Muslim Patients' Religious & Spiritual Resource Needs in US Hospitals: Findings from a National Survey.

BACKGROUND: Healthcare provided without attending to patients' religious/spiritual needs contributes to inequities. OBJECTIVE: Assess Muslim American views on the importance and accessibility of religious/spiritual resources in hospitals. DESIGN/PARTICIPANTS/MAIN MEASURES: A survey was distributed at community events and online to self-reported Muslim adults. It contained measures of religiosity, importance and availability of specific religious/spiritual resources, and conventional sociodemographic descriptors. Analyses utilized chi-squared tests and regression models to test associations between participant characteristics and views on the importance and availability of religious/spiritual resources in hospitals. KEY RESULTS: Of the 1281 respondents, many (68%; n = 875) were women, and South Asian (39%; n = 492) or Arab (37%; n = 469). Almost all (95%; n = 1203) noted it was important to have their religious/spiritual needs met in the hospital. The most important resources were halal food (93%; n = 1188), a neutral prayer space (93%; n = 1188), and medications without pork or alcohol (92%; n = 1177), yet a minority found such resources available; halal food (17%; n = 111), prayer space (26%; n = 169), and medication without pork or alcohol (9.3%; n = 59). Almost all (92%, N = 1180) felt comfortable identifying as Muslim in the hospital, yet few (27%, N = 173) were asked. Participants with higher positive religious coping placed greater importance on religious/spiritual needs being met (OR 1.15, p < .05). Those regularly attending congregational prayer services (ß 0.2, p < 0.001), with more positive religious coping (ß 0.11, p < 0.001), for whom Islam informed their whole approach to life (ß 0.34, p < 0.001), and those with greater perceived discrimination in medical settings (ß 0.03, p < 0.022) placed greater importance on the availability of Islamic resources in hospital. Those asked about religious affiliation (OR 2.23, p < 0.01) had higher odds of believing their religious/spiritual needs were met. CONCLUSIONS: Muslim Americans have substantial unmet religious/spiritual resource needs in hospital settings. Patient-centered, equitable care may be enhanced by clinicians inquiring about, and mobilizing resources to attend to these.

Interprofessional relationships and their impact on resident hospitalizations in nursing homes: A qualitative study.

AIM: The aim of this study is to explore experiences and perspectives of nurses and providers (e.g., physicians, medical directors, fellows, and nurse practitioners) on reducing preventable hospitalizations of nursing home (NH) residents in relation to interprofessional relationship and hospitalization decision-making process. BACKGROUND: Preventable NH resident hospitalization continues to be a pressing public health issue. Studies show that improved interprofessional relationship may help reduce hospitalization, yet research on communication processes and interactions among different NH staff remains limited. METHODS: This is a qualitative descriptive study. Two focus groups were held with fourteen nurses and thirteen in-depth, qualitative interviews were conducted with providers from two Chicagoland NHs. Focus group sessions and interviews were transcribed, coded, and analyzed for common themes based on qualitative description method. RESULTS: All study participants agreed that providers have the ultimate responsibility for hospitalization decisions. However, nurses believed they could influence those decisions, depending on provider characteristics, trust, and resident conditions. Nurses and providers differed in the way they experienced and conveyed emotions, and differed in key elements affecting hospitalization decisions such as structural or environmental factors (e.g., lacking staff and equipment at the facility, poor communication between the NH and hospitals) and interpersonal factors (e.g., characteristics of effective nurses or providers and the effective interactions between them). CONCLUSIONS: Interpersonal factors, including perceived competence, respect, and trust, may influence NH hospitalization decisions and be targeted for reducing preventable hospitalizations of residents.

Capturing the Work of Patients' Family Members in the Medical Intensive Care Unit Using Naturalistic Observations.

