Nurses and other health providers should be adequately prepared to offer culturally competent care to patients from diverse ethnic backgrounds. Giger and Davidhizar’s transcultural assessment model was developed to guide nursing students and practitioners when assessing patients’ cultural values concerning health and disease behaviors. Therefore, this tool could be used to assess poor Filipinos living in the United States in a bid to understand how their cultural beliefs affect the process of offering care to them. The tool would be applied by understanding the Filipino’s culture in the six cultural dimensions of Giger and Davidhizar’s transcultural assessment model as discussed in this paper.
Filipino’s History in Relation to the US
In the early 20th century, Filipinos started to immigrate to the US in masses. A mix of race and culture characterizes intra-ethnic diversity among Filipinos in the US. Their folklore has stories explaining the causes of different health conditions. According to Filipinos, being healthy encompasses both physical and mental wellbeing. However, this ethnic group does not seek medical help until a disease has advanced.
Besides, family members have to be consulted before making a decision to seek medical attention. Spiritually, the majority of Filipinos in the US are Catholics. According to Lagman, Yoo, Levine, Donnell, and Lim (2014), most Filipinos rely on God’s healing power to manage health matters. Death rituals include mourning for in stages for a year. The first stage involves nine days of prayer, while the second one takes 40 days where the departed soul is expected to enter heaven. The last stage takes a year to commemorate the dead. However, most Filipinos do not acknowledge the benefits of advanced care planning.
Giger and Davidhizar Assessment Model
Biological Variations
Filipinos in the US have distinct body size and structure with visible skin color visible characteristics. Besides, genetic make-up, dietary preferences, and other lifestyle aspects increase the susceptibility of this ethnic group to hypertension, cancer, diabetes, cardiovascular complications, and HIV/AIDS.
Space
According to Karabudak, Tas, and Basbakkal (2013), “Space refers to distance and intimacy techniques utilized when relating verbally or nonverbally to others” (p. 343). Collapsed space is common among Filipinos due to their close family ties. In this case, patients do not value their personal space. Besides, a Filipino client may bring the entire family when seeking medical attention. Similarly, family members are most likely to hover around the bed if one of them is admitted to a health care facility.
Social Organization
This dimension of the model refers to the way cultural groups organize around family structures. Filipinos have close family ties, and thus in most cases, health decisions have to be made and approved by family members. The social organization also guides birth and death rituals together with the nature of religious beliefs that should be followed.
Time
Different cultural groups can be future, present, or past time oriented. When people are oriented towards the past, they focus on traditions that have been used to offer health solutions. Present-oriented cultural groups focus on the issue at hand without considering the past or planning for the future. Filipinos are past and present-time oriented, and thus they may not be motivated to plan for their future health outcomes. They also run on their time, which explains why they may be late for appointments or deadlines.
Environmental Control
This dimension refers to the ability to influence one’s environment to achieve set goals. Folklore is common among Filipinos in the US, and thus they believe that their well-being is subject to external factors. As such, they use home remedies for their health conditions. They also consult shamans and curers as part of their folk medicine.
Planning for Culturally Congruent Health Care
Nurses should be fully prepared to address the ever-changing patient demographics for by being culturally competent. When planning for culturally congruent health care, the three-dimensional model with five constructs [awareness, knowledge, skill, encounter, and desire] can be used to achieve the best patient outcomes (Repo, Vahlberg, Salminen, Papadopoulos, & Leino-Kilpi, 2017).
Cultural awareness entails self-examination to understand one’s professional and cultural background and evaluate the underlying health care believes and values (Newman Giger, 2013). Nurses also prepare by acquiring cultural knowledge of different ethnic groups to understand issues surrounding the concept of health among the individuals in context. Cultural skill requires nurses to gain the ability to collect relevant data from a patient and interpret it using culturally specific assessment.
On the other hand, through a cultural encounter, nurses are encouraged to be deliberately involved in cross-cultural interactions with patients from diverse ethnic backgrounds. This aspect ensures that nurses are culturally competent. Finally, nurses can prepare for culturally congruent health care through cultural desire, which is the motivation become aware of patients’ ethnic backgrounds. In the context of American Filipinos, nurses can use this model to understand why this ethnic group is disproportionately predisposed to lifestyle diseases such as cancer, diabetes, and cardiovascular complications.
Conclusion
The current patient demographics are highly dynamic, and nurses should be prepared to offer culturally competent care to different ethnic groups. Understanding the American Filipino’s culture through the Giger and Davidhizar assessment model allows nurses to come up with the best intervention measures for improved patient outcomes. Besides, when planning to offer culturally congruent health care, nurses can use the three-dimensional model to improve their cultural awareness, knowledge, skill, encounter, and desire and understand the unusual predisposition of American Filipinos to lifestyle diseases.
References
Lagman, R. A., Yoo, G. J., Levine, E. G., Donnell, K. A., & Lim, H. R. (2014). “Leaving it to God” religion and spirituality among Filipina immigrant breast cancer survivors. Journal of religion and health, 53(2), 449-60.
Newman Giger, J. (2013). Transcultural nursing: Assessment intervention (6th ed.). St. Louis, MO: Elsevier Mosby.
Repo, H., Vahlberg, T., Salminen, L., Papadopoulos, I., & Leino-Kilpi, H. (2017). The cultural competence of graduating nursing students. Journal of Transcultural Nursing, 28(1), 98-107.