Melissa IbarraProf. Sandra Peppard RN, MSN

ADN 113LSpring 2012

Delivering Culturally Competent Nursing Care - To the Filipino Patient

Background of Filipino Population in the U.S.A. According to U.S. Census Survey 2010, there is 2,555,923

People of Filipino descent1.

Predominantly in West coast of the United States and the state of Hawaii.2

In California, approximately 664,935 Filipinos located mostly in San Diego, Los Angeles, San Francisco, Stockton, Daly City, Salinas, and Watsonville3.

Almost one-third of employed Filipino-born women had health-care and related occupations.4

There were 81,545 Filipino-born veterans of the US Armed Forces in the United States in 2006.4

Nearly half of Filipino foreign-born adults had a bachelor's or higher degree.4

About one-third of Filipino immigrants in 2006 were limited English proficient.4

Nearly two-thirds of Filipino immigrants in 2006 were adults of working age.4

Filipino immigrant women outnumbered men by about three to two in 2006. 4

Over half of Filipino-born lawful permanent residents in 2007 were admitted as the immediate relatives of US citizens.4

Filipino-born lawful permanent residents made up 3.8 percent of all those eligible to naturalize as of 2006.4

Filipino Population in U.S. in 2000

History Discovered and conquered by the West

in 1565 by Spanish Explorer, Ferdinand Magellan.5

Independence from Spain in 1898 after 332 years of rule.5

From 1898-1946, US occupied Philippines as well as Japanese Occupation from 1942-1945.5

From 1965-1986, President Ferdinand Marcos implements Martial Law.5

1987 – present revised constitution is implemented.5

Throughout History, the Roman Catholic Church has been the dominating religion in the Philippines.

Over 70% of the population is Roman Catholic.5

Way Of Life for Filipinos in the United StatesFilipino Cuisine

The traditional Filipino diet is quite healthy and incorporates many different herbs and spices.

Boiled rice, garlic and onions are staples of the Filipino diet and are eaten with almost every meal.

Other common foods include ground corn, rice noodles (pancit), mixed vegetables (panakbet), fish, pork, poultry and various fruits.

Common dishes amongst Filipino population are pancit palabok, lechon, carioca, leche flan, lumpia, and purple squid.

Faith:

Iglesia Filipina Independiente (Philippine Independent Church) – An independent Catholic church founded by Filipino priest Gregorio Aglipay in 1902.

Iglesia ni Kristo (Church of Christ) – Founded in 1914 by Filipino Felix Y. Manalo. The church claims to be modeled after the first church founded by Jesus.

Languages spoken amongst Filipino population

28.1% Tagalog

13.1% Cebuano 7.6% Bisaya & Binisaya

7.5% Ilongos

6% Bicolanos

3.4% Waray-Waray

1% Chinese

24.3% Split between other groups

*English is the official second language*

Common Religious Practices Roman Catholic holy days, such as Christmas, and Good Friday are observed as official national holidays.

Spanish-Mexican Culture and Catholicism has significantly influenced culture and traditions.

On the 3rd Sunday of January the country celebrates the festival of the Santo Niño de Cebú, the largest being held in Cebu City with the celebration of the Sinulog Festival.

However, other areas such as Kalibo, Aklan are also known for their own celebration known as the Ati-Atihan and in Iloilo City they celebrates on the 4th Sunday of January as the Dinagyang.

With regard to Holidays of Obligations, the Catholic Bishops' Conference of the Philippines has granted dispensation on all faithful who will not attend masses on these days, except on December 8 (Solemnity of the Immaculate Conception, the Principal Patroness of the Archipelago), December 25 (Christmas Day), and January 1 (Solemnity of Mary, the Mother of God).

In 2001, the same Conference approved a reform in the liturgical calendar, which included the Feasts of Our Lady of Guadalupe, Maximilian Kolbe, Rita of Cascia, Ezequiel Moreno and many others in its list of obligatory memorials.

Filipino Diaspora Overseas Filipinos have spread Filipino culture the world over, and have brought Filipino Catholicism with

them. Filipinos have established two shrines in the Chicago Metropolitan Area: one at St. Wenceslaus dedicated to Santo Niño de Cebú, as well as another at St. Hedwig's with its statue to Our Lady of Manaoag.

Role of Religion in HealingRoman Catholic Church Beliefs often shape Filipinos’

outlook on treatments and prevention methods. Medical Procedures frowned upon the Catholic church

are, Interventions related to Birth control, Organ donation, euthanasia, and homosexual practices.

Traditional Filipinos abide by the churches’ standards for the church is more of way of life rather than just a faith.

Family Dynamics

Extended Family members common in Filipino families such as Grandparents and aging parents.

Composition of extended family members due to immigration factors as well cultural factors.

Collectivist culture seen in Philippines as well as abroad.

Strong family ties seen in immigration trend.

Respect for elders in linguistics as well as in behavior.

In Philippine society, multigenerational households are accepted arrangements where respect and love for parents and older family members are taught and expected of the children. Caring for aging relatives is integrated over time into these relationships, and interdependence is deeply embedded in the culture.

Incidence and Prevalence of Diseases Affecting the Filipino Community

Cardiovascular Disease and Diabetes8

Cancer8

Dementia8

Depression and Suicide8

Elder Abuse8

Gout8

Infectious Disease: TB and HIV8

Outlook on Health & Caring

Health promotion/treatment concepts. Beliefs are oriented towards protection of the body.

1) Flushing. The body is thought to be a vessel or container which can collect impurities and must be cleansed of debris by stimulating

physiological events such as sweating, vomiting, expelling gas, or having appropriate volume of menstrual bleeding.

