Tareen Mona
Program Lead, Palliative and Supportive Care, Institute of Oncology, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
Am J Hosp Palliat Care. 2024 Nov 26;42(11):10499091241303684. doi: 10.1177/10499091241303684.
Non-disclosure practices hold significant weight in end-of-life care for Muslim communities, where cultural and religious beliefs are deeply intertwined with healthcare decision-making. This narrative review explores the complexities of medical decision-making and disclosure practices among terminally ill Muslim patients, examining how these factors shape palliative care delivery. The primary objective of this review is to investigate the impact of non-disclosure practices on end-of-life care in Muslim populations, focusing on key themes that influence medical decision-making. Additionally, the review identifies ways in which Healthcare Provider (HCP) can navigate these culturally sensitive issues to enhance care. A comprehensive narrative review was conducted, utilizing articles from CINHAL, PsychINFO, Scopus, and PubMed databases published between 2009 and 2024. An initial search yielded 2025 articles. After applying inclusion and exclusion criteria, 12 studies were included for analysis. The SANRA guidelines for narrative reviews were followed, and the SPIDER framework was used for qualitative synthesis. Of the 2041 articles initially retrieved, 2014 were excluded after screening, 8 were duplicates, and 7 full texts were excluded for not meeting the inclusion criteria. The final review included 12 studies. Three key themes emerged: (1) cultural, religious, and emotional factors driving requests for non-disclosure, (2) the prominent role of family in medical decision-making, and (3) healthcare provider communication challenges contributing to disparities in palliative care access. Non-disclosure practices present significant barriers to effective palliative care in Muslim communities. To improve care outcomes, culturally competent communication strategies and family-centered decision-making models are crucial.
在穆斯林社区的临终关怀中，保密措施具有重要意义，在这些社区中，文化和宗教信仰与医疗决策紧密相连。本叙述性综述探讨了晚期穆斯林患者医疗决策和信息披露措施的复杂性，研究这些因素如何影响姑息治疗的提供。本综述的主要目的是调查保密措施对穆斯林人群临终关怀的影响，重点关注影响医疗决策的关键主题。此外，该综述还确定了医疗服务提供者（HCP）应对这些文化敏感问题以改善护理的方法。我们进行了一项全面的叙述性综述，利用了2009年至2024年期间发表在CINHAL、PsychINFO、Scopus和PubMed数据库中的文章。初步检索得到2025篇文章。在应用纳入和排除标准后，纳入12项研究进行分析。遵循了叙述性综述的SANRA指南，并使用SPIDER框架进行定性综合。在最初检索的2041篇文章中，筛选后排除2014篇，8篇为重复文章，7篇全文因不符合纳入标准而被排除。最终综述纳入12项研究。出现了三个关键主题：（1）推动保密要求的文化、宗教和情感因素；（2）家庭在医疗决策中的突出作用；（3）医疗服务提供者的沟通挑战导致姑息治疗可及性的差异。保密措施给穆斯林社区的有效姑息治疗带来了重大障碍。为了改善护理结果，具有文化胜任力的沟通策略和以家庭为中心的决策模式至关重要。
