Ch13 1
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Transcript of Ch13 1
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Copyright © 2013 F.A. Davis Company
Filipino Americans
Larry Purnell, PhD, RN, FAAN
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage
Almost 2 million in the United States Literally all speak English and Tagalog (Pilipino),
and many speak Spanish and another language Predominantly from Malayan ancestry with
influence and mixtures from other Asian groups, Spanish, and Arab
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage Continued
Americanization of the Philippines began after the Spanish–American War
Immigrant Filipinos make up the majority of Filipinos in the United States
Unrestricted immigration in the early 1900s then very restricted in 1924 because of the Exclusionist policies of Immigration Act of 1924
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage Continued
Immigration and Nationality Act of 1965 eliminated the quota system for the Philippines resulting in large numbers of middle class and professionals coming to the United States
Included relatives of Filipinos living in the United States
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage Continued
First group were primarily single men who were brought to the United States to work in Alaskan canneries, farms in California, and plantations in Hawaii and endured much discrimination
Most were restricted from owning or leasing land and could not become US citizens
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Overview/Heritage Continued
After WW II, many Filipino Veterans immigrated and settled on the West Coast
Now more women than men immigrate to the United States
Well educated immigrants continue to have difficulty in finding similar work in the United States unless they are in the healthcare field
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Communications
Tagalog is the national language with English the second official language
Eight other dialects are spoken as well as Spanish
Taglish is common among immigrants and American born Filipinos
Highly contextual communication patterns
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Communications Continued
Pakikisama—smoother interpersonal relationships and sacrifice exact meaning
External or outsider communication and internal or one-of-us communication proceeds on different levels
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Communications Continued
Interacting level Participating level Conforming level Adjusting level Understanding and acceptance level Getting involved level Being one with level
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Communications Continued
An exclusive “we” and an inclusive “we” Eye contact varies with age, education, and
acculturation Many ways to say yes, but how do you say no?
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Communications Continued
Respect the past, enjoy the present, and hope for the future
Filipino time for social events, clock time if really important events, business, and work usually
Many names are Spanish in origin One of the middle names is the mother’s maiden
name
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
Many Filipinos speak Tag-Lish, which is
a. A combination of Tagalog and English.
b. The indigenous language of the Philippines.
c. The official language of the Philippines.
d. A combination of Spanish and English.
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: A
Tag-Lish is a combination of Tagalog and English.
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles
Matriarchal before Spanish, then Patriarchal, now more egalitarian in decision making
Gender neutral pronouns causing confusion with he and she in English
Respect is a dominant family value and older children may assume the role of parent
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles Continued Honor and care for parents or brings shame
to the family Nuclear family is dominant although
polygamous families exist among Moslem Filipinos
Extended family members are important Education is paramount for children and
parents sacrifice so at least one child will become educated and help the others if necessary
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles Continued
Respect is shown to elders with deferential behavior
Grandparents become surrogate parents for their grandchildren in the United States especially
Advance degree brings higher social status
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Family Roles Continued
Filipino organizations targeted to gays and lesbians
Chastity is valued premaritally Single parenting becoming more common in the
United States
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology
Varying skin tones of brown and tan with dark eyes, flat nose bridges, and mildly flared nostrils
Most are of smaller stature than European Americans
More difficult to determine age than in European Americans because of youthful face
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Biocultural Ecology Continued
Endemic conditions in the Philippines include malaria, tuberculosis, gastrointestinal disorders, due to parasitosis, cardiovascular related disease, cancer, respiratory diseases, nutritional diseases, HTN, and diabetes
Sensitive to the effects of alcohol and require lower doses of neuroleptics
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition
Fundamental form of socialization Any occasion is an occasion for food Wide variety of foods and prepared in a variety of
ways Outsiders are served western food Insiders are served Filipino food To help in the kitchen you are really an insider
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition Continued Rice may be served at every meal, most
common meats are fish, chicken, and pork Diet varies among urban and rural areas Lactose intolerance among adults Milk in cooked desserts is tolerated well Salt and vinegar are used frequently Moderation in food is considered important
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Nutrition Continued
Considered polite to leave some food on your plate
Herbs are grown in many homes to be used for cooking and for medicinal purposes
Newer immigrants are at risk of nutritional deficiencies if unfamiliar with American foods
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Childbearing Family
Catholic religion influences birth control practices —rhythm method only
Abortion is considered a sin, carries a stigma, and leads to back door abortions
Pregnancy is a time for pampering and attention from entire family
Mother of pregnant woman has a very special role
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Childbearing Family Continued
Consult healthcare provider plus a massage therapist for advice
Reluctant to take any medicine during pregnancy, even vitamins for fear of harming the fetus
Satisfy cravings so baby will not be marked with the craving
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Childbearing Family Continued
Should be protected from a sudden fright for fear it will harm the fetus
Mother rather than husband may be the coach during birthing
Traditional may not want to bathe but engage in sponge bath and aromatic oils
Soup increases lactation
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Death Rituals
Three days to week for wake after death to await for family to come together—varies in United States because of work schedules
Plenty of food available and family support Nine days of novenas in the home or church are
common Ritualistic mourning wearing black for one year
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Death Rituals Continued
Burial is the most common but cremation is okay Body or ashes may be returned to the Philippines Open expression of emotions and may include
fainting
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Spirituality
80% Christian with 90% of them Roman Catholic 5% practices Islam Many returning to Bathala, ancestral religion with
a spiritualist guide who is usually a woman
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Spirituality Continued
Novenas and prayers are commonly said for the sick person
Good health comes to those who are in good with God and is the “Will of God”
Many are considered fatalistic, life is up to God, there is little one can do to change life circumstances and the forces of nature, monsoons, tides, volcanoes, earthquakes, etc.
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Healthcare Practices
Adhere to Western medicine and traditional practices simultaneously
Health is the result of balance and moderation and God’s Will
Adequate sleep, rest, nutrition, and cleanliness are important for good health
Aromatic baths restore balance
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Healthcare Practices Continued
In the Philippines many medicines can be purchased over-the-counter
May hoard and share medicine Many do not seek care until the illness is
advanced Many distrust the healthcare environment In the Philippines, one pays for testing before the
testing is done
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Healthcare Practices Continued
Protect oneself from wind and cold Avoid extremes of hot and cold—balance Introduce changes gradually Pain is part of life and may be atonement for
immoral behavior and leads to stoicism Mental illness carries a stigma, is hereditary and
may affect one’s ability for a spouse
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Healthcare Practices Continued
Mental illness may be severe before help is sought —take care of family member at home
Somatization of symptoms is common Important to maintain self-esteem and self-image
for self and family Able to enter the sick role easily
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
ClickerCheck
Mrs. Lino, age 38 years, has been seeing a traditional Filipino healer for her pregnancy complications. A Filipino traditional healer is
a.Galang.
b.Utang na loob.
c. Hilot.
d.Hiya.
Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition
Correct Answer
Correct answer: C
A hilot is a traditional Filipino healer.