Department of General, Visceral and Vascular Surgery, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany.
Research Programme "Clinician Scientist Programme", Interdisciplinary Center of Clinical Research, Medical Faculty Jena, Jena University Hospital, Friedrich Schiller University Jena, Salvador-Allende-Platz 29, 07747, Jena, Germany.
BMC Med Ethics. 2024 Oct 18;25(1):116. doi: 10.1186/s12910-024-01114-z.
Engagement of healthcare professionals with patients from diverse cultural and religious backgrounds is crucial in our multicultural society, where miscommunication and errors in medical history taking can lead to incorrect treatment. In particular, Muslim patients may present unique considerations due to their specific cultural and religious beliefs, which can significantly impact treatment outcomes. This study focuses on perioperative medication therapy for patients undergoing upper and lower gastrointestinal tract and pancreatic tumor surgery, specifically examining whether Islamic beliefs were duly considered in medication selection compared to a matching patient cohort.
Data from January 2004 to July 2023 were analyzed. Muslim patients were identified using the onomastic method and matched with non-Muslim patients at a 1:3 ratio based on age, gender, and procedure. Analysis included examination of subcutaneous, oral, and intravenous medications, with attention to ingredients and compatibility with Islamic principles.
Among 5272 patients, only 5 met the study's inclusion criteria as Muslim patients, undergoing procedures such as anterior rectum resection, gastrectomy, and pancreatic head resection. Their religious affiliations were not documented in the admission records. According to the matched-pair analysis, consistent treatment was performed regardless of religious beliefs. All patients received subcutaneous medication, primarily enoxaparin, instead of fondaparinux, an Islam-compliant alternative. Intravenous heparin was used once for short period. Contrary to Islamic dietary restrictions and the availability of alternatives, capsules containing animal-derived gelatin and other non-compliant medications were administered orally.
This study underscores the importance of acknowledging Muslim patients' cultural and religious backgrounds in the perioperative setting, as failure to do so may lead healthcare professionals to overlook their potential alternative medication needs, which are essential for providing tailored medical care in modern societies. Integration of diversity-related topics into medical curricula is essential for better preparing physicians for clinical practice and ensuring patient-centered care.
在我们的多元文化社会中，医疗保健专业人员与来自不同文化和宗教背景的患者互动至关重要，因为沟通不畅和病史采集错误可能导致治疗不当。特别是，穆斯林患者可能因其特定的文化和宗教信仰而带来独特的考虑因素，这可能会对治疗结果产生重大影响。本研究专注于接受上消化道和下消化道以及胰腺肿瘤手术的患者的围手术期药物治疗，具体研究了在药物选择方面是否充分考虑了伊斯兰信仰，与匹配的患者队列进行比较。
分析了 2004 年 1 月至 2023 年 7 月的数据。使用命名法识别穆斯林患者，并根据年龄、性别和手术以 1:3 的比例与非穆斯林患者匹配。分析包括检查皮下、口服和静脉内药物，注意成分和与伊斯兰原则的相容性。
在 5272 名患者中，只有 5 名符合穆斯林患者的研究纳入标准，接受了前直肠切除术、胃切除术和胰头切除术等手术。他们的宗教信仰在入院记录中没有记录。根据配对分析，无论宗教信仰如何，都进行了一致的治疗。所有患者均接受了皮下药物治疗，主要是依诺肝素，而不是法安明，这是一种符合伊斯兰教的替代药物。仅在短时间内使用过一次静脉肝素。尽管存在与伊斯兰饮食限制和替代品可用性相关的问题，但仍给予了含有动物源性明胶和其他不符合规定药物的胶囊口服。
本研究强调了在围手术期环境中承认穆斯林患者的文化和宗教背景的重要性，因为未能这样做可能导致医疗保健专业人员忽略他们潜在的替代药物需求，而这对于在现代社会中提供量身定制的医疗护理至关重要。将与多样性相关的主题纳入医学课程对于更好地为医生的临床实践做准备并确保以患者为中心的护理至关重要。
