The individual’s name interviewed is G.F. Her ethnic background is Filipino. G.F. has been a registered nurse for 22 years and is currently working as a House Supervisor at Central Valley Specialty Hospital. The interview was arranged by requesting an interview with G.F. at her earliest convenience. The meeting was conducted in G.F. residence, prior to the interview consent was obtained as well as expressed again before the interview began. G.F. moved to the United States in 2010, however, makes trips back to Davao City in the Philippines at least once a year and is undoubtedly a part of her culture till this day.
The interview used the twelve cultural domains from Purnell and Paulanka as the framework in assessing the Filipino culture. The twelve domains of Purnell and Paulanka’s cultural competence examines the various aspects of overview/heritage, communication, family roles and organization, workforce issues, bicultural ecology, high-risk behaviors, nutrition, pregnancy and childbearing, death rituals, spirituality, health care practices, and healthcare practitioners. This paper will delve into the Filipino culture through personal record and avail oneself to better understand and apply culturally sensitive care needed for a diverse patient population.
According to G.F., the Filipino decent originally came from Southeast Asia and Indonesia. The culture itself is diverse due to the many surrounding islands and there being hundreds of different cultures and languages that collectively are Filipino. Davao City, her home city, is located at the southernmost island of Mindanao in the Philippines. The topography of Davao City is composed of sandy beaches, valleys, and mountains with the climate explained as mild all year around. According to G.F., the government in her country is run as a unitary republic, which is defined as sovereign state governed as a single entity. G.F. describes the government from a history standpoint to present day as being corrupt, however, states the economy has improved over the recent years, but not significantly. Both men and women are encouraged to attend school equally. Because of the poverty, rural areas, and low-income, most individual’s go abroad to the United States to excel in their careers financially.
According to G.F., there are multiple native languages and dialects spoken in the Filipino culture, however, the most dominant being Filipino and Tagalog. Greetings are typically based on the age and relationship of people; when speaking to elders or individuals of higher status, politeness and a soft tone is always used as a sign of respect when communicating. Filipino’s are outgoing in nature, approachable, and enthusiastic conversationalists; however, may be hesitant to speak of any topic for example, politics, that may cause them to be embarrassed. In the Filipino culture, physical touch is welcomed, it is common to see people walking arm in arm, or holding hands when speaking to one another.
According to G.F. the Philippines is a matriarchal society as of recent times, it is common to see the female significance both in the workforce and in the family. Although, the core belief was equality amongst all family members regardless of gender.
A typical household in the Philippines will consist of immediate family such as grandparents, parents, and grandchildren. In the Filipino culture, marriage is considered to be a milestone and expected that individual’s will one day have a suitable partner. Divorce and having a child out of wedlock is not accepted and heavily frowned upon.
According to G.F., acculturation to American life, or any country they reside in, can come easily to people of the Filipino culture due to most of the population being taught and able to speak English as a secondary language while in school. Both men and women are encouraged to have autonomy to pursue a higher education and in what career path they choose. The healthcare system in the Philippines is considered to be of a good standard, accessible, and able to provide quality healthcare needed in the country. G.F. states, the healthcare practices and hospitals in the Philippines are similar of those in the United States, but the facilities themselves may not be as advanced or “high end”, in comparison.
According to G.F., the Filipino culture is diverse due to the many surrounding islands, with each, come with individuals that differ from language, dialect, and physical attributes.
This also can be attributed to the Philippines being colonized by different countries in the past, which has made the unique cultural and racial blend known as Filipino today. Just like the diverse cultures, the topography of the Philippines is extremely varied. G.F. states, the climate depending on the time of year, which has wet and dry seasons, can be mild or severe. The Philippines have had their share of natural disasters.High-risk behaviorsAccording to G.F., the Filipino culture does partake in some high-risk behaviors. Alcohol consumption being one them, is seen more often with the older generations, and only occasionally. Smoking is a big problem with the Filipino youth and is a socially accepted behavior between men and women of the culture. Obesity in the Filipino culture has been on the rise, mostly due to overeating and lack of exercise.
Some traditional Filipino dishes can be high in sodium and fats, which is also a contributor. G.F. states, that depending on where an individual lives, exercise can be limited if they cannot afford to go to a gym, or if individuals live in a rural area there might not even be sidewalks or paved streets to walk or run on safely.
According to G.F., food is important to the Filipino culture because it is considered a gift from god and is a blessing to receive. One common food that is a staple in every meal in the Filipino culture is rice, and is included in breakfast, lunch, and dinner. Meats like fish, chicken, and pork are eaten alongside with rice, or made with soup, or stew. Food can also be used in the Filipino culture as a tool in the treatment of an individual that is ill. For example, food poisoning is believed to be the doings of the evil spirits. To undo the spell, the individual needs to see a herbalaryo (witch doctor). The treatment involves a ritual sprinkling of rice, dining, and dancing of unmarried individuals to the sound of Filipino music. The conclusion of the ceremony involves saying a prayer to the cursed individual, which is claimed to eliminate the curse of that person.
