Center of Excellent Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
| |
Collapse
|
14
|
Amin MEK, Abdelmageed A. Clinicians' Perspectives on Caring for Muslim Patients Considering Fasting During Ramadan. JOURNAL OF RELIGION AND HEALTH 2020; 59:1370-1387. [PMID: 31104298 DOI: 10.1007/s10943-019-00820-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study explores clinicians' perspectives on factors affecting care provided to Muslim patients who decide to fast during Ramadan. Semi-structured interviews were conducted with a purposeful sample of clinicians in Egypt (11) and the USA (10). Framework analysis was conducted through mapping data to constructs within social cognitive theory. Data were mapped into clinician's belief in ability to care for those patients, belief in group's ability to provide care, anticipated consequences of providing such care, knowledge, learning by observing other clinicians, cultural norms and perceived acceptability and prevalence of care provision, environmental barriers and opportunities, and communication approach.
Collapse
Affiliation(s)
| | - Ahmed Abdelmageed
- College of Pharmacy, Natural and Health Sciences, Manchester University, 10627 Diebold Rd., Fort Wayne, IN, 46845, USA
| |
Collapse
|
15
|
Amin MEK, Abdelmageed A. RAMCOM: A qualitative study of clinicians' viewpoints on a tool for communication with Muslim patients considering fasting during Ramadan. PLoS One 2020; 15:e0228888. [PMID: 32053645 PMCID: PMC7017985 DOI: 10.1371/journal.pone.0228888] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/24/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Fasting during the month of Ramadan is a basic pillar of Islam. While patients may be religiously exempted from fasting, literature indicates that the majority decide to fast. Caring for millions of Muslim patients who decide to fast during Ramadan can be challenging for clinicians around the globe. This study proposes a communication tool, RAMCOM, which aims to assist clinicians in communicating with Muslim patients considering fasting during Ramadan. It addresses the following questions: What are the clinicians' preferences for the tool in terms of Content, Format, Style, Length and language? How do clinicians perceive factors that would impact their intentions to sue the tool? What would facilitate the implementation and dissemination of the proposed tool? METHODS Semi-structured interviews were conducted with a purposeful sample of clinicians in Egypt (11) and the US (10). Clinicians were purposefully sampled to assure variance in age, gender, time in practice, specialty, and religious background. Directed content analysis was conducted and emerging data were mapped to constructs within the theory of planned behavior. Iterative sampling and analysis continued until saturation was reached. RESULTS In total, 21 clinicians were interviewed. The tool was iteratively revised according to clinicians' comments on format, content, language and usability. Factors contributing to using RAMCOM included perception of tool (need for use, perceived burden of use), perceived norm (perceived patient expectations), and ability to use tool (time, frequency of seeing patients, knowledge of Ramadan and Islam). Practice environment factors that impact the use of RAMCOM include education, early reminders, colored laminated copies, communication training, involvement of support staff, and patient education. CONCLUSION Clinicians provided valuable perceptions on the implementability and use of RAMCOM, a new communication tool designed to assist in caring for Muslim patients during Ramadan. These perceptions should be considered by different stakeholders to facilitate goal-concordant care for Muslim patients considering fasting.
Collapse
Affiliation(s)
| | - Ahmed Abdelmageed
- Department of Pharmacy Practice, Manchester University College of Pharmacy, Fort Wayne, Indiana, United States of America
| |
Collapse
|
16
|
Affiliation(s)
- Irfan A Dhalla
- Health Quality Ontario (Dhalla, Tepper); Department of Medicine (Dhalla) and Department of Family and Community Medicine (Tepper) and Institute of Health Policy, Management and Evaluation (Dhalla, Tepper), University of Toronto; St. Michael's Hospital (Dhalla, Tepper), Toronto, Ont.
