Culturally competent nursing care - To the Filipino Patient
Prof. Sandra Peppard RN, MSN
Delivering Culturally Competent
Nursing Care - To the Filipino Patient
Background of Filipino Population in the
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
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
Discovered and conquered by the West
in 1565 by Spanish Explorer, Ferdinand
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
Throughout History, the Roman
Catholic Church has been the
dominating religion in the Philippines.
Over 70% of the population is Roman
Way Of Life for Filipinos in the United
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
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.
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
7.6% Bisaya & Binisaya
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.
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 Healing
Roman 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.
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
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
Depression and Suicide8
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
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
Essential for nursing staff to be aware of patient’s:
The cultural background of each patient
The expectations and beliefs of each about healthcare
The 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
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
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
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
U.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:
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
Student Xchange. (n.d.). Phillippine Alternative Medicine [The Healers]. Retrieved from
Mcbride, M. (2000). Health and Healthcare of Filipino American Elders. Retrieved 2000, from Stanford
Geriatric Education Center Stanford University School of Medicine, Stanford, California
Taylor, C. R. (2011). Fundamentals of Nursing - The Art and Science of Nursing Care. Philadelphia: Lippincott Williams &