This Filipino culture paper was the final for the nursing culture class in the RN to BSN
The paper requirement was to interview someone from another culture and evaluate for cultural assimilation. The chosen individual was from the Filipino culture had maintained some of the Filipino culture as well as adapted to some of the American culture. The paper was based on research and an interview with a Filipino woman in relation to the Filipino culture.
** was an 84-year-old Filipino woman who
came to the United States from the Philippines at the age of 24 years as
a war bride. Marrying a Caucasian American, she became a naturalized
citizen, and considered herself to be a Filipino-American. Living in the
United States for many years, she has assumed some American traditions,
but also continues with some of her Filipino traditions. She was one
of the 1,850,314 Filipino’s living in the United States as reported on
the 2000 census (United States Census Bureau, n.d.). An increase of
seventy-two percent between the 1990 and 2000 United States census makes
the Asian population the fastest growing ethnic group (Ngo-Metzger,
Phillips, & McCarthy, 2008).
According to Spector (2004), several races, including those individuals from the Philippines fall under the Asian culture. The Asian culture includes many races with a wide variety of beliefs about health and illness. Some of the generalized Asian beliefs were noted to be different from the beliefs of the Filipino culture. Observations were made of an Asian community that may also have some differences than a purely Filipino community may have. This culture was being evaluated for health and illness beliefs as an Asian community, when possible specifics to the Filipino culture were included.
According to Becker (2003) health in the Filipino culture was based on the principle of balance and harmony. Health was a result of being in balance, while illness was the result of an imbalance. The Filipino people had beliefs about hot and cold, and felt that keeping the body in a warm condition promoted health, while a rapid change between hot and cold could bring on disease and illness (Becker, 2003). According to McBride (2001) childbirth is considered to be a cause of overheating the body by the Filipino culture, and therefore it is felt that cooling off too rapidly after child birth may lead to illness. In the study by Becker (2003) it was discussed that the Filipino people felt a responsibility to their family, and social groups to maintain good health. This feeling of responsibility to the family, rather than an individual responsibility, was noted to be what would lead the Filipino people to seek medical attention when needed, and follow medical treatment plans.
The Asian culture had strong beliefs in family. The Filipino families cared for their children, and the parents expected respect and obedience from their children. The Filipino parents believed in setting rules for the children, and the children were obligated to obey these rules. Although they do obey the rules it was reported that during the adolescent period the parent and child do argue, which seemed to be related to the obligation to obey the rules mixed with the need of the adolescent for autonomy (Darling, Cumsille, & Peña-Alampay, 2005). These strong family beliefs may be contributing to the frustrations the adolescent may feel when trying to be independent, and these beliefs also played a role in health maintenance, as maintaining health was viewed as a responsibility to the family.
To maintain, protect, and restore health the Asian people do many things. The practice of acupuncture, moxibustion, and herbal remedies were common among the Asian culture (Spector, 2004), as were prayers, rituals, and massage (McBride, 2001). Becker (2003) noted that many Filipino’s reported maintaining health through diet, although this may be difficult as rejecting food while a guest in another’s home brings shame to the host in the Filipino culture. Becker’s study also revealed that the Filipino people used exercise, including walking, as a way to maintain health. Bodily awareness was also noted to be an important aspect in maintaining health. It was felt that being aware of the body helped to maintain balance, which equated to maintaining health (Becker). The Filipino people also believed in keeping the body strong by being clean, orderly and appropriate in social situations to maintain balance, and therefore health (McBride). Becker also noted that the Filipino culture believed in Westernized medicine, and that some diseases required medical treatment. They believed the illness should be controlled, and that the individual was responsible to do so. When treating these Filipino-American patients it would be beneficial to use the focus of body awareness in education and treatment plans as this could be a strong tool to enhance disease management. It was also important to note that diet restrictions may be difficult for some based on their cultural beliefs about food (Becker).