| | - Joshua Tepper
- Health Quality Ontario (Dhalla, Tepper); Department of Medicine (Dhalla) and Department of Family and Community Medicine (Tepper) and Institute of Health Policy, Management and Evaluation (Dhalla, Tepper), University of Toronto; St. Michael's Hospital (Dhalla, Tepper), Toronto, Ont
| |
Collapse
|
17
|
Best M, Sleasman M, Hegedus E, Schlub TE. Protestant Christian attitudes to ART. Hum Reprod Open 2019; 2019:hoz018. [PMID: 31528709 PMCID: PMC6735866 DOI: 10.1093/hropen/hoz018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 05/27/2019] [Accepted: 06/07/2019] [Indexed: 11/15/2022] Open
Abstract
STUDY QUESTION How do Christian religious beliefs affect attitudes to ART? SUMMARY ANSWER Attitudes to ART depend on the religiosity of the respondent, and although the majority of those that had successfully used ART were positive or moderately positive in their views, the acceptability of procedures fell when damage to the marriage relationship or the embryo was a potential outcome. WHAT IS KNOWN ALREADY Religion can impact views on ART. Sanctity of marriage and sanctity of the embryo are major concerns for some Christians, but details are unclear. METHODS A cross-sectional online survey was used to collect data from 1587 participants over a 3-month period in 2013, of which 1334 were of the Christian faith and included in this study. Descriptive statistics were reported for individual ARTs, and a general score of all ART approval was calculated. A multivariable linear and logistic regression was conducted on general approval for ART to identify predictors of ART approval. MAIN RESULTS AND THE ROLE OF CHANCE Indicators of religiosity (religious meeting attendance and Bible reading frequency) showed that this was a highly religious sample. We found that in this cohort of English-speaking, well-educated, practising and mainly Protestant Christians 164 (12.3%) of those had personal experience of ART. Most participants that had successfully used ART were positive or moderately positive in their views. Throughout the cohort, procedures were less acceptable if there was a perception that the marriage relationship or the life of the embryo was threatened: including donated gametes (28.7-29.1% approval), surrogacy (22.7-33.1% approval), and PGD (1.0-23.8% approval). A multivariable analysis of the ART approval score found that it was higher among those with Protestant compared with Catholic/Orthodox faith (P < 0.001; mean score difference, 5.06; 95% CI 4.36-5.81) and those who believe life begins after fertilisation (P < 0.001; mean score difference, 4.86; 95% CI 4.14-5.57). Approval was also higher, but to a lesser extent, in women than men (P = 0.008; mean score difference, 0.73; 95% CI 0.18-1.28), and those with lower religiosity (P < 0.001). The area raising most indecision for this cohort was disposal of excess embryos. LIMITATIONS REASONS FOR CAUTION This sample includes an uneven geographical spread of respondents and restriction to English-speaking participants. Different views may be expressed by a different religious cohort. Use of an online survey platform means that a bias towards those with computers (consistent with education levels of this cohort) could exist. Use of this platform also makes it impossible to know the response rate, and the veracity of responses cannot be verified. However, despite these limitations we believe this survey gives us insight into the reservations held among a certain population of Christians regarding the use of reproductive technology. WIDER IMPLICATIONS OF THE FINDINGS Our findings highlight the need for ART clinicians to consider the influence of patient spiritual beliefs on therapeutic options and provide detailed information that will allow them to be accommodated. Practices such as widening the options for collecting semen and limiting the number of embryos created through IVF so as to reduce or eliminate excess embryos may be helpful for these patients. STUDY FUNDING/COMPETING INTERESTS This study was supported by a grant from The Center for Bioethics & Human Dignity in Deerfield, Illinois, USA. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- M Best
- Faculty of Psychology, Faculty of Medicine, University of Sydney, Sydney Health Ethics, Sydney NSW Australia.,Institute for Ethics and Society, The University of Notre Dame Australia, Sydney, NSW Australia
| | - M Sleasman
- The Center for Bioethics & Human Dignity, Trinity International University, Deerfield, IL, USA
| | - E Hegedus
- School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - T E Schlub
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
18
|
Bello AK, Kurzawa J, Osman MA, Olah ME, Lloyd A, Wiebe N, Habib S, Qarni U, Shojai S, Pauly RP. Impact of Ramadan fasting on kidney function and related outcomes in patients with chronic kidney disease: a systematic review protocol. BMJ Open 2019; 9:e022710. [PMID: 31446401 PMCID: PMC6720242 DOI: 10.1136/bmjopen-2018-022710] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 12/11/2018] [Accepted: 12/19/2018] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Fasting during the month of Ramadan is a significant Islamic religious practice that involves abstinence from food, drink and medication from dawn to dusk. As just under a quarter of the world's population identifies as Muslim, the effect of fasting on chronic conditions, such as chronic kidney disease (CKD) is a topic of broad relevance. To date, the information in this area has been mixed, with many limitations of previous studies. This study aims to synthesise the evidence of the effect of Ramadan fasting on changes on kidney function, risk factors, episodes of acute kidney injury and impact on the quality of life in patients with CKD or kidney transplant. METHODS AND ANALYSIS A systematic review of the literature will be conducted, using electronic databases such as MEDLINE, Embase, Global Health, CINAHL and Scopus. Original research and grey literature on the effect of Ramadan fasting in adult patients with CKD or renal transplantation will be included. Two reviewers will independently screen articles for inclusion in the review and independently assess the methodology of included studies using a customised checklist. Mean difference or risk ratio will be reported for continuous or dichotomous outcomes and results will be pooled using a random-effects model where heterogeneity is reasonable. If possible, subgroups (CKD status, setting, season and risk of bias) will be analysed for effect modification with fasting and the outcomes of interest. Risk of bias will be assessed using the Downs and Black checklist. ETHICS AND DISSEMINATION The results will be disseminated using a multifaceted approach to engage all stakeholders (patients, practitioners and community leaders). Research ethics board approval is not required as this is a systematic review of previously published research. PROSPERO REGISTRATION NUMBER CRD42018088973.
