How does culture affect healthcare?

Contributor(s): David Berg, MA, MDiv

Question: I am a nurse practitioner who has accepted a position in a clinic with a largely Muslim clientele.  What should I know about Muslim culture, to make sure I offer the best care?

Answer: David Berg, Chaplain and Cultural Competency Educator at Fairview-University Medical Center in Minneapolis, writes:
As you already realize, healthcare is not a “one-size-fits-all” profession! It is important to be sensitive to ways in which culture and faith impact your patients’ healthcare experiences.

One good place to start with all patients is to let them know that you want to make them comfortable and ask them what they need. An attitude of openness and acceptance will do wonders.

Recognize that with Muslims, as with many faiths, there are varying beliefs and practices, so talking to the patient directly is useful. That said, it can be helpful to have a general understanding of different cultures. Here are a few basic but very important considerations for your Muslim patients.

DIET: Observant Muslims will fast from sunrise to sunset during Ramadan, occurring in the ninth month of the Muslim calendar. Although sick people are not strictly obligated to fast, many of your patients may choose to do so. Since some of these patients may have a vital need to eat for recovery, communicating with them about this is necessary.

MEDICINE: Many medications have a gelatin base. This pork derivative is taboo in Muslim culture, so alternative formulations or remedies are preferred.

COMMUNICATION/INTERACTION: It is important to read non-verbal cues. Some of your Muslim patients will not be comfortable shaking hands with a member of the opposite sex. But if the patient extends his or her hand when you meet, of course you should shake it. Modesty is very important to Muslims, and many of them will prefer a same-sex provider, and will be comfortable undressing or uncovering only the part of the body currently being examined.

As you can see, this list simply scratches the surface of how cultural sensitivity will help you (and your patients) in your new position!

There are many cultural competency resources that can help you access, comprehend, and assess the role of culture in healthcare. Primarily, these tools will help you gain a greater appreciation for how the patient understands their health/illness with regard to culture, preferred healer and interventions, traditional health practices, and communication patterns.

Many of these tools are based on the CLAS (Culturally and Linguistically Appropriate Services) standards (http://www.omhrc.gov/clas/po.htm), developed by the U.S. Department of Health and Human Services, the Office of Minority Health, and Resources for Cross Cultural Health Care. In addition to learning about the CLAS Standards, check out the following sites for more cultural competency information:

American Medical Association Cultural Competence

Cross Cultural Health Care Program


And here is a website with more information on Islamic culture and faith
http://www.islam.com