Methodological and ethical challenges while conducting qualitative research on spirituality and end of life in a Muslim context: a guide to novice researchers.

Abstract Spirituality could be understood as a personal belief, a relation with sacred, divine experience, a sense of purpose and meaning towards life, authenticity and connectedness. It is a continually evolving, highly complex, contextual, subjective, and sensitive construct. A continuous development is seen around understanding about spirituality and spiritual concepts, such as spiritual experiences, spiritual pain and spiritual distress, especially among patients and families at the end of life. The concepts, values, attitudes, and beliefs around spirituality, spiritual needs and expressions vary among different individuals, cultures, and religions. There is a dearth of literature around spirituality, especially among Muslim patients and families at the end of life. The complexities around the concept of spirituality in the literature raise several ethical and methodological concerns for a novice researcher while planning and conducting a study on spirituality during end-of-life care in a hospice setting, especially among a Muslim population. This paper aims to share some of the methodological and ethical challenges that can be faced by qualitative researchers while conducting research around spirituality and end-of-life care in an Islamic/Muslim context. Major challenges include defining the term spirituality, spirituality and culture, communication, power relations, language and translation, recruitment and selection of the participants, emotional distress, and reflexivity and reciprocity. Having an in-depth understanding of these challenges can guide researchers to address these issues adequately in their spirituality research in a Muslim context.

Community mental health initiatives in Pakistan.

AIM: To identify mental health needs in local communities, and provide and evaluate nurse-led services to promote community mental health in Karachi, Pakistan. METHOD: Using an action research approach, mental health nurses implemented activities to promote mental health and psychiatric rehabilitation in 15 urban communities in Karachi. The activities were planned and implemented in collaboration with a community-based social welfare organisation. FINDINGS: Community mental health interventions were implemented by a multidisciplinary team including nursing educators and postgraduate nursing students. Positive transformation of the mental health of clients in the community was found. CONCLUSION: The challenges in identifying, diagnosing and rehabilitating clients with mental health needs in the community in Pakistan is acknowledged, and the benefits of enhanced support for clients and their families provided by community mental health nurses are described.

Media created violence: a social determinant of mental health.

In today's high technological world, scientific discoveries contribute remarkable development to human life, but it could also have an adverse impact on mankind. Among all these advancements, media is one of the inventions which aims at capturing a countless group of viewers and transmit information via various mediums. Media violence is considered one of the hampering determinants which harms an individual psychologically. The primary goal of a health professional is to work for the maintenance of mental health. Therefore, it is imperative to create an understanding about the impact of media violence on mental health, particularly in the Pakistani context. Violence has become a major public health problem in Pakistan. The main cause of violence seems to be anger and frustration due to poverty, political conflicts, lack of education, and the overall governance approach in the country. Therefore, there is a prime need to think and work on this neglected area like conducting research and increasing public awareness, and to curb media violence.