Collapse
Affiliation(s)
- Aminu K Bello
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Julia Kurzawa
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Mohamed A Osman
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle E Olah
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Anita Lloyd
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Natasha Wiebe
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Syed Habib
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Uwais Qarni
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Soroush Shojai
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Robert P Pauly
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
19
|
Furqan Z, Awaad R, Kurdyak P, Husain MI, Husain N, Zaheer J. Considerations for clinicians treating Muslim patients with psychiatric disorders during Ramadan. Lancet Psychiatry 2019; 6:556-557. [PMID: 31056458 DOI: 10.1016/s2215-0366(19)30161-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Zainab Furqan
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Rania Awaad
- Stanford Muslims and Mental Health Lab, Stanford Diversity Clinic, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Khalil Center-Bay Area, Stanford, CA, USA
| | - Paul Kurdyak
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Muhammad I Husain
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; General Psychiatry and Health Systems Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nusrat Husain
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK; Lancashire Care NHS Foundation Trust, Preston, UK
| | - Juveria Zaheer
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; General Psychiatry and Health Systems Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| |
Collapse
|
20
|
Exploring Drug-Related Problems in Diabetic Patients during Ramadan Fasting in Saudi Arabia: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030499. [PMID: 30754675 PMCID: PMC6388163 DOI: 10.3390/ijerph16030499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 01/29/2019] [Accepted: 02/05/2019] [Indexed: 11/16/2022]
Abstract
This study aimed to identify any drug-related problems (DRPs) in diabetic patients during Ramadan fasting in Saudi Arabia. The study used a mixed-methods approach consisting of two phases and was conducted in Makkah, Saudi Arabia from December 2017 to March 2018. The first phase of the study involved qualitative semi-structured individual interviews with diabetic patients. A 13-item questionnaire was used in the second phase to further identify DRPs in the wider population. The data was mainly presented as frequencies and percentages. Inferential statistics was performed using Statistical Package for Social Sciences (SPSS) version 21 to compare relevant variables/questions using the chi-square test. Twenty patients (10 male, 10 female) attended face-to-face interviews during the first phase of the study while 95 (40 male, 55 female) completed the questionnaire in the second phase of the study. Two possible risk factors for DRPs were identified from the qualitative data: patient-related factors, including changes in their medicine intake during fasting, and healthcare professionals-related factors, including lack of advice from healthcare professionals regarding fasting. The quantitative results indicated that 52 (54%) of the 95 participants who observed fasting reported to have changed the way they were taking their medicines. Furthermore, 41% of the participants experienced general healthcare problems such as hypoglycemia, hyperglycemia, fatigue, excessive sweating, and gastrointestinal disturbances. Healthcare professionals need to educate patients who are at risk of DRPs by providing structured education and counseling.
Collapse
|
21
|
An evaluation of the translation of continuing education into diabetes public health care by pharmacists. Int J Clin Pharm 2017; 39:774-782. [PMID: 28500437 DOI: 10.1007/s11096-017-0477-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 04/29/2017] [Indexed: 01/30/2023]
Abstract
Background Pharmacists are assuming greater public health roles and partaking in continuing education to advance knowledge and skills necessary for the provision of this patient care. Objective We sought to determine what conditions in a Middle East context influence how community pharmacists actually incorporate new information into practice. Setting Community pharmacies in Qatar. Methods A continuing professional development (CPD) program regarding the management of fasting diabetes patients during Ramadan was developed and delivered. Participants then maintained a record of their patient encounters when attempting to screen fasting diabetes patients for risk and offer medication, lifestyle, and monitoring advice. Diary entries were coded using inductive methods and follow-up focus group discussion was conducted to further corroborate the thematic analysis. Main outcome measure Facilitators and barriers to care. Results Forty-one pharmacists attended the CPD program and 35 subsequently made at least one diary entry during the 3-weeks preceding and during Ramadan. One-hundred and forty-eight submitted records and the transcript of one focus group (n = 6) were analyzed. Three main factors were found to influence pharmacists' ability to engage use new knowledge and skills: situational, patient, and pharmacist. Patient reception was the overwhelming influence whereby positive interactions encouraged pharmacists to continue screening and counseling attempts, but difficult encounters were negative reinforcing stimuli in almost equal measure. Conclusion In this Middle East setting, environmental factors play a considerable role in the pharmacists' ability to engage in public health care and reinforce that continuing education for health professionals must be closely aligned with the realities of practice and purposefully considered as part of its evaluation.
