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Between Life and Death: How do Muslim Terminal Patients in Pakistan cope with Hepatitis C utilizing their Beliefs and Social Support?

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Life-threatening events including terminal illness intensify the search for meaning and incite individuals to get closer to religion. Terminal patients can often find religious practices as helpful as medical therapy for bettering both physical and mental health. The present research aims to explain the interaction between religion, spirituality, and social support in coping with terminal illness among Muslim hepatitis C patients in Pakistan. A semi-structured open-ended interview guide was utilized to collect the data. Participants expressed that the deployment of religious and spiritual beliefs along with socio-emotional support during illness fostered medical therapy. Participants also revealed that belief in God provided them the strength to be steadfast during the terminal stage of the disease. Religious beliefs enabled terminal participants to accept death as an eventual reality and a normal part of their lives. Furthermore, participants put forward their longing for those kinds of religious practices that terminal diseases usually restrained them from receiving. The emotional support stemming from social relationships also improved resilience to cope with the terminal stage of illness. The study concludes that the interplay of religion, spirituality, and social support normalizes the fear of death, lessens pain, and improves resilience among Muslim hepatitis C patients in Pakistan.

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We would like to express our great appreciation to the doctors, psychologists, and staff working at Lever Center Faisalabad for their valuable and constructive suggestions during the development of the interview guide and support during the collection of data. We also thank the volunteer patients who participated in this study. Last but not the least, we would also like to thank the anonymous reviewers for their insightful suggestions and careful reading of the manuscript.


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Authors and Affiliations



AA and MMS performed conceptualization; MA and MRS did methodology; MA and MMS have done formal analysis; MMS and AA investigated the study; MMA and FS did data curation; AA and MA did writing—original draft preparation; MRS contributed to writing—review and editing; FS supervised the study; FA administrated the project; all authors have read and agreed to the published version of the manuscript.

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Correspondence to Muhammad Asim.

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Appendix: Examples of Participant Quotes by Theme

Appendix: Examples of Participant Quotes by Theme



Hope for life

If God takes pity on me, I can still walk on my feet and I can be healthy and strong like a horse (A local proverb to feel healthy and sound) (49-year-old female)

It’s my emaan (faith) and trusts in God and I am still not disappointed even in this severe crisis of life like this (32-year-old male)

A man (human) doesn’t die when he is ill. He dies when he leaves the hand of hope (39-year-old male)

God’s presence is enough to infuse hope in me and survive through this time (45-year-old female)

Normalization of death

Every Muslim should have faith that God has consigned this life to us and we have to happily return it to God when the time comes (32-year-old male)

No one wants to die. But, we have to return to God (43-year-old male)

I trust in my God that whatever he has destined for me would be the best (39-year-old male)

God has consigned this life to us and we have to happily return it to God when the time comes (32-year-old male)

Longing for religious practices/performances

My religious activities have been limited with this disease and I am not happy (49-year-old female)

This disease has made me helpless and I can't pray and recite the holy Quran (55-year-old male)

I am in pain, have difficulty in breathing, and feel depressed. I often think of when I used to visit the mosque five times a day (55-year-old male)

My religious activities have been limited with this disease. I pray to Holy God to forgive me for this (49-year-old female)

Connectedness to God

I feel I am more connected to my God now. I want to talk about spirituality (45-year-old male)

This disease has connected me with my God. Perhaps, it is a time of rebuilding my forgotten relationship with the creator (44-year-old male)

God decides our life then he creates some reason to make us die (55-year-old male)

Improved resilience

My family and relatives frequently come to see me at the hospital. I feel good to see them (49-year-old female)

…… My family encourages me to stay strong. I am alive, it is just because of my family (43-year-old male)

I am unable to take care of my children but my brothers and laws took good care of them. It is a much relieving (44-year-old male)

I lose heart and my family encourages me to stay strong (49-year-old female)

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Ahmad, A., Asim, M., Malik, N. et al. Between Life and Death: How do Muslim Terminal Patients in Pakistan cope with Hepatitis C utilizing their Beliefs and Social Support?. J Relig Health (2023).

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