The Asian population believed in family centered decision making, which contributed to the cultural beliefs about death and dying. The Asian people often felt that the patient should not be informed of a terminal illness, preferring to protect their family from despair and allowing them to maintain hope. This may contribute to the low hospice use of the Asian population (Ngo-Metzger, Phillips, & McCarthy, 2008). The study by Ngo-Metzger et al (2008) found that although hospice use of the Asian people was low, the Filipino population did tend to enroll in hospice earlier than Caucasians. The thoughts behind this included that Filipino-Americans tended to use more Westernized medicine than other Asian groups. Another contributing factor was likely the fact that approximately eighty percent of the Filipino people were Catholic (McBride, 2001). The Catholic religion believed that dying was the ultimate union with God, and therefore this group may be less against hospice than other Asian groups (Ngo-Metzger et al.). To provide culturally competent care in this situation a more family centered focus would be appropriate, allowing the patient to designate the family to make the decisions. Home hospice would be a culturally appropriate choice as it would allow the family to continue to care for the patient, which is important in the Asian culture (Ngo-Metzger et al.).
The Filipino-American populations, with the high percentage being Catholic, believed that those who lived by the doctrine went to heaven, while the sinners went to hell (Braun & Nichols, 1997). According to Braun and Nichols (1997) when a death occurred the Filipino people held a Novena, in which for 9 days prayers were held each night. The ninth night was an atang, where the individual who had died may return to say their goodbyes. The Filipino culture also held another service on the fortieth day. The family would wear back for the funeral, with the exception being that they wore white if a child had died. The Filipino individual was buried along with their personal belongings.
Although ** grew up in the Philippines, she had resided in the United States for many years. The strong belief in family togetherness, and responsibility to family members were evident in her stories. At the time of the interview ** lived with her daughter, and son-in-law, in a middle class suburban area of Houston. Her neighborhood had a mixture of cultures and races, as was true for Houston, with no one particular culture standing out more than another. Her neighborhood was not representative of her culture, therefore an area in Southwest Houston which was full of Asian culture was observed. This area of Southwest Houston contained many Asian focused businesses. The supermarkets, medical offices, community centers, and churches were all focused toward this culture. The signs on many of these businesses were in Asian symbols, or both Asian as well as English. The street signs in this area were also both in English and an Asian language. This area included a Chinese community center, Chinese fine arts and literature library, and the Hong Kong City Mall. There were also numerous types of Asian restaurants.
This community was observed to have a variety of cultures moving around within it, but a high ratio of Asian individuals were noted. Driving through this area, it was observed to be clean for a Houston area with no major health risks identified. The Asian names on the medical clinics, and pharmacies, were viewed as beneficial to identify these services to those individuals that may not read English. The large grocery store was clean, and contained a variety of food items that were different from the suburban grocery stores in the area. It was obvious that it was geared toward the Asian culture with many oriental items, and food items were labeled with Asian names. This particular supermarket had a small restaurant inside, and a variety of races were observed eating there as well as shopping in the store. There was no evidence that anyone was paying attention to those that were not of their culture. The store employees greeted, and smiled at everyone, regardless of their culture. Some of the foods observed throughout this store were surprising. Although I personally enjoy Chinese food many items that were observed were not anything I would be interested in. I did not have any biases on this culture, as I have always been around a variety of cultures, and some of my best childhood friends were Filipino. I did not feel out of place during this tour as a variety of individuals were observed to be in the area.