Collapse
|
22
|
Almansour HA, Chaar B, Saini B. Fasting, Diabetes, and Optimizing Health Outcomes for Ramadan Observers: A Literature Review. Diabetes Ther 2017; 8:227-249. [PMID: 28181087 PMCID: PMC5380495 DOI: 10.1007/s13300-017-0233-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Globally, and in Australia, diabetes has become a common chronic health condition. Diabetes is also quite prevalent in culturally and linguistically diverse pockets of the Australian population, including Muslims. There are over 90 million Muslims with diabetes worldwide. Diabetes management and medication use can be affected by religious practices such as fasting during Ramadan. During Ramadan, Muslims refrain from oral or intravenous substances from sunrise to sunset. This may lead to many potential health or medication-related risks for patients with diabetes who observe this religious practice. This literature review aimed to explore (1) health care-related interventions and (2) intentions, perspectives, or needs of health care professionals (HCPs) to provide clinical services to patients with diabetes while fasting during Ramadan with a view to improve health outcomes for those patients. METHODS Using a scoping review approach, a comprehensive search was conducted. Databases searched systematically included PubMed, Medline, Embase, and International Pharmaceutical Abstracts. Studies published in English that described interventions or intentions to provide interventions regarding diabetes and Ramadan fasting were included. RESULTS Fourteen published articles that met the inclusion criteria were retrieved and content analyzed. Of those, nine intervention studies regarded diabetes management education. Five studies described professional service intention, four of which were related to the role of pharmacists in diabetes management in Qatar, Australia, and Egypt, and one French study examined the general practitioners' (GPs) experiences in diabetes management for Ramadan observers. The intervention studies had promising outcomes for diabetes management during Ramadan. Effect sizes for improvement in HbA1c post intervention ranged widely from -1.14 to 1.7. Pharmacists appeared to be willing to participate in programs to help fasting patients with diabetes achieve a safe therapeutic outcome. Service intention studies highlighted pharmacists' and GPs' need for training prior to providing services from a clinical as well as cultural competence perspective. CONCLUSION Interventions research in this area requires robustly designed and structured interventions that can be tested in different contexts. This literature review revealed many gaps regarding diabetes management in Ramadan. Health professionals are willing to provide services for fasting diabetes patients, but need upskilling.
Collapse
Affiliation(s)
| | - Betty Chaar
- Faculty of Pharmacy, University of Sydney, Sydney, Australia
| | - Bandana Saini
- Faculty of Pharmacy, University of Sydney, Sydney, Australia
| |
Collapse
|
23
|
Lee JY, Wong CP, Tan CSS, Nasir NH, Lee SWH. Type 2 diabetes patient's perspective on Ramadan fasting: a qualitative study. BMJ Open Diabetes Res Care 2017; 5:e000365. [PMID: 28761651 PMCID: PMC5530234 DOI: 10.1136/bmjdrc-2016-000365] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 02/15/2017] [Accepted: 03/27/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We evaluated the beliefs, experience and diabetes management strategies of type 2 diabetes mellitus (T2DM) Muslim patients that chose to fast during Ramadan. RESEARCH DESIGN AND METHODS A semistructured focus group interview was conducted with 53 participants with T2DM. Participants were purposefully sampled and asked to share their perspective on Ramadan fasting. All interviews were audio recorded, transcribed verbatim and analyzed thematically. RESULTS Participants reported optimism towards fasting during Ramadan, as they believed that fasting was beneficial to their overall well-being, and a time for family bonding. Most participants made limited attempts to discuss with their doctors on the decision to fast and self-adjusted their medication based on experience and symptoms during this period. They also reported difficulty in managing their diet, due to fear of hypoglycemia and the collective social aspect of fasting. CONCLUSION Muslims are optimistic about their well-being when fasting during Ramadan. Many choose to fulfill their religious obligation despite being discouraged by their doctors. Collaboration with religious authorities should be explored to ensure patients receive adequate education before fasting during Ramadan. TRIAL REGISTRATION NUMBER NCT02189135; Results.
