Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco.
BMC Cancer. 2021 May 7;21(1):516. doi: 10.1186/s12885-021-08175-y.
In 2020, Morocco recorded more than 59,370 new cases of cancer and more than 35,265 cases of death (International Agency for Research on Cancer, Annual report Morocco, 2020). Cancer is always accompanied by socially constructed, differentiated, and contingent interpretations and practices according to the socio-cultural and religious characteristics of each region. The study aims at describing the evolution of the socio-cultural and religious aspects of Moroccan cancer patients followed at the National Institute of Oncology (NIO) of Rabat between 2010 and 2020.
We have prospectively studied all cancer cases diagnosed at the National Oncology Institute (NIO), Rabat in 2019. We have collected 1102 cases. The data collected was compared with the results of the study carried out in 2010 (1600 cases). Statistical analysis has been assessed by SPSS 20 software and the correlations between socio-cultural characteristics were examined using a chi-square test.
From a socio-economic point of view, almost all patients claim that cancer is a costly disease as well as a disease that leads to a drop in income and the inevitable impoverishment of Moroccan patients. The illiteracy rate is still high; rising from 38% in 2010 to 42.80% in 2020. On the psychological level, damage to body image (alopecia, mastectomy, hysterectomy,) can lead to stigmatizing and harms the marital relationship. The number of patients experiencing divorce and marital separation that seems to occur following cancer pathology remains high, despite a decrease of nearly 50% between 2010 and 2020. Concerning the spiritual aspect, in the Arab-Amazigh-Muslim culture, the impact of the occurrence of cancer is very particular, and the repercussions are assessed differently depending on the degree of conviction. For practicing believers, cancer is considered a divine test and an opportunity to improve. In the Qur'an, God tests the best of his disciples to reward them The rate of practicing believers has evolved from 49% in 2010 to 85.50% in 2020.But for non-practicing believers, cancer is regarded as a divine punishment coming from outside. New behaviors reported by this research concern the use of "roquia". This spiritual cure is considered as an anti-cancer remedy. It uses Allah's words from the holy "qur'an", his faires names and his attributes. 42% of patients use "roquia". Concerning phytotherapy, there was an increase in the percentage of participants using medicinal plants and even the most harmful plants (Arestiloch, Euphorbia) from 26% in 2010 to 51.50% in 2020.
The precarious social level of cancer patients, the lack of social and medical coverage, illiteracy, and lack of knowledge of religion, as well as dissatisfaction with conventional medicine, may lead patients to the use of traditional medicine (medicinal plants, visit of "marabouts", "roquia"). This can have a negative impact on the quality of access to oncology care.
2020 年，摩洛哥记录了超过 59370 例新的癌症病例和超过 35265 例死亡病例（国际癌症研究机构，摩洛哥年度报告，2020 年）。癌症总是伴随着根据每个地区的社会文化和宗教特征而产生的社会建构、差异化和偶然的解释和实践。本研究旨在描述 2010 年至 2020 年期间在拉巴特国家肿瘤学研究所（NIO）接受治疗的摩洛哥癌症患者的社会文化和宗教方面的演变。
我们前瞻性地研究了 2019 年在国家肿瘤学研究所（NIO）诊断出的所有癌症病例。我们收集了 1102 例病例。收集的数据与 2010 年进行的研究结果进行了比较（1600 例）。使用 SPSS 20 软件进行统计分析，使用卡方检验检查社会文化特征之间的相关性。
从社会经济角度来看，几乎所有患者都认为癌症是一种昂贵的疾病，也是导致收入下降和摩洛哥患者不可避免贫困的疾病。文盲率仍然很高；从 2010 年的 38%上升到 2020 年的 42.80%。在心理层面上，身体形象的损害（脱发、乳房切除术、子宫切除术）会导致污名化，并影响婚姻关系。经历离婚和婚姻分离的患者人数似乎仍然很高，尽管与 2010 年相比下降了近 50%。关于精神方面，在阿拉伯-阿马齐格-穆斯林文化中，癌症的发生影响非常特殊，其影响因信仰程度而异。对于虔诚的信徒来说，癌症被认为是神的考验和提高的机会。在《古兰经》中，上帝考验他最好的门徒以奖励他们。虔诚信徒的比例从 2010 年的 49%上升到 2020 年的 85.50%。但对于非信徒来说，癌症被视为来自外部的神罚。这项研究报告的新行为涉及到使用“罗基亚”。这种精神疗法被认为是一种抗癌疗法。它使用真主的话语，从神圣的“古兰经”，他的公正的名字和他的属性。42%的患者使用“罗基亚”。关于植物疗法，使用药用植物的参与者比例甚至是最有害的植物（Arestiloch、Euphorbia）都有所增加，从 2010 年的 26%增加到 2020 年的 51.50%。
癌症患者社会地位不稳定，社会和医疗保障不足，文盲，宗教知识匮乏，以及对传统医学的不满，可能导致患者使用传统医学（药用植物、“marabouts”、“roquia”）。这可能会对获得肿瘤学护理的质量产生负面影响。
