Transcultural nursing

Introduction

Transcultural nursing has come to be perceived as a vital component in contemporary healthcare settings (Shen, 2014); (Purnell & Pontious, 2014). As such, it is now embraced as a critical requirement for practicing nursing professional given the multicultural phenomenon, not only rife in the American context but globally as well. This is in an effort to enable nursing professionals to counter significant challenges that may arise as a result of cultural differences concerning healthcare beliefs, values and customs (Abesamis, Fruh, Hall, Lemley & Zlomke, 2015). Acquiring skills and knowledge towards greater cultural competency is critical towards availing holistic and more so, individualized care for patients and their families  (Purnell & Pontious, 2014); (Salami, Nelson, Hall, Muntaner & Hawthorne, 2014). This paper seeks to present an individual cultural assessment through an interview aimed at extensively understanding the beliefs and patterns of people originally from Philippines residing in the US. This will be achieved through an interview involving A. F., a naturalized US citizen from the Philippines. The individual cultural assessment will employ the Andrew/Boyle Transcultural Nursing Assessment Guide for Individuals and Families to carry out the individual assessment and thereafter, present findings gotten therefrom.

Interviewee Profile

6. F. is now a full-fledged, law abiding American citizen. She was, however, born in the Philippine region of Cebu but was raised up in the Bohol region where she lived with her brother and parents until she attained 9 years of age. Her first visit to America was when she was aged only 7 years though, she sis not appreciate what the country had to offer back then. As much as she was in the secure company of her parents, she opted to move back to the Philippines where she was taken in by her Aunt and now deceased grandmother. She works as a nurse and her highest educational credentials are a Bachelor of Nursing degree. A.F.’s grandmother passed on recently and as such, this special circumstances interrupted the interview process as she requested to travel back to the Philippines to attend final burial rights in line with her culture. The following is the interview with A. F. in an attempt to further understand the beliefs and patterns inculcated among people of Philippine origin. The interview was slated to be conducted over a period of four weeks. A. F. was to voluntarily avail herself from 6.30 pm to 7.30 pm every Monday to Friday at the public library for a private closed door interview session.

Biocultural Variations

Me: Hello A. F. how was your day today?

1. F: I had a wonderful day, thank you. Hope your day was well too.

Me: Yes, indeed, my day was fine too. I will move on directly to the subject matter of the issue at hand.

1. F: That’s well with me, let’s proceed.

Me: I would like to enquire as to whether you are aware of any genetic conditions prevalent with you or other members of your immediate family and more so, does you or your family relates with such a medical history (Andrews & Boyle, 2008)?

1. F.: I suffered Asthma as a child. Concerning my other family members, I know my brother experienced asthma too and my mother told me that my grandmother also suffered from the condition too.

Me: What socioenvironmental conditions have resulted in the prevalence of asthma in your country of origin?

1. F.: I can attribute high pollution rates in urban regions and burning of refuse in rural regions to the prevalence of the respiratory condition.

Me: Which disease do you have most resistance for (Andrews & Boyle, 2008)?

1. F: Malaria.

Me: which distinct feature common among your cultural group do you and close family members possess (Purnell, 2012)?

1. F: We are generally short in stature with slender bodies.

Communication

Me: which language do you commonly use at home while communicating with other family members (Andrews & Boyle, 2008)?

1. F.: While in the Philippines, we communicate in Tagalog, especially when relating to the elderly but the use of American English is frequent too. Here, in America, we rarely communicated in any other language other than English. We can all read and write in Tagalog and English. In the Philipines,

Me: What do you believe promotes health from a Philippines perspective (Cura, 2015)?

1. F.: Good nutrition, conforming to ritualized practices and eating indigenous foods of the Philippines people. Our people also appreciate American foods to a great extent thought only those who can afford them indulge often. However, given the opportunity, they often opt for traditional meals.

 

Me: What are the preferred cultural avenues for communication among peoples from your ethnic background (Purnell & Pontious, 2014)?

1. F.: It is rather difficult to get no for an answer especially among those who still adhere deeply to our religious practices. It is also impolite to interfere when one individual is speaking to you or another individual. It is also common to find that people of Philippine descent tend to use nonverbal styles of communication a lot and more so, the use of the physical gestures are universally accepted among people of from our culture.

Social Networks and Kingship

Me: What is the composition of your family (Andrews & Boyle, 2008)?

1. F.: At present, we are only three. My parents and I, my older brother lives with his wife and two children. Among the Filipino communities at home, the extended family makes up the conventional family unit headed by the elderly such as grandfathers and grandmothers.

Me: What is the composition of your social network and its influence on your health status (Salami, Nelson, Hall, Muntaner & Hawthorne, 2014)?

1. F.: It is made up of my immediate and extended family, former high school friends, neighbors, former university peers and workmates. None of my family members smoke which is a positive influence on me but some of my neighbors, peers, and workmates smoke which I don’t appreciate much. I know it present negative outcome to my health, especially the fact that am prone to asthmatic attacks as well as adversely influencing their own health. Back in the Philippines, social circles are largely composed of the extended family members who at time are quite many.

Me: Who makes decisions about health and healthcare in your immediate family (Andrews & Boyle, 2008)?