Collapse
Affiliation(s)
- Jun Yang Lee
- School of Pharmacy, Monash University, Subang Jaya, Selangor, Malaysia
| | - Chee Piau Wong
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Christina San San Tan
- School of Allied Health Sciences, SEGi University and Colleges, Petaling Jaya, Selangor, Malaysia
| | | | | |
Collapse
|
24
|
Pharmacists' perspectives about their role in care of patients with diabetes observing Ramadan. Res Social Adm Pharm 2017; 13:109-122. [DOI: 10.1016/j.sapharm.2016.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 11/22/2022]
|
25
|
Best M, Butow P, Olver I. Why do We Find It so Hard to Discuss Spirituality? A Qualitative Exploration of Attitudinal Barriers. J Clin Med 2016; 5:jcm5090077. [PMID: 27598212 PMCID: PMC5039480 DOI: 10.3390/jcm5090077] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/26/2016] [Accepted: 08/29/2016] [Indexed: 11/30/2022] Open
Abstract
Background: Despite known health benefits of spiritual care and high patient interest in discussing spirituality with their physicians, the frequency of spiritual discussions in the medical consultation is low. We investigated spiritual conversations for doctors caring for patients with advanced cancer; why these conversations so difficult; and what the underlying challenges are for discussing spirituality with patients; Methods: Participants were contacted through the Australian and New Zealand Society of Palliative Medicine and the Medical Oncology Group of Australia, including physicians from two secular countries. Semi-structured interviews were taped and transcribed verbatim. The text was analyzed using thematic analysis; Results: Thematic saturation was reached after 23 participants had been interviewed. The following themes were identified: (1) confusing spirituality with religion; (2) peer pressure; (3) personal spirituality; (4) institutional factors; (5) historical factors; Conclusion: This study explored the underlying attitudes contributing to the reluctance doctors have to discuss spirituality in the medical consultation. Underlying confusion regarding the differences between religion and spirituality, and the current suspicion with which religion is regarded in medicine needs to be addressed if discussion of spirituality in the medical consultation is to become routine. Historical opposition to a biopsychosocial-spiritual model of the human being is problematic.
Collapse
Affiliation(s)
- Megan Best
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney 2006, Australia.
| | - Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney 2006, Australia.
| | - Ian Olver
- Division of Health Sciences, University of South Australia, Adelaide 5001, Australia.
| |
Collapse
|
26
|
Abstract
BACKGROUND Discussion of religion and/or spirituality in the medical consultation is desired by patients and known to be beneficial. However, it is infrequent. We aimed to identify why this is so. AIM We set out to answer the following research questions: Do doctors report that they ask their patients about religion and/or spirituality and how do they do it? According to doctors, how often do patients raise the issue of religion and/or spirituality in consultation and how do doctors respond when they do? What are the known facilitators and barriers to doctors asking their patients about religion and/or spirituality? DESIGN A mixed qualitative/quantitative review was conducted to identify studies exploring the physician's perspective on discussion of religion and/or spirituality in the medical consultation. DATA SOURCES We searched nine databases from inception to January 2015 for original research papers reporting doctors' views on discussion of religion and/or spirituality in medical consultations. Papers were assessed for quality using QualSyst and results were reported using a measurement tool to assess systematic review guidelines. RESULTS Overall, 61 eligible papers were identified, comprising over 20,044 physician reports. Religion and spirituality are discussed infrequently by physicians although frequency increases with terminal illness. Many physicians prefer chaplain referral to discussing religion and/or spirituality with patients themselves. Such discussions are facilitated by prior training and increased physician religiosity and spirituality. Insufficient time and training were the most frequently reported barriers. CONCLUSION This review found that physician enquiry into the religion and/or spirituality of patients is inconsistent in frequency and nature and that in order to meet patient needs, barriers to discussion need to be overcome.
Collapse
Affiliation(s)
- Megan Best
- The University of Sydney, Sydney, NSW, Australia
| | | | - Ian Olver
- University of South Australia, Adelaide, SA, Australia
| |
Collapse
|
27
|
Karateke A, Kaplanoglu M, Avci F, Kurt RK, Baloglu A. The effect of Ramadan fasting on fetal development. Pak J Med Sci 2016; 31:1295-9. [PMID: 26870085 PMCID: PMC4744270 DOI: 10.12669/pjms.316.8562] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the effects of Ramadan fasting on fetal development and outcomes of pregnancy. METHODS We performed this study in Antakya State Hospital of Obstetrics and Child Care, between 28 June 2014 and 27 July 2014 (during the month of Ramadan). A total of two hundred forty healthy pregnant women who were fasting during Ramadan, were included in the groups. The three groups were divided according to the trimesters. The each group was consisted of 40 healthy pregnant women with fasting and 40 healthy pregnant women without fasting. For evaluating the effects of Ramadan on fetus, ultrasonography was performed on all pregnant women in the beginning and the end of Ramadan. We used the essential parameters for the following measurements: increase of fetal biparietal diameter (BPD), increase of fetal femur length (FL), increase of estimated fetal body weight (EFBW), fetal biophysical profile (BPP), amniotic fluid index (AFI), and umbilical artery systole/diastole (S/D) ratio. RESULTS No significant difference was found between the two groups for the fetal age, maternal weight gain (kilogram), estimated fetal weight gain (EFWG), fetal BPP, AFI, and umbilical artery S/D ratio. On the other hand, a statistically significant increase was observed in maternal weight in the second and third trimesters and a significant increase was observed in the amniotic fluid index in second trimester. CONCLUSION In Ramadan there was no bad fetal outcome between pregnant women with fasting and pregnant women without fasting. Pregnant women who want to be with fast, should be examined by doctors, adequately get breakfast before starting to fast and after the fasting take essential calori and hydration. More comprehensive randomized studies are needed to explain the effects of fasting on the pregnancy and fetal outcomes.
