Assessment of Spiritual Well-being in Muslim Patients: A Systematic Review
Zain Khera, NYU Grossman School of Medicine, New York, NY; Waqas Haque, MD, MPH, NYU Grossman School of Medicine, New York, NY; and Sondos Al Sad, MBBS, MPH, University of California, San Francisco, San Francisco, CA
Background:
Spiritual wellness is increasingly recognized as a component of one’s overall health, and by extension, is tied to a patient’s ability to cope with difficulty and illness. Spiritual assessment tools are used in healthcare settings to better understand patient’s perceptions of a clinical exchange, what a patient expects of their clinical care, and to ultimately enhance the patient-physician relationship. Muslim patients can be marginalized in healthcare settings due to a lack of accommodations and understanding of their spiritual needs and practices. Spiritual assessment tools in the literature were predominantly formulated based on sampling non-Muslim patients. Instruments designed based on sampling Muslims’ spiritual well-being offer relevant and accurate grounding to further advocacy and research efforts that optimizes health outcomes. Our systematic review of studies aims to assess the current state of the medical literature on measuring spiritual well-being in Muslim patient populations.
Methods:
We conducted a search on PubMed with the following keywords: ((Spiritual Well-being) AND (scale OR assessment) AND ("muslim" OR "muslims" OR "islam"[MeSH Terms] OR "islam" OR "islamic" OR "islamism" OR "Allah")). The search was completed for the years 2001 through July 2023. 197 unique studies were identified. The studies were manually reviewed to only include papers measuring personal spiritual well-being or spirituality in a Muslim majority sample. Studies measuring spirituality using non-survey based (e.g. focus groups or interviews) were excluded, as were survey measures related to behavior rather than attitudes (those measuring Muslim religiosity and coping methods). Twenty six studies were included in the final analysis. In our secondary analysis, we examined all unique survey instruments used in the included studies. The survey instruments’ corresponding validation studies were reviewed for context and relevance to Muslim patient populations.
Results:
There were 26 studies examining spirituality and/or spiritual well-being in Muslim patients that fulfilled our study criteria. Among these studies, a total of 12 unique survey instruments were employed. Cancer patients were the most common study population, comprising 14/26 (53.8%) studies. 19/26 (73%) of studies were completed in Iran, with no studies in the United States or other western countries. Of the 12 survey instruments used, the majority (8/12) were originally validated in non-Muslim populations. Except for 2/12 of the survey instruments, all used factor analysis in their original studies.
Conclusion:
Despite the growing amount of literature examining spirituality and spiritual well-being in patients, relatively little attention is paid to Muslim patients with no studies on Muslim patients in the United States. Most survey instruments used to assess spiritual well-being and spirituality among Muslims were not originally validated in Muslim populations, which may mitigate the validity of respective study findings. There is a need for health researchers and spiritual care department affiliated staff to develop spiritual survey instruments rigorously validated and applied to the American-Muslim population.
Spiritual wellness is increasingly recognized as a component of one’s overall health, and by extension, is tied to a patient’s ability to cope with difficulty and illness. Spiritual assessment tools are used in healthcare settings to better understand patient’s perceptions of a clinical exchange, what a patient expects of their clinical care, and to ultimately enhance the patient-physician relationship. Muslim patients can be marginalized in healthcare settings due to a lack of accommodations and understanding of their spiritual needs and practices. Spiritual assessment tools in the literature were predominantly formulated based on sampling non-Muslim patients. Instruments designed based on sampling Muslims’ spiritual well-being offer relevant and accurate grounding to further advocacy and research efforts that optimizes health outcomes. Our systematic review of studies aims to assess the current state of the medical literature on measuring spiritual well-being in Muslim patient populations.
Methods:
We conducted a search on PubMed with the following keywords: ((Spiritual Well-being) AND (scale OR assessment) AND ("muslim" OR "muslims" OR "islam"[MeSH Terms] OR "islam" OR "islamic" OR "islamism" OR "Allah")). The search was completed for the years 2001 through July 2023. 197 unique studies were identified. The studies were manually reviewed to only include papers measuring personal spiritual well-being or spirituality in a Muslim majority sample. Studies measuring spirituality using non-survey based (e.g. focus groups or interviews) were excluded, as were survey measures related to behavior rather than attitudes (those measuring Muslim religiosity and coping methods). Twenty six studies were included in the final analysis. In our secondary analysis, we examined all unique survey instruments used in the included studies. The survey instruments’ corresponding validation studies were reviewed for context and relevance to Muslim patient populations.
Results:
There were 26 studies examining spirituality and/or spiritual well-being in Muslim patients that fulfilled our study criteria. Among these studies, a total of 12 unique survey instruments were employed. Cancer patients were the most common study population, comprising 14/26 (53.8%) studies. 19/26 (73%) of studies were completed in Iran, with no studies in the United States or other western countries. Of the 12 survey instruments used, the majority (8/12) were originally validated in non-Muslim populations. Except for 2/12 of the survey instruments, all used factor analysis in their original studies.
Conclusion:
Despite the growing amount of literature examining spirituality and spiritual well-being in patients, relatively little attention is paid to Muslim patients with no studies on Muslim patients in the United States. Most survey instruments used to assess spiritual well-being and spirituality among Muslims were not originally validated in Muslim populations, which may mitigate the validity of respective study findings. There is a need for health researchers and spiritual care department affiliated staff to develop spiritual survey instruments rigorously validated and applied to the American-Muslim population.