德国接受肿瘤手术的穆斯林患者的围手术期药物治疗:一项回顾性研究。

IF 3 1区 哲学 Q1 ETHICS BMC Medical Ethics Pub Date : 2024-10-18 DOI:10.1186/s12910-024-01114-z
Aysun Tekbaş, M von Lilienfeld-Toal, F Sayrafi, U Settmacher
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引用次数: 0

摘要

目的:在我们这个多元文化的社会中,医护人员与来自不同文化和宗教背景的患者接触至关重要,因为沟通不畅和病史采集错误可能会导致错误的治疗。尤其是穆斯林患者,由于其特殊的文化和宗教信仰,可能会有独特的考虑因素,这可能会对治疗效果产生重大影响。本研究重点关注接受上下消化道和胰腺肿瘤手术患者的围手术期药物治疗,特别是与匹配的患者队列相比,研究伊斯兰教信仰是否在药物选择中得到了适当考虑:对 2004 年 1 月至 2023 年 7 月的数据进行了分析。根据年龄、性别和手术方式,采用拟态法确定穆斯林患者,并与非穆斯林患者按 1:3 的比例进行配对。分析包括对皮下注射、口服和静脉注射药物的检查,并关注药物成分和与伊斯兰原则的兼容性:在 5272 名患者中,只有 5 人符合研究的穆斯林患者纳入标准,他们接受了直肠前部切除术、胃切除术和胰头切除术等手术。他们的宗教信仰未在入院记录中记录。根据配对分析,无论宗教信仰如何,治疗方法都是一致的。所有患者都接受了皮下注射药物治疗,主要是依诺肝素,而不是符合伊斯兰教教规的磺达肝癸。静脉注射肝素一次,时间较短。与伊斯兰教的饮食限制和替代品的可用性相反,患者口服了含有动物源明胶的胶囊和其他不符合规定的药物:本研究强调了在围手术期了解穆斯林患者的文化和宗教背景的重要性,否则可能会导致医护人员忽视他们潜在的替代用药需求,而这对于在现代社会提供量身定制的医疗服务至关重要。将与多样性相关的主题纳入医学课程对于更好地培养医生的临床实践能力和确保以患者为中心的医疗服务至关重要。
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Perioperative medication therapy for Muslim patients in Germany undergoing oncological surgery: a retrospective study.

Purpose: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

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来源期刊
BMC Medical Ethics
BMC Medical Ethics MEDICAL ETHICS-
CiteScore
5.20
自引率
7.40%
发文量
108
审稿时长
>12 weeks
期刊介绍: BMC Medical Ethics is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies.
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