Collapse
Affiliation(s)
- Atilla Karateke
- Dr. Atilla Karateke, Antakya State Hospital of Obstetrics and Child Care, Hatay, Turkey
| | - Mustafa Kaplanoglu
- Dr. Mustafa Kaplanoglu, Department of Obstetrics and Gynecology, Adiyaman University Medical School, Adiyaman, Turkey
| | - Fazil Avci
- Dr. Fazil Avci, Agri Patnos State Hospital of Obstetrics and Child Care, Agri, Turkey
| | - Raziye Keskin Kurt
- Dr. Raziye Keskin Kurt, Department of Obstetrics and Gynecology, Mustafa Kemal University Medical School, Hatay, Turkey
| | - Ali Baloglu
- Dr. Ali Baloglu, Izmir Private Gynecology Clinic, Izmir, Turkey
| |
Collapse
|
28
|
Creating a safe space: A qualitative inquiry into the way doctors discuss spirituality. Palliat Support Care 2015; 14:519-31. [DOI: 10.1017/s1478951515001236] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:Spiritual history taking by physicians is recommended as part of palliative care. Nevertheless, very few studies have explored the way that experienced physicians undertake this task.Method:Using grounded theory, semistructured interviews were conducted with 23 physicians who had experience in caring for advanced cancer patients. They were asked to describe the way they discuss spirituality with their patients.Results:We have described a delicate, skilled, tailored process whereby physicians create a space in which patients feel safe enough to discuss intimate topics. Six themes were identified: (1) developing the self: physicians describe the need to understand and be secure in one's own spirituality and be comfortable with one's own mortality before being able to discuss spirituality; (2) developing one's attitude: awareness of the importance of spirituality in the life of a patient, and the need to respect each patient's beliefs is a prerequisite; (3) experienced physicians wait for the patient to give them an indication that they are ready to discuss spiritual issues and follow their lead; (4) what makes it easier: spiritual discussion is easier when doctor and patient share spiritual and cultural backgrounds, and the patient needs to be physically comfortable and willing to talk; (5) what makes it harder: experienced physicians know that they will find it difficult to discuss spirituality when they are rushed and when they identify too closely with a patient's struggles; and (6) an important and effective intervention: exploration of patient spirituality improves care and enhances coping.Significance of results:A delicate, skilled, tailored process has been described whereby doctors endeavor to create a space in which patients feel sufficiently safe to discuss intimate topics.
Collapse
|
29
|
Best M, Butow P, Olver I. Do patients want doctors to talk about spirituality? A systematic literature review. PATIENT EDUCATION AND COUNSELING 2015; 98:1320-8. [PMID: 26032908 DOI: 10.1016/j.pec.2015.04.017] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 04/21/2015] [Accepted: 04/25/2015] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The aim of this systematic literature review was to ascertain the patient perspective regarding the role of the doctor in the discussion of spirituality. METHODS We conducted a systematic search in ten databases from inception to January 2015. Eligible papers reported on original research including patient reports of discussion of spirituality in a medical consultation. Papers were separated into qualitative and quantitative for the purposes of analysis and quality appraisal with QualSyst. Papers were merged for the final synthesis. RESULTS 54 studies comprising 12,327 patients were included. In the majority of studies over half the sample thought it was appropriate for the doctor to enquire about spiritual needs in at least some circumstances (range 2.1-100%, median 70.5%), but patient preferences were not straightforward. CONCLUSION While a majority of patients express interest in discussion of religion and spirituality in medical consultations, there is a mismatch in perception between patients and doctors regarding what constitutes this discussion and therefore whether it has taken place. PRACTICE IMPLICATIONS This review demonstrated that many patients have a strong interest in discussing spirituality in the medical consultation. Doctors should endeavor to identify which patients would welcome such conversations.
Collapse
Affiliation(s)
- Megan Best
- The University of Sydney NSW 2006 Australia; Greenwich Hospital Palliative Care Service, Greenwich NSW 2065 Australia.