According to G.F., family is held to a high value in the Filipino culture. Bearing a child is extremely special, not only to the immediate family, but is celebrated throughout the community. The physical and mental well-being in this culture is interconnected, so with a pregnancy, anything that affects the mother can directly affect the baby. G.F. states, traditional and modern-day approaches have come together in regard to pregnancy, birth, and post-partum care. Women do go to hospital to give birth, and medications such as an epidural are approved.
According to G.F., if there is a death in the family, it is important for the family members to come together to mourn the loss. Traditionally, a wake is held in the house of the deceased for three to seven days. But, can last longer dependent on how long it takes extended family or any family members abroad to travel. G.F. states, that during this time, family members and friends take turns to stay awake and not sleep to keep watch over the casket. In Catholic tradition, a nine-day novena (prayer), is held. It is believed on the fortieth day of death, he or she ascends to heaven and a celebration is held.
G.F. stated that her family practices Catholicism. She states that there is a diversity of religions in the Philippines, however, Catholicism remains dominant. For many Filipinos and Filipino Americans, Catholic practices and ethnic identity are intricately interwoven into cultural meanings of identity, family, and community. Catholics are devout and go to church every week, it brings them comfort and guidance to manage daily obstacles. Filipino Catholics find strength in a close relationship to their family, as well as a close relationship to God.Religion and spirituality have a major impact on many Filipinos approach to health care or wellness.
According to G.F., individuals in the Filipino culture, especially the elder population, normally will turn to a family member, or someone they trust to ask if a health issue arises first before seeking professional medical care. The Filipino culture puts emphasis on health being viewed as holistic and life energies need to be balanced through linkage of mind, body, and soul. Sometimes, a healer or priest is used if an individual believes the illness is caused by evil spirits. This belief is associated with mystical causes. Use of holy oils and wearing religious objects or amulets can be common as well.
According to G.F., health care practitioners are accepted in the Filipino culture, and depending on the severity of illness, are inquired for professional care. In fact, individuals, male and female, who practiced as doctors in the Philippines are nurses in the United States. Many Filipinos work in the medical field and are knowledgeable of modern medicine and practice. G.F. states through personal experience of ill family members, that gender of the health care provider is not an issue. Being culturally sensitive to the care and tending to the needs of her family members is the focus.
Noncommunicable diseases are considered a major public health concern in the Philippines, accounting for six of the top 10 causes of death (2010). A common disease in the Philippines that is said to be the leading cause of death is heart and vascular disease. According to the World Health Organization (WHO), hypertension causes 7 million deaths every year while 1.5 billion people suffer due to its complications. If a Filipino, male, is admitted for uncontrolled hypertension with a past medical history of diabetes mellitus and high cholesterol, one nursing diagnosis could be decreased cardiac output related to increased vascular resistance, vasoconstriction.
One example of an intervention is to review patients at risk factors such as lifestyle, cultural beliefs, family history, accessibility to healthcare, and other conditions. Prevention of worsening symptoms and treatment will be guided by these factors to provide culturally sensitive care. Another diagnosis is Imbalanced nutrition: more than body requirements related to excessive intake in relation to metabolic need. Due to overeating and lack of exercise, obesity in the Filipino culture has been on the rise, which has led to many comorbidities such as, hypertension. Education on healthy eating habits and exercise in a way an individual of this culture can easily understand is of great importance to the prevention and treatment of their current health status. For example, incorporating food preferences in their culture that are healthy when teaching on nutrition. Living a healthy lifestyle plays an important role in treating hypertension. Patients diagnosed with high blood pressure, should avoid smoking, minimize salt intake and alcohol consumption and a regular exercise routine are among the key strategies which may avoid, delay or reduce the need for medication.
A third diagnosis is knowledge deficit regarding disease process, treatment, and individual needs relating to unfamiliarity of information. In the Filipino culture, individuals will treat themselves, depending on the severity of symptoms. They may self-medicate with food, herbs, or over-the-counter medicines. Also, seeking medical attention is dependent on their experience from social interactions in the community, the previous experience of other family members, and the experience of the elders themselves when seeking medical care. An important nursing intervention would be to identify barriers to learning and the individual’s readiness. Having an interpreter explain medication regime and educational materials would be most beneficial and reassuring to the patient.
The interview took about three hours. G.F. was welcoming and enthusiastic when being asked about information pertaining to her culture. The author of this paper made sure to accept any food or drinks offered and verbalize gratitude each time. Also, the author listened attentively and made direct eye contact while conversing with G.F. to show respect and genuine interest.
The 12 cultural domains were explained prior to the interview starting so the transitions of subjects were smooth and gave G.F. time to think and answer accordingly. What may work better for next time is writing down specific questions for each domain. With a plethora ofinformation under the general topics, and it might help organizationally to target specifically what is needed to cover. The interview overall went well, and the knowledge gained by the author on the Filipino culture has increased tremendously.
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