Filipino Culture, Values, and Practices in Healthcare PDF

FILIPINO CULTURE, VALUES, AND PRACTICES IN RELATION TO HEALTH CARE OF INDIVIDUAL AND FAMILY Ma. Elena O. Aguilar, MAN, MS Psychology Family Solidarity - Intergenerational solidarity refers to the degree of closeness and support between different generations. The notion of solidarity helps...

FILIPINO CULTURE, VALUES, AND PRACTICES IN RELATION TO HEALTH CARE OF INDIVIDUAL AND FAMILY Ma. Elena O. Aguilar, MAN, MS Psychology Family Solidarity - Intergenerational solidarity refers to the degree of closeness and support between different generations. The notion of solidarity helps us to understand how people of different generations relate to, help and depend on one another in their daily lives. (Timonen, n.d) Dimensions of Solidarity in Intergenerational Family Relations Structural Solidarity - This means how factors like geographical distance can constrain or enhance interaction between family members. Associational Solidarity - This dimension refers to the frequency of social contact and shared activities between family members.  Affectual Solidarity - Solidarity can manifest itself in feelings of emotional closeness, affirmation and intimacy between family members. Consensual Solidarity - Family members have different levels of actual or perceived agreement in opinions, values and lifestyle.  Functional Solidarity - Exchanges of practical and financial assistance and support between family members are examples of functional solidarity. Normative Solidarity - It refers to the strength of obligation felt towards other family members. Filipino Family Values 1. Communication Use of therapeutic communication techniques, identifying verbal and non-verbal cues, responding to clients needs while using formal and informal channels of communication and appropriate information technology.  Communication Style - Filipinos will try to express their opinions and ideas diplomatically and with humility to avoid appearing arrogant. The tone of voice varies widely by language, dialect and region -When speaking to those who are older or of higher status, Filipinos tend to use polite forms of speech. At the end of phrases, sentences or questions, they will say ‘po’ to demonstrate this respect for hierarchy. ○  Pace of Conversation: - Filipinos often communicate indirectly in order to prevent a loss of face and evoking hiya on either side of an exchange. - They tend to avoid interrupting others and are more attentive to posture, expression and tone of voice to draw meaning. - Allow brief periods of silence or pauses in the conversation to enable the patient to process information.  Physical Distance: - When interacting with people they are familiar with, Filipinos tend to prefer standing at an arm's length from one another. Around strangers this distance is farther. Maintain a reasonable personal space of 1 to 2 feet. Take height into consideration. A seated position for interaction is highly recommended. 2. Helping Others and Gratitude Pakikisama has the connotation of getting along with people in general. ○ There is a general yearning to be accepted and well-liked among Filipinos. This applies to one and his or her friends, colleagues, boss, and even relatives. This desire is what steers one to perform pakikisama. ○ The word pakikisama literally translates to "helping others." Therefore, this trait usually fosters general cooperation and performing good or helpful deeds, which can lead to others viewing you in a favorable light.  Utang na Loob means to pay your debt with gratitude. ○ With utang na loob, there is usually a system of obligation. When this value is applied, it imparts a sense of duty and responsibility on the younger siblings to serve and repay the favors done to them by their elders. 3. Respect The English translation of paggalang means to be respectful or to give respect to a person. Filipinos are accustomed to using the words “po,” “opo,” and “ho” when they are conversing with older people or, sometimes, with those who are in a high role or a prestigious member of society. Using these words is customary in the Philippines, and it shows a sign of respect if you do so.  Paggalang can also be shown toward your elders by kissing their hands before leaving/to say goodbye and upon arrival/to greet them. The younger members of the family can show respect toward older siblings by calling them kuya (older brother) or ate (older sister). 4. Independence ○ The ability of a person to make their own choices and carry out daily tasks independently and it is also important for healthy development. ○ Importance of independence i. It boosts your self-confidence and self-esteem. ii. It decreases the burn you place on family, friends and society. iii. It turns you into an asset to help other people. iv. It leads to financial freedom as you are skilled and capable. v. It makes you physically capable of caring for yourself and others. vi. It fills you with a sense of joy and happiness that can come from no other source. vii. It sets you up for further progress and self-sufficiency. 5. Service ○ This is an act of helping or doing work for someone (assistance). ○ In a hospital, healthcare professionals provide us their services when we are in our vulnerable state to attain well-being. Importance of good quality service in healthcare i. Patients will be more happy and satisfied as they’ve received exceptional care and are more likely to come back for check-ups and even refer your facility to other people. ii. Healthcare professionals develop lasting relationships with patients rather than approaching visits as a transaction. iii. The healthcare industry depends heavily on accurate patient data to make diagnostic and treatment recommendations. Errors, incomplete records and staff’s inability to access needed data can severely impact the quality of care given to the patient that can result in threatening mistakes and malpractice lawsuits. 