| | | | - Ian Olver
- University of South Australia, PO Box 2471, Adelaide, SA 5001 Australia
| |
Collapse
|
30
|
|
31
|
Wilbur K, Al Tawengi K, Remoden E. Diabetes patient management by pharmacists during Ramadan. BMC Health Serv Res 2014; 14:117. [PMID: 24606885 PMCID: PMC3975299 DOI: 10.1186/1472-6963-14-117] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 02/21/2014] [Indexed: 11/30/2022] Open
Abstract
Background Many Muslim diabetes patients choose to participate in Ramadan despite medical advice to the contrary. This study aims to describe Qatar pharmacists’ practice, knowledge, and attitudes towards guiding diabetes medication management during Ramadan. Methods A cross-sectional descriptive study was performed among a convenience sample of 580 Qatar pharmacists. A web-based questionnaire was systematically developed following comprehensive literature review and structured according to 4 main domains: subject demographics; diabetes patient care experiences; knowledge of appropriate patient care during Ramadan fasting; and attitudes towards potential pharmacist responsibilities in this regard. Results In the 3 months prior to Ramadan (July 2012), 178 (31%) pharmacists responded to the survey. Ambulatory (103, 58%) and inpatient practices (72, 41%) were similarly represented. One-third of pharmacists reported at least weekly interaction with diabetes patients during Ramadan. The most popular resources for management advice were the internet (94, 53%) and practice guidelines (80, 45%); however only 20% were aware of and had read the American Diabetes Association Ramadan consensus document. Pharmacist knowledge scores of appropriate care was overall fair (99, 57%). Pharmacists identified several barriers to participating in diabetes management including workload and lack of private counseling areas, but expressed attitudes consistent with a desire to assume greater roles in advising fasting diabetes patients. Conclusion Qatar pharmacists face several practical barriers to guiding diabetes patient self-management during Ramadan, but are motivated to assume a greater role in such care. Educational programs are necessary to improve pharmacist knowledge in the provision of accurate patient advice.
Collapse
Affiliation(s)
- Kerry Wilbur
- College of Pharmacy, Qatar University, PO Box 2713 Doha, Qatar.
| | | | | |
Collapse
|
32
|
Patel NR, Kennedy A, Blickem C, Rogers A, Reeves D, Chew-Graham C. Having diabetes and having to fast: a qualitative study of British Muslims with diabetes. Health Expect 2014; 18:1698-708. [PMID: 24438123 DOI: 10.1111/hex.12163] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There are approximately 2.7 million Muslims in the UK, constituting 4.8% of the population. It is estimated that 325,000 UK Muslims have diabetes. Whilst dietary practices of Muslims with diabetes have been explored, little work has described the beliefs and decisions to fast during Ramadan, whereby Muslims with diabetes refrain from eating, drinking and taking medication between sunrise and sunset. OBJECTIVE To explore beliefs and experiences of fasting during Ramadan of Muslim respondents with diabetes and their perceptions of the role played by their general practitioner (GP) and/or practice nurse (PN) in supporting them. DESIGN Qualitative study. SETTING General practices and community groups located in Greater Manchester. PARTICIPANTS 23 South Asian Muslims. METHODS Semi-structured interviews were conducted as part of the Collaboration of Applied Health Research and Care (CLAHRC) programme, Greater Manchester. Respondents were recruited using random and purposive sampling techniques. Interviews were analysed thematically using a constant comparison approach. RESULTS Thirteen respondents reported they fasted and altered diabetes medication and diet during Ramadan. The decision to fast was influenced by pressures from the family and the collective social aspect of fasting, and respondents made limited contact with primary care during fasting. CONCLUSION Tensions exist between the respondent's personal desire to fast or not fast and their family's opinion on the matter, with a strong reluctance to disclose fasting to GP and/or PN. Future research needs to explore whether GPs or PNs feel competent enough to support patients who wish to fast.
Collapse
Affiliation(s)
- Neesha R Patel
- Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | - Anne Kennedy
- Health Services Research, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Christian Blickem
- Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | - Anne Rogers
- Health Systems Implementation, Health Services Research, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - David Reeves
- Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | - Carolyn Chew-Graham
- General Practice Research, Primary Care Sciences, Research Institute: Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| |
Collapse
|
33
|
Spiritual support of cancer patients and the role of the doctor. Support Care Cancer 2013; 22:1333-9. [DOI: 10.1007/s00520-013-2091-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 12/05/2013] [Indexed: 01/01/2023]
|
34
|
South F, Upton D, Upton P. The Impact of Ramadan on lifestyle behaviours and implications for cardiac rehabilitation: A review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2013. [DOI: 10.12968/ijtr.2013.20.7.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: The Muslim population worldwide have a higher incidence of cardiovascular disease than that of the non-Muslim population, and this may become exaggerated during the religious observances of Ramadan. This review assessed the evidence regarding the impact of Ramadan on lifestyle behaviours in Muslims with cardiovascular disease. Method: This article reviews the literature concerning the impact of Ramadan on lifestyle behaviours and its effects on cardiac rehabilitation between 2000 and 2012. Studies were identified, using Academic Search Complete, Google Scholar, PsycInfo, PsycARTICLES, Medline and CINAHL Plus. The search terms used were: ‘cardiac rehabilitation’; ‘cardiovascular disease’; ‘Ramadan’; ‘fasting’; ‘physical activity’; ‘exercise’; ‘diet’; ‘smoking’; ‘sleep’; ‘behaviour change’; ‘medication’; and ‘treatment’. Findings: Evidence suggests that fasting during Ramadan can have a beneficial effect on factors such as cholesterol levels, body weight and blood pressure; however, benefits are rarely sustained in the long term. Other behavioural changes such as non-adherence to medication, and diet and exercise regimes have more negative consequences for sufferers of cardiac disease. Conclusions: Lifestyle behaviours adopted during Ramadan can have a negative impact on cardiovascular disease. Health professionals are urged to find innovative ways to engage this population in healthy lifestyle choices throughout this period.