1. F.: I do. My parents as well as my brother’s family respect my opinion with regards to health issues facing them. It is common to find that back in the Philippines, the elderly people’s opinion with regards to the health of family members is much respected.

Me: what are the special occasions in your culture and how do these affect your health (Purnell & Pontious, 2014)?

1. F: My family rarely practices the cultural events common in the Philippines. However, the Philippines Independence Day is one celebration my people patriotically look forward to and as such, this has rubbed off on me to. Religious festivities are, however, warmly embraced at home with the Barrio Fiesta, Flores de Mayo, Easter Sunday and the Misa de Gallo being the most adored days of celebration. Other than much feasting, there is no other way that the days of celebration affect my health.

Me: How do they participate in your attempt to promote a health conscious lifestyle (Andrews & Boyle, 2008)?

1. F.: My parents still have a strong impact in the way I conform to healthy living. They are ardent students towards maintaining good health and this motivates me to follow their steps as challenging as this sometimes is.

Me:  How do your cultural and ethnic background as well as religious faith influence your health (Andrews & Boyle, 2008)?

1. F. well, my ethnic background as well as my religious affiliations do not have much influence though it is important to point out that I do not indulge in alcohol. I believe it is because my family strongly advices against it. However, men in the Philippines enjoy taking alcoholic drinks after meals and on festive occasions.

Nutrition

Me: in what ways does your cultural background influence your nutritional factors?

A.F.: We Filipinos enjoy holding conversations while having a meal. It is due to our collective nature. Fruits and vegetables are in abundance back home due to good weather and rich soils. Fish is also plentiful and the main source of proteins while noodles and rice make up for most of our starch intakes. Breakfast is often made up of leftovers from last dinner. We have lunch at midday and sit in for dinner at 6pm in the evening. Snacks are generally taken at 10am and 3 in the afternoon. It is common to have all food laid out on a dinner tables for one to choose what to consume from an array of dishes.

Religion and Spirituality

Me: What about you religious affiliation (Andrews & Boyle, 2008)?

1. F: All my family members practice the Catholic faith but we are keen on adhering to cultural practices considered as fine relative to the teachings of the bible. There are, however, other religions practiced back in the Philippines. These include the Protestants, Muslims and Buddhism. Some groups continue to conform to age old religious and spiritual practices.

Values Orientation  

Me: In what ways is the American healthcare system perceived by you and your family members (Andrews & Boyle, 2008)?

1. F.: We appreciate America’s healthcare system very much and it has enabled us lead healthy lives. However, back in the Philippines, some elderly people like my grandmother continue to embrace the services of cultural healers. This is especially the case for people considered as mentally ill as demons and witchcraft are associated with a compromised mental state.

Cultural Affiliations

Me: Do you intermarry?

A.F.: It is common to find that our people often opt to marry amongst themselves though it is taboo to marry a blood relative. In the US, we are finding intercultural marriages thrive and as such, the elders of our communities are now embracing the new trend.

Cultural Sanctions and Restrictions

Me: Are there any specific gender issues attributable to your ethnic background (Andrews & Boyle, 2008)?

1. F.: Yes, they are indeed numerous, women are mandated to be submissive to their husbands, fathers and brothers. They are also expected to value their role within the family over everything else just to name a few. At social gatherings, women and children commune together while men commune separately.

Discussion and Conclusion

A rather unexpected event affected A.F. quite much and she formally requested that we adjourn the interview sessions. She explained that her dear aged grandmother had passed away as a result what her parents simply termed as old age. I got the perception that it is considered disrespectful to the dearly departed before they are accorded final burial rights. A.F. promised to continues with the interviews to their conclusion upon her return.

This interview was quite insightful in that, I came to comprehend that the young naturalized American from the Philippines are generally well educated. This is especially the case with A.F. and her close family members, peers and neighbors. As such, the influence of the American culture of her and her family is pronounced though they are innately inclined to conform to their ethnical customs, values and belief systems. As such, A.F. has provided sufficient insights into how much her cultural upbringing has positively contributed to her health.

 

 

References

Abesamis, C. J., Fruh, S., Hall, H., Lemley, T., & Zlomke, K. R. (2015). Cardiovascular Health of Filipinos in the United States A Review of the Literature. Journal of Transcultural Nursing.

Andrews, M. M., & Boyle, J. S. (Eds.). (2008). Transcultural concepts in nursing care. Philadelphia, PA: Lippincott Williams & Wilkins.

Cura, J. D. (2015). Respecting Autonomous Decision Making Among Filipinos: A Re-emphasis in Genetic Counseling. Journal of genetic counseling, 24(2), 213-224.

Purnell, L. D. (2012). Transcultural health care: A culturally competent approach. Philadelphia, PA: FA Davis.

Purnell, L., & Pontious, S. (2014). Cultural competence. Multicultural approaches to health and wellness in America, 1, 1-28.

Salami, B., Nelson, S., Hall, L. M., Muntaner, C., & Hawthorne, L. (2014). Workforce integration of Philippine-educated nurses who migrate to Canada through the Live-in Caregiver Program. CJNR (Canadian Journal of Nursing Research), 46(4), 65-82.

Shen, Z. (2014). Cultural Competence Models and Cultural Competence Assessment Instruments in Nursing a Literature Review. Journal of Transcultural Nursing.