6. Trust ○ This is a firm belief in the reliability, truth, or ability of someone or something. ○ Being trustworthy in a health care setting is acting consistently for the good of the patient and having high levels of judgment, confidence and skill competence. ○ Importance of trust in healthcare i. Healthcare involves an element of uncertainty and risk for the vulnerable patient who is reliant on the competence and intentions of the healthcare professional. ii. Patients who trust their health professionals are more likely to follow treatment protocols and are more likely to succeed in their efforts to change behaviors. iii. It also lowers the anxiety of the patients in relation to any treatments taken. iv. Patients are more likely to open-up and disclose information if they trust their healthcare professional, and the quality of interaction may improve, resulting in greater patient autonomy and shared decision making. Filipino Family Culture and Tradition The Philippines is more commonly referred to as the melting pot of western and eastern cultures. Its culture and tradition is heavily influenced by the traditions of the indigenous Austronesian people. In addition, the cultural landscape shows the influence of the people of Spanish, American, Japanese, Arabic, and Indonesian origin. The major religions of the country being Christianity and Islam played a significant role in shaping the culture of the Philippines. Social Belief and Customs - Primarily influenced by religion and demographics of the region where they are practiced. - Based on the beliefs of the Austronesian inhabitants of the Philippines. Examples: Getting rid of hiccups by placing a short thread wet with saliva on the forehead Usog- By showing fondness or affection when meeting a baby for the first time, you may cause the baby to feel uneasy or make the baby cry non-stop which is commonly referred to as "na-usog.“ - Things to do to avoid passing the negative energy and cure the infant of usog: a. you must dab your saliva on the baby’s forehead or abdomen b. greet the child by saying “pwera usog” meaning for protection from the hex c. buy their child a bracelet made from black and red or coral beads to fight usog. - Hitting the sack right after a shower is believed to cause blindness and insanity.. - Not patting your sweat dry with a towel can cause you to get pneumonia. - Washing sweaty hands can lead to spasmodic hands or pasma. - It’s a common Filipino advice not to wash your hands right after finishing labor-intensive chores to avoid pasma—the reason for shaky hands, sweaty palms, and numbness or pain in the hands. – - It is believed that taking a bath after a workout can lead to illnesses. Religion and Festivals - Approximately, 90.07% of Filipino residents are identified as Christians with 80.58% of them being Roman Catholic and about 11% being other Christian denominations Islam is the second largest religion in the country with about 5.6% of the citizens. - Catholics believe that the prayers of the saints in heaven are powerful enough to alleviate or heal illnesses. There are several patron saints for healing namely St. Dymphna (Patron Saint of Depression and Mental Illness), St. Peregrine (Patron Saint of Cancer Healing), St Maximillian Kolbe (Patron Saint for Addictions), St. Lidwina (Patron Saint for Those Suffering from Chronic Pain) and St. Jude (Patron Saint of Hopeless Causes). - One such example is the feast of the Black Nazarene. It is traditionally celebrated with a grand procession called Traslacion, where millions of devotees would jostle their way to touch the carriage carrying the venerated statue as they believe doing so could bring healing, answer prayers, or lead to miracles. Music and Dance - Traditional folk songs are inspired primarily indeginous customs and beliefs. - The Obando Fertility Dance is a festival where couples who hope to be blessed by children perform street dances in a long procession. The Fertility Dance of Obando is both a festival and a prayerful appeal for devotees. The month of May has always been the season for the Fertility Dance. Initially, the native childless couples dance in front of idols to request that they would soon have children. When the Spanish took over, they convinced the natives that they can keep the Fertility Dance but would instead dance in front of images of saints instead of idols. Cuisine - Influenced by local and foreign cultures. Rice is the staple meal in the country and usually prepared through steaming and served together with other foods. - Pancit is as crucial to each Filipino feast as rice is to every complete Filipino meal. It is a fixture at many significant milestones such as weddings, baptisms, graduations, and most especially during birthdays, where their inherently Chinese symbolism as edible harbingers of a long life (provided you don’t cut the noodles before you eat them) are frequently invoked. Clothing and Accessories -Maria Clara is the traditional dress of the Filipino women. This attire gets its name from a famous character named Maria Clara in the epic 19th- Century narrative “Noli Me Tangere” written by Jose P. Rizal. It is made up of four components: Saya - a long dress Tapis- a knee-long skirt Camisa- a collarless chemise Panuelo- a stiff scarf - Barong Tagalog is traditionally worn by men during special occasions. It is also known as Baro. Barong Tagalog features a formal long shirt decorated with embroidery. - In the Philippines, specially made amulets or talismans are believed to protect the wearer from bullets and knife wounds. - One such example is an amulet called “kontra-usog”- usually a combination of seeds and dried plant material, wrapped in red cloth with or without a cross outside. It is a kind of juvenile amulet, pinned to the shirt of a child for protection. Health Practices Studies of health practice among Filipino Americans suggests that people originally from rural areas in the Philippines are more knowledgeable regarding home remedies, traditional healing techniques, and supernatural ailments, whereas those in the urban areas rely more on Western medical intervention and over-the-counter drugs. However, in both rural and urban areas, there exists a variety of indigenous folk practices and modern health care systems which are simultaneously utilized.  