Collapse
Affiliation(s)
- Felicity South
- psychological sciences at the University of Worcester, UK
| | | | | |
Collapse
|
35
|
Mygind A, Kristiansen M, Wittrup I, Nørgaard LS. Patient perspectives on type 2 diabetes and medicine use during Ramadan among Pakistanis in Denmark. Int J Clin Pharm 2013; 35:281-8. [PMID: 23354808 DOI: 10.1007/s11096-012-9716-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 10/08/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND Type 2 diabetes is highly prevalent among people of Pakistani background. Studies show that adherence to medicines is complicated for people with type 2 diabetes in general. Also, studies indicate that many people with type 2 diabetes and Muslim background fast during the month of Ramadan without adequate counselling on how to adjust their medicines. OBJECTIVE To explore patient perspectives on medicine use during Ramadan, reasons for fasting and experiences with counselling on medicine use during Ramadan among people of Pakistani background with type 2 diabetes and at least one other chronic condition. SETTING Greater Copenhagen, Denmark. METHOD The analysis is based on a study exploring lived experiences with counselling on medicines using semi-structured interviews and medication reviews. The analysis presented here builds on the subset of patients with Pakistani background (six interviewers). RESULTS All interviewees pointed out that Islam allows ill people to refrain from fasting during Ramadan. However, all had fasted during Ramadan despite being diagnosed with type 2 diabetes. While fasting, they adapted their use of medicines in different ways, e.g. by changing the time of intake or by skipping morning medicines. Fasting during Ramadan meant a feeling of improvement in well-being for all interviewees. Reasons for this improvement included physiological, social and religious aspects. Healthcare professionals were rarely included in the decision-making process on whether or not to fast. Instead, friends and relatives, especially those with type 2 diabetes, were considered important to the decision-making process. CONCLUSION For people with Muslim background and a chronic condition, fasting during Ramadan may mean changes in medicine use that are not always discussed with healthcare professionals. Healthcare professionals should acknowledge that Muslim patients may find fasting during Ramadan beneficial to their well-being and therefore choose to fast despite the Islamic rule of exemption. This patient-centred approach to counselling on medicines may facilitate better medicine use and thus better clinical health outcomes among patients that choose to fast.
Collapse
Affiliation(s)
- Anna Mygind
- Section for Social Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100, Copenhagen, Denmark.
| | | | | | | |
Collapse
|
36
|
Bajaj S, Khan A, Fathima FN, Jaleel MA, Sheikh A, Azad K, Fatima J, Mohsin F. South Asian consensus statement on women's health and Ramadan. Indian J Endocrinol Metab 2012; 16:508-11. [PMID: 22837905 PMCID: PMC3401745 DOI: 10.4103/2230-8210.97995] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Fasting during Ramadan, the holy month of Islam, is mandatory for all healthy adult Muslims. It is estimated that there are 1.1-1.5 billion Muslims worldwide, comprising 18-25% of the world population. About 62% of the world's Muslim population resides in Asia. Women comprise approximately 50% of this population. There is great religious fervor and enthusiasm in the majority of Muslims the world over for observing the religious fasting. Many of the Muslim women perhaps due to the family and societal pressures or lack of proper information hesitate and fail to avail themselves of the generous provisions of temporary or permanent exemptions from fasting available in Islam. It is therefore important that medical professionals as well as the general population be aware of potential risks that may be associated with fasting during Ramadan. This familiarity and knowledge is as important in South Asia and the Middle East as it is in Europe, North America, New Zealand, and Australia. There has not yet been any statement of consensus regarding women's health issues during Ramadan, namely menstruation, sexual obligations of married life, pregnancy, and lactation. This document aims to put forward some of the general guidelines for these issues especially for the South Asian Muslim women.
Collapse
Affiliation(s)
- Sarita Bajaj
- Department of Medicine, MLN Medical College, Allahabad, India
| | - Afreen Khan
- Department of Medicine, MLN Medical College, Allahabad, India
| | - Farah Naaz Fathima
- Department of Community Health, St. John's Medical College, Bangalore, India
| | - Mohammed Abdul Jaleel
- Department of Medicine, Bangalore Diabetes Hospital, Vasanthanagar, and AJ Diabetes Care and Polyclinic, BTM Layout, Bangalore, India
| | - Aisha Sheikh
- Section of Endocrinology, Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan
| | - Kishwar Azad
- Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | - Jalees Fatima
- Department of Medicine, Era's Lucknow Medical College, Lucknow, India
| | - Fauzia Mohsin
- Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| |
Collapse
|