Transcultural Health Care
Copyright © 2013 F.A. Davis Company
Transcultural 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 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 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 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 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 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 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 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 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 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 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 Edition
Correct Answer
Correct answer: A
Tag-Lish is a combination of Tagalog and English.
Transcultural 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 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 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 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 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 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 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 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 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 Edition
Childbearing Family
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