RAMCOM: A qualitative study of clinicians' viewpoints on a tool for communication with Muslim patients considering fasting during Ramadan.

objectivesFasting during the month of Ramadan is a basic pillar of Islam. While patients may be religiously exempted from fasting, literature indicates that the majority decide to fast. Caring for millions of Muslim patients who decide to fast during Ramadan can be challenging for clinicians around the globe. This study proposes a communication tool, RAMCOM, which aims to assist clinicians in communicating with Muslim patients considering fasting during Ramadan. It addresses the following questions: What are the clinicians' preferences for the tool in terms of Content, Format, Style, Length and language? How do clinicians perceive factors that would impact their intentions to sue the tool? What would facilitate the implementation and dissemination of the proposed tool?

methodsSemi-structured interviews were conducted with a purposeful sample of clinicians in Egypt (11) and the US (10). Clinicians were purposefully sampled to assure variance in age, gender, time in practice, specialty, and religious background. Directed content analysis was conducted and emerging data were mapped to constructs within the theory of planned behavior. Iterative sampling and analysis continued until saturation was reached.

resultsIn total, 21 clinicians were interviewed. The tool was iteratively revised according to clinicians' comments on format, content, language and usability. Factors contributing to using RAMCOM included perception of tool (need for use, perceived burden of use), perceived norm (perceived patient expectations), and ability to use tool (time, frequency of seeing patients, knowledge of Ramadan and Islam). Practice environment factors that impact the use of RAMCOM include education, early reminders, colored laminated copies, communication training, involvement of support staff, and patient education.

conclusionClinicians provided valuable perceptions on the implementability and use of RAMCOM, a new communication tool designed to assist in caring for Muslim patients during Ramadan. These perceptions should be considered by different stakeholders to facilitate goal-concordant care for Muslim patients considering fasting.