Considering this neighborhood community, and the beliefs and practices identified, this area did support the general Asian culture. Medical clinics, pharmacies and grocery stores were visible and were evident to be geared toward the Asian culture by their Asian words and decorations. As many Filipino-Americans believed in Westernized medicine, this area supported that by offering regular medical clinics. Although the clinics themselves were not entered, it would be expected that the medical staff spoke a variety of Asian languages to accommodate this vast range of cultures. A benefit of having medical care within this Asian community would be that they would understand the different beliefs and practices of the Asian patients. This would allow for culturally competent care of ** and the Asian population in that they would know what to ask to obtain a comprehensive history. They would also be aware of the cultural desires for same sex providers. Having Asian providers in this community may help in improving the number of Asian people with a primary care provider. According to Healthy People 2010, only seventy-two percent of all Asians have a primary care provider, compared to the national average of seventy-seven percent. Increasing the national average to eighty-five percent was one of the objectives of Healthy People 2010. Overall, an understanding of the culture they are treating would be deemed a great benefit, and may improve these statistics. Although these particular medical services were provided in a highly Asian community, all healthcare providers should be responsible to take cultural differences into consideration while providing care.
Some things that may seem very small to health care providers may make a huge impact on someone from another culture. Spector (2004) discussed that the Asian population often does not like hospital food, and rather than complain they would become quiet and withdrawn (Spector, 2004). Being aware of this may help the nurse to ask questions, or offer something different if this behavior was noted. To show respect it is important to not address the Filipino person by their first name (McBride, 2001). The Asian culture often does not maintain eye contact during discussions, but it would be important to note this is a sign of respect on their part. The Asian people also have a strong preference to be cared for by someone of the same gender (Arif, 2006), and being aware, and honoring this may make a big difference in the perception of the care received. To provide culturally competent care, health care providers should keep some of these points in mind, and be cognizant of the culture they are caring for. Respecting an individual’s beliefs and values while providing care, ultimately assists in providing culturally competent care.
Arif, Z. (2006). Shame on you. Nursing Standard, 20(36), 32-33. Retrieved July 24, 2009 from Academic search complete
Becker, G. (2003). Cultural expressions of bodily awareness among chronically ill Filipino Americans. Annals of Family Medicine, 1(2), 113-118. Retrieved July 24, 2009 from Nursing/Academic Edition
Braun, K. L., & Nichols, R. (1997). Death and dying in four Asian American Cultures: A descriptive study. Death Studies, 21(4), 327-259. Retrieved July 24, 2009 from Academic search complete
Darling, N., Cumsille, P., & Peña-Alampay, L. (2005). Rules, Legitimacy of Parental Authority, and obligation to obey in Chile, the Philippines, and the United States. New Directions for Child & Adolescent Development, 2005(108), 47-60. Retrieved July 24, 2009 from Academic search complete
Healthy People 2010 (n.d.). 1-5.1-5. Increase the proportion of persons with a usual primary care provider. Retrieved July 25, 2010, from http://www.healthypeople.gov/document/html/objectives/01-05.htm
McBride, M. (2001). Health and health care of Filipino American elders. Retrieved July 24, 2009, from http://www.stanford.edu/group/ethnoger/
Ngo-Metzger, Q., Phillips, R. S., & McCarthy, E. P. (2008). Ethnic disparities in hospice use among Asian-American and Pacific Islander patients dying with cancer. Journal of the American Geriatrics Society, 56(1), 139-144. Retrieved July 24, 2009 from Academic search complete
Spector, R. E. (2004). Cultural diversity in health and illness (6th ed.). Upper Saddle River, NJ: Pearson Education, Inc.
United States Census Bureau (n.d.). American factfinder: Quick tables. Retrieved July 24, 2009, from http://factfinder.census.gov/servlet/QTTable?_bm=y&- qr_name=DEC_2000_SF1_U_QTP7&-ds_name=DEC_2000_SF1_U&-CONTEXT=qt&-redoLog=false&-_caller=geoselect&-geo_id=01000US&-geo_id=NBSP&-format=&-_lang=e
We find it very interesting learning about other cultures, such as the Filipino culture. Our world has so many unique cultures. As people move from one country to another assimilation is bound to happen. So many people pick up on the cultures of the area they are living but they often hold on to their own culture as well. We feel that the elderly tend to hold true to their culture more than the younger generation. This is true with our study case ** as she held on to many of her beliefs from the Filipino culture. We hope you enjoy reading about ** and learning about the Filipino culture as much as we did.