BACKGROUND: The contributions of cognitive and behavioral work of patients' family members in intensive care units remain largely unrecognized. OBJECTIVE: The objective of this study was to develop a framework of outwardly observable family work, with specific focus on describing the physical space. METHODS: We conducted approximately 50 hrs of naturalistic observations of family activities on a medical intensive care unit (MICU) at a large, Midwestern teaching hospital. RESULTS: We created a framework of activities that include requesting, receiving, or delivering either information or action, along with examples. Further, we identified clinician and staff roles with whom families interact and characterized the physical spaces in which interactions take place. CONCLUSIONS: Knowledge contribution is a proposed framework of family activities in the MICU. It has the potential to guide and be further described by future research and to inform development of human-centered family-facing interventions to support cognitive and behavioral cognitive and behavioral work.

Associations Between Every day and Medical Setting-Based Discrimination and Religious and Sociodemographic Characteristics of Muslim Americans: Findings from a National Survey.

We investigated the associations between sociodemographic factors, religiosity traits, and the perception of discrimination among Muslim Americans in both everyday life and medical settings. A self-administered web-based questionnaire, comprising validated measures of discrimination and religiosity, was completed by a convenience sample of English-speaking adult Muslim Americans, recruited through both in-person and online channels. Among the 1281 respondents, less than half were born in the USA (46%), and a significant portion displayed visible religious markers, such as wearing a hijab or having a beard (61%). Only 154 (12%) reported never experiencing everyday discrimination, while 358 (28%) reported not experiencing discrimination in medical settings. In a multivariable linear regression model, greater perceived everyday discrimination (ß = 1.053, p < 0.01) was positively associated with greater discrimination in medical settings. Participants more comfortable self-identifying as Muslim in hospital settings (ß = -0.395, p < 0.05) were less likely to perceive healthcare discrimination. Those visibly expressing their religiosity (ß = 0.779, p < 0.01) and those with greater intrinsic religiosity (ß = 0.231, p < 0.05) were more likely to encounter everyday discrimination. Conversely, older participants (ß = -0.015, p < 0.05), adult immigrants to the US (ß = -0.375, p < 0.05), those in better health (ß = -0.157, p < 0.05), and those more comfortable identifying as Muslim (ß = -0.305, p < 0.05) had lower perceptions of everyday discrimination. This study underscores the significance of the relationship between religiosity characteristics and experiences of both hospital and everyday discrimination for Muslim Americans.

COVID-19 Vaccine Hesitancy among Health Professional Students: Cross-Sectional Data from the First Wave of the HOLISTIC Cohort Study.

Vaccine hesitancy has been observed around the world, but there is a paucity of data among a broad range of U.S. health professional students. The goal of this report is to present findings about COVID-19 vaccine hesitancy among a cross-section of U.S. health professional students and determine if hesitancy varies by demographic characteristics, health science college, and other factors. A cross-sectional analysis of HOLISTIC Cohort Study participants enrolled from April 14 2021 to May 5 2021 at seven health sciences colleges in the University of Illinois Chicago was used. Exploratory and confirmatory factor analysis were used to evaluate vaccine hesitancy items and identify domains. Among 555 health professional students, three domains (perceived benefit, trustworthiness, and risk) contribute to vaccine hesitancy. Significant differences were observed in the domains among students of different races as well as vaccination history. Compared to students in the College of Medicine, students in the Colleges of Applied Health Science (OR 0.43; CI [0.19-0.96]), Pharmacy (OR 0.38; CI [0.17-0.87]), Nursing (OR 0.35; CI [0.16-0.78]), and Social Work (OR 0.30; CI [0.11-0.78]) reported lower perceived benefit. Compared to students in the College of Medicine, students in the College of Applied Health Sciences (OR 0.39; CI [0.17-0.94]), Dentistry (OR 0.27; CI [0.10-0.76]), Nursing (OR 0.38; CI [0.16-0.94]), and Social work (OR 0.31; CI [0.11-0.86]) reported more trustworthiness and more concerns about risk (OR 2.80; CI [1.15-6.81] for College of Applied Health Sciences, OR 9.12; CI [2.80-29.75] for Dentistry, OR 3.77; CI [1.47-9.65] for Nursing, OR 3.14; CI [1.02-9.67] for Social Work). Our findings suggest the need for a tailored vaccination strategy among different subgroups of health professional students.