Self-Medication - Among the traditional forms of self-medication are certain Chinese ointments or oils which serve as a remedy or a cure in relaxing, heating, and comforting aching muscles and providing relief for dizziness, colds, headaches, sore throats and so forth. - Includes folk healing techniques consistent with the Chinese hot/cold classification system of diseases and concept of wind illness. One example is ventosa, a technique used for treating joint pains believed to be caused by the presence of bad air. This technique consists of wrapping a coin with cotton, wetting the tip with alcohol , lighting it, and placing the coin on the aching joint area, then immediately covering it with a small glass or cup. The fire is then soon extinguished as it is covered, creating a vacuum that will suck bad air out of the joint. Use of Herbs and Roots; Faith Healers - More serious illnesses typically warrant seeking the help of a local healer who may utilize herbs and roots. Although healers are presumed to possess a God given gift, their relative popularity and prestige in the community depends a great deal on their interpersonal relationships with their patients. People in rural areas are accustomed to friendly and accommodating folk healers and expect the same treatment from physicians. If these expectations are not met, they avoid Western health centers or switch doctors. Moreover, when healers are viewed with trust and respect, they often are expected to perform instantaneous healing. If there is no immediate improvement in an illness or related symptoms, individuals may change doctors. - These healers include midwives, masseurs, and specialists for supernaturally caused ailments. Although these types of healers each have native labels, there is no traditional word for faith healers, the newest and increasingly popular genre of Philippine folk healers. Faith healers do not attempt to identify or diagnose a disease, which is in contrast to the traditional concern for identifying the cause of illness (which could presumably be supernatural). Their orientation is holistic and uniform and incorporates the belief in concurrent physical, emotional, and spiritual healing. Regardless of the individual's specific affliction, the same techniques are employed. ◦ - Psychic Surgery involves the painless insertion of the healer's fingers into the individual's body, removal of tissues, tumors, growths, or foreign matter, and closing the incision without a scar. Numerous Western scientists have investigated tales of miracle cure produced by psychic surgeons and found evidence of fakery; however, they also have reportedly witnessed incredible feats of healing. ◦ - As the spiritual element is of importance, practitioners may ask questions that are origin oriented, such as why the patient believes they were injured, and counsel them on spiritual matters related to the event of origin. Faith healers also sense energies, auras, and passed figures who may have been related to the patient. Despite the introduction of Christianity in the 16th century, indigenous healing methods maintained an integration with spirituality. ◦ Hilot ◦ - the art and science of the ancient Filipino healing traditions that are grounded on the concept of balance among the physical elements along with the mental, emotional, and spiritual aspects of a person. This practice includes the use of manipulations and massages that help in the prevention of disease and the restoration and maintenance of one’s health and well-being. Hilot also makes use of medicinal plants and bulong/orasyon (whispered or written prayers) ◦ - is performed by a person called Manghihilot who is able to not only heal but also identify illnesses through reading areas of energy imbalances in the body ◦ - the knowledge of the hilot is something that is passed down through generations. Manghihilot undergoes extensive training in order to master the art of healing. A session with a manghihilot usually depends on what it is that’s making one feel uncomfortable. The manghihilot starts off by feeling the pulse, and through this then decides what needs to be done in order to alleviate one’s symptoms. After that, the manghihilot feels around the body for areas where they feel energy could be trapped and massages the areas in order to decongest them.  Tuob/ Suob (Steam Inhalation) -is a part of Filipino culture and traditional health practices and is one of the most extensively utilized home treatments for relieving colds symptoms as part of primary health care practice. -has been shown in scientific studies to be useful in reducing cold symptoms and improving nasal patency  -done by inhaling steam from boiling water from 8-12 inches away with a towel draped over one’s head. The procedure is done for at least 2-5 minutes. - Benefits of tuob include detoxification, cleansing the skin, muscle relaxation, increasing body metabolism, boosting the immune system, keeping mucous membranes from drying, and relieving comfort from asthma, allergies, and arthritis  Tawas ◦ - Tawas is an abstract form of communication whereas the practitioner of Tawas gather information from the subject utilizing tools such as paper, water, candle, oils and others to observe and analyze form and symbols. It is a indigenous art of Divination and Diagnosis practiced by rural folks to determine the cause of illness. - it is used in the purview of the albularyo for a variety of febrile conditions, a child's incessant crying or failure to thrive. -The TAWAS is used to 'cross' (sign of the cross) the forehead and other suspicious or ailing parts of the body while prayers are being whispered (bulong). - It is then placed on glowing embers, removed when it starts to crack, then transferred to a small receptacle of water. - As it cools, its softened form spreads on the water surface and assumes a shape that may suggest the cause of the illness, often one of several indigenous forces: dwarfs, devils or other evil spirits (na-nuno, na-kulam, na-demonyo). - The water in the vehicle is then used to anoint the ailing part or parts of the body to counteract the evil forces or illness. - The tawas is then discarded and thrown westward, preferably into the setting sun.  Herbalism and Plant Medicine - The Philippines is home to 10,000 to 14,000 plant species. While 1,500 of them contain potential medicinal value, only 120 have been scientifically validated. - An albularyo is a practitioner who uses a combination of modalities: herbalism, prayers, incantