Exploring the influence of ethnic background, culture and faith on perceptions towards advance care planning conversations with British Muslim communi

背景和理由：在英国，有证据表明，在少数族裔群体中，提前护理计划(ACP)和姑息护理的接受率较低。这些人并不认为自己属于白人族群(Saltus和Pithara，2015)。人口预测表明，到2026年，65岁以上少数族裔群体的人口将达到130万(Calanzani等人，2013年)。几乎三分之一的少数族裔群体是英国穆斯林(英国穆斯林委员会，2015)。与其他英国人相比，年长的英国穆斯林(65岁以上)患糖尿病、心脏病和高血压等慢性病的比例更高。而年长的穆斯林妇女报告患有“坏”或“非常坏”的可能性是英格兰其他妇女的两倍(Sherif等人，2019年)。强调需要确保围绕偏好和未来护理的ACP对话是为这一群体量身定做的。医疗保健专业人员描述了围绕ACP对话的挑战，其中包括患者和家庭的价值观和信仰(Sherif等人，2019年，De Vries等人，2019年)。在少数族裔群体中，人们发现了一些围绕非加太对话的障碍。这些问题包括对非典的认识有限，对医疗保健系统的不信任，以及对关于死亡的讨论可能给患者和家人造成的痛苦的担忧(Canny等人，2022年)。从对少数族裔群体和英国穆斯林的研究中，需要文化上有能力和可获得的非加太资源(Canny等人，2022年，Sherif等人，2019年，Moss等人，2022年)，与来自社区的人合作开发(Ahmed和Siddiqi，2016)。这可以促进探索对少数族裔背景的人来说什么是重要的，并提供临终关怀和临终关怀，使他们获得尽可能好的临终体验。目的：这项博士研究的目的是：(1)探索种族背景、文化和信仰对英国穆斯林对非典对话的态度的影响；(2)共同为患者和家庭制作一份资源，并为医疗专业人员提供指导或沟通工具，以支持与英国穆斯林社区的人进行有文化能力的非典对话。(阶段1)文献综述，探索穆斯林实现非加太的障碍和促进者的现有证据。(第二阶段)与英国穆斯林理事会合作开展同行研究，与英国穆斯林社区的其他人进行访谈，以探索对姑息治疗、非加太的理解以及文化和信仰对开放和对这一过程的态度的潜在影响。(第三阶段)共同设计讲习班，以制定建议。(阶段4)共同为患者和家庭制作和传播资源，并为卫生保健从业者提供指导或沟通工具。预期结果：这项研究将提高患者和英国穆斯林社区患者和家庭获得ACP的意识并促进他们获得ACP。为患者和家属提供资源，以支持他们参与非典对话，以及对文化和信仰敏感的指南或沟通工具，以支持姑息治疗环境中的卫生保健从业者与英国穆斯林社区进行非典对话。这些将与来自英国穆斯林社区的人和卫生保健从业者共同制作。以英国穆斯林和家庭的声音为中心，将使人们能够有价值地深入了解有文化能力的姑息治疗可能是什么样子。传播计划：由于该项目代表着伦敦大学学院、利兹大学、玛丽·居里和英国穆斯林委员会之间的合作，这项研究的成果有明确的途径，通过参与组织的广泛影响和影响来产生影响。

Background and rationale: In the UK, there is evidence of lower uptake of Advance Care Planning (ACP) and palliative care among minoritised ethnic groups. These are people who do not self-identify as belonging to the White ethnic group (Saltus and Pithara, 2015). Population projections suggest that people from minoritised ethnic groups aged 65+ will reach 1.3 million by 2026 (Calanzani et al., 2013). Almost 1 in 3 of minoritised ethnic groups are British Muslims (The Muslim Council of Britain, 2015). Older British Muslims (65+) have higher prevalence of chronic illnesses such as diabetes, heart conditions and high blood pressure compared to the rest of the UK population. While older Muslim women being twice as likely to report having "bad" or "very bad" compared to the rest of the population of women in England (Sherif et al., 2019). Highlighting the need for ensuring ACP conversations around preference and future care are tailored for this group. Healthcare professionals describe challenges around ACP conversations that are inclusive of patients and families values and beliefs (Sherif et al., 2019, De Vries et al., 2019). Among people from minoritised ethnic groups, a number of barriers to conversations around ACP have been identified. These include limited awareness of ACP, mistrust of healthcare systems and apprehension about possible distress discussions about dying may cause for patients and families (Canny et al., 2022). From research with minoritised ethnic groups and British Muslims, there is a need for culturally competent and accessible ACP resources (Canny et al., 2022, Sherif et al., 2019, Moss et al., 2022), developed in collaboration with people from communities (Ahmed and Siddiqi, 2016). This can facilitate explorations of what is important to people from minoritised ethnic backgrounds and to deliver palliative and end of life care that gives them the best possible end of life experiences. Aims: The aims of this doctoral study will be: (1) to explore the influence of ethnic background, culture and faith on attitudes towards ACP conversations for British Muslims; (2) to co-produce a resource for patients and families and a guide or communication tool for healthcare professionals to support culturally competent ACP conversations with people from the British Muslim community.Methods: The PhD will consist of four phases. (Phase 1) A literature review to explore existing evidence on barriers and facilitators to ACP for Muslims. (Phase 2) Peer research in collaboration with Muslim Council of Britain to undertake interviews with others from the British Muslim community to explore understanding of palliative care, ACP and the potential influences of culture and faith on openness and attitudes towards this process. (Phase 3) Co-design workshops for developing recommendations. (Phase 4) Co-producing and disseminating a resource for patients and families and a guide or communication tool for health care practitioners.Expected Outcomes: This research will raise awareness and facilitate access to ACP for patients and families with British Muslim communities. A resource for patients and families to support them in engaging with ACP conversations, and a guide or communication tool that is culture and faith sensitive to support health care practitioners in palliative care settings in having ACP conversations with British Muslim communities. These will be co-produced with people from the British Muslim community and health care practitioners. Centering upon the voices of British Muslims and families will enable valuable insights into what culturally competent palliative care may look like.Plans for dissemination: As this project represents a collaboration between University College London, University of Leeds, Marie Curie and The Muslim Council of Britain, the outputs from this research have clear pathways to impact via the wide ranging reach and influence of the organisations involved.