2) Heating. Related to balance described above

3) Protecting: a gate keeping system to guard the body.

Indigenous Health Beliefs

Principle of Balance (Timbang). This is a key indigenous health concept that includes a complex set of fundamental principles.

A range of “hot’ and “cold” beliefs concerning humoral balances in the bodyand food and dietary balances includes the following:

Rapid shifts from “hot” to “cold” lead to illness.

“Warm” environment is essential to maintain optimal health.

Cold drinks or cooling foods should be avoided in the morning.

An overheated body (as in childbirth or fever) is vulnerable; and heated body or muscles can get “shocked” when cooled suddenly.

A layer of fat is preferred to maintain “warmth” and protect vital energy.

Heat and cooling relate to quality and balance of air in the body.8

(Cont.) Outlook on Health & Caring Cultural Values

a. Interpersonal Relationships. Smooth interpersonal relationships are a major component of the Filipino core value8

b. It is expressed as sensitivity and regard for others, respect and concern, helping out, understanding and making up for others’ limitations, rapport and acceptance, and comradeship

c. Traditional psychosocial interactions - occur in the external domain

d. The second domain includes: mutual trust/rapport. b. Family Responsibility. Many contemporary Filipino American families continue to function in a complex process of a natural support system of reciprocity within interdependent/dependent relationships based on extended family membership, group harmony and loyalty, respect for elders and authority, and kinship that goes beyond strong biological connections.

E. Spiritual Life and Religiosity: A consistent theme in health and caregiving studies on Filipino Americans is the importance of prayer, church affiliation, spiritual fellowship, and spiritual counseling.8

Nursing Interventions to fulfill Cultural ExpectationsEssential for nursing staff to be aware of patient’s:The cultural background of each patientThe expectations and beliefs of each about healthcareThe cultural context of the encounter.The degree of agreement between the two persons’ sets

of beliefs and values. To help ensure patient satisfaction by following the 6

norms of the cultural norms of the healthcare system: Beliefs, Practices, Habits, Likes, Dislikes, and Customs.9

Traditional Medicine Approach Albularyo- General practitioners, the primary dispensers of health care. As with other

healers, there is usually a history of a healer in the family-linemost attribute their “powers” to the Holy Spirit.7

Manghihilot-a practitioner (or the practice) of the craft of 'chiropractic' manipulation and massage for the diagnosis and treatment of musculoligamentous and muskuloskeletal ailments. 7

Magpapaanak –Someone who has basic knowledge in herbal medicinal plants, utilizing them in a variety of prenatal needs and postnatal care.7

Mangluluop- a specialist that determines the cause of an illness through the ritual of luop. This differs from the healing ritual of luop that is used for gastrointestinal complaints caused the inhalation of unpleasant odors.7

Mangtatawas – alternative healers that serves in providing clues as to the nature and cause of the illness. 7

Mediko- An albularyo with further training, assimilates and adopts new skills and "expertise," merging folkloric therapies with mainstream medicine, incorporating allopathic treatment modalities like acupuncture, injection medications and prescription pharmaceuticals into his practice. 7

Increasing cultural sensitivity in the workplace Increasing Cultural Harmony in the workplace can be enhanced by the human

resources department by organizing Orientation programs for new hires, having senior employees act as mentors or coaches to help newer employees adapt better, recruiting bilingual supervisors to help the transition easier for foreign employees. The company may also benefit by providing sensitivity training to native employees to make them aware of cultural differences.

Immigrant and foreign workers could make an extra effort to learn the local language and understand the culture.

Having native employees could proactively try to make the foreign workers feel comfortable and help them adapt faster.

Avoiding the use of slang and local jargon, which may not make any sense to foreigners.

Overall, an organization employing a diverse workforce can adapt easily in a global market. Employees from different backgrounds bring a variety of experiences and ideas that can help an organization ultimately grow.6

ReferencesU.S Government. (2010). Race Reporting for the Asian Population by Selected Categories: 2010 more information

[U.S. Census Bureau]. Retrieved from American Fact Finder database.

U.S Government. (2000). Race Reporting for the Asian Population by Selected Categories: 2000 more information

[U.S. Census Bureau]. Retrieved from <www.stajump.com>.

Pacific Coast Immigration Museum. (2007). Profile: Philippines [Immigrant Population Profile].

Retrieved from http://learn.pacificcoastimmigration.org/countries/profiles/ph/index.html#geography

Terrazas, A. (2008, September). Migration Information Source - Fresh thought, authoritative data,

Global Reach [Filipino Immigrants in the United States]. Retrieved from Migration Policy Institute

website: http://www.migrationinformation.org/USfocus/display.cfm?id=694#13.

Woods, A. D. L. (2006). The Philippines - A global Studies Book. Santa Barbara, CA: ABC CLIO.

(Original work published 2006)

Kunal, K. (2011, April 18). EHow - Money [Cultural Issues in Workplace Ethics]. Retrieved from

http://www.ehow.com/info_8248334_cultural-issues-workplace-ethics.html

References (Cont.)Student Xchange. (n.d.). Phillippine Alternative Medicine [The Healers]. Retrieved from

http://www.stuartxchange.org/Albularyo.html

Mcbride, M. (2000). Health and Healthcare of Filipino American Elders. Retrieved 2000, from Stanford

Geriatric Education Center Stanford University School of Medicine, Stanford, California

website: http://www.stanford.edu/group/ethnoger/filipino.html

Taylor, C. R. (2011). Fundamentals of Nursing - The Art and Science of Nursing Care. Philadelphia: Lippincott Williams &

Wilkins.

Thank You