Running head: CULTURAL AND SPIRITUAL CARE: MUSLIM AMERICANS

Cultural and Spiritual Care:

Muslim Americans
Elise Howard
The Pennsylvania State University

CULTURAL AND SPIRITUAL CARE: MUSLIM AMERICANS

Cultural competency in care in all regards is incredibly important in the successful and
effective healing and care of patients. It is nearly impossible to be competent in all of the
spiritualties and religions in the United States, but it is very important to research and learn what
is important to each patient that we care for. Spirituality or religion impact an individuals life
and therefore their care in a healthcare setting. It is estimated that there are six to eight million
people in the United States that follow the Islam religion and these number are growing rapidly.
With this projected increase (at such high numbers) I think that it is important to know how to
care for those individuals who currently make up about 0.8% of the current U.S. population
(Ibrahim & Dykeman, 2011).
One important distinction to keep in mind is that the religion is called Islam and those who
practice Islam are generally called Muslims. There are many sects of Islam that are represented
with different variations of practice and religiosity. With all of this variation within one religious
group, it can be difficult to understand and practice competent care. However, all practicing
Muslims adhere as closely as they can to the Five Pillars of Islam: 1.) a belief in one God and the
final messenger, Mohammad, 2.) prayer five times daily, 3.) charity, 4.) a month of fasting from
sunup to sundown called Ramadan, and 5.) a pilgrimage to the holy city Mecca called Hajj at
least once in a lifetime. Remembering these basic tenants of Islam, along with knowing that their
worldview is guided by the Quran, may help and guide in caring for a patient to practices Islam
(Ibrahim & Dykeman, 2011).
Living in the United States as a practicing Muslim tends to be difficult. There are many
negative connotations that arise when the Islam religion in regarded. After 9/11 there seemed to
be an increase in the negative views about Islam and a general Islamophobia (Ibrahim &
Dykeman, 2011). Some associate Muslims as extreme radicals with radical ideations and

CULTURAL AND SPIRITUAL CARE: MUSLIM AMERICANS

religiosities simply because those that orchestrated the 9/11 attacks were majorly of the Islam
religion. It is important when caring for Muslim patients that all biases be identified and put
aside; nurses are to give the best care to every patient regardless of personal beliefs.
There are religious observance aspects that need to be maintained in the Islam faith and
helping a patient maintain proper observance may also help them to heal. An important facet for
Islam faith is ablution and bathing. Before prayer, it is required to perform ablution (washing)
and if it is not advisable to bathe, other steps must be taken such as Tayammum (Queensland
Health & Islamic Council of Queensland, 2010).
As stated before, prayer at least five times a day with some exceptions such as women
postnatally and the cognitively impaired. All prayers must be said while facing Mecca, so
orienting the patient to the room is very important. Communicating with the patient about
personal prayer times is imperative so that nursing care can be completed without disrupting
their prayer (Queensland Health & Islamic Council of Queensland, 2010).
Diet is a very vital aspect of the Islam religion. Muslims follow a halal diet in which certain
foods are not allowed to be consumed, including: pork or pork products, meat and meat products
that are not killed ritually, and alcohol. Vegetarian diet are very common as well as fish and eggs.
These prohibited items become especially important when giving medications that contain
alcohol or porcine products. There are resources to investigate these restrictions and it is
important to be aware (Queensland Health & Islamic Council of Queensland, 2010).
There is also a level of modesty that must be maintained, especially for women. Making sure
that they are as covered as they can be during procedures is critical for the patient to feel
comfortable and respected. Procedures that require Muslim patients to expose their bodies
usually wish to have someone of the same sex to preform them. When the patient cannot bathe

CULTURAL AND SPIRITUAL CARE: MUSLIM AMERICANS

themselves, it is important to show sensitivity towards them while helping them bathe. There is a
great emphasis in the Islam faith on hygiene and it is therefore critical for Muslim patients to
have access to proper hygiene equipment. One this that may be overlooked is that it is necessary
for them to use water to cleanse themselves. With the frequent use of alcohol-based hand
sanitizer (which is prohibited to use in Islam due to alcohol content), it is very important to
provide adequate methods in which the patient can properly cleanse themselves (Queensland
Health & Islamic Council of Queensland, 2010).
Visiting the sick is essential in the Islam faith as it is considered a communal obligation.
There may be a large number of visitors and this may impair the patients ability to rest and heal.
Communication about this to the patient and their family members should be open
accommodating (Queensland Health & Islamic Council of Queensland, 2010).
Other factors of health care such as sexual and reproductive health, organ transplantation,
dress, mental health, and fasting are highly variable individually and views and beliefs should be
properly assessed (Queensland Health & Islamic Council of Queensland, 2010).
There are end of life issues to keep in mind as well. Islam faith holds that preservation of
life is of utmost importance, however it does not require that treatment be in place simply to
prolong life. Because of the grey lines about treatments and prolong life, it is vital to keep open
communication with the family and discuss advanced directives. There are also a number of end
of life considerations that must be held intact in the Islam faith (Queensland Health & Islamic
Council of Queensland, 2010).
Understanding that there are various sects of Islam with varying dedication and
commitments to the faith, I believe that it is very important to keep lines of communication open
with both the patient and the family. Knowing the basic tenants of Islam is important, but every

CULTURAL AND SPIRITUAL CARE: MUSLIM AMERICANS

person is different; every individual has their own set standards of religiosity and spirituality and
the only way to know and understand them is to talk openly. I have been in a relationship with a
Turkish guy who identifies himself as Muslim when asked, however, he maintains only certain
parts of the religious aspects in his daily life. I, myself was raised in a very Catholic family, went
to Catholic middle school and high school, and went to mass every Sunday, but now only
maintain certain beliefs of the Catholic faith. This is why I feel that it is incredibly important to
know the patient you are taking care of and how to best take care of them. Communication is
your best resource. In as stated by Perry and Potter, it is useful to ask open-ended, focused, and
contrast questions during the assessment with an aim of encouraging patients to describe
[their] values, beliefs, and practices that are significant to their care (Perry & Potter, 2013).
The inclusiveness of the patients culture in everyday life explains why assessment of the
patients culture and beliefs are so incredibly important in their care. The sunrise model, shown
below demonstrates just that. Inspecting this model shows that individualistic care can be
achieved if we just take the time to communicate and ask the patient or their family questions. As
nurses we aim for individualistic care that incorporates the persons mind, body, and soul. This
cultural competence is a large part in that. I plan to use this approach of individualistic and
highly communicative method of nursing in my future career as I believe that it achieve success
in the holistic caring of a person.

CULTURAL AND SPIRITUAL CARE: MUSLIM AMERICANS

(Leininger, 1991)

CULTURAL AND SPIRITUAL CARE: MUSLIM AMERICANS

REFERENCES
Ibrahim, F. A., & Dykeman, C. (2011). Counseling Muslim Americans: Cultural and
spiritual assessments. Journal of Counseling & Development, 89(4), 387-396.
doi:10.1002/j.1556-6676.2011.tb02835.x
Leininger, M. M. (Ed.). (1991). Culture care diversity and universality: A theory of
nursing. New York: National League of Nursing.
Potter, P. A., & Perry, A. (2013). Culture and ethnicity. In Fundamentals of nursing
(8th ed., pp. 101-115). St. Louis, MO: Elsevier.
Queensland Health & Islamic Council of Queensland. (2010). Health care providers
handbook on Muslim patients (2nd ed.). Retrieved from
http://www.health.qld.gov.au/multicultural/health_workers/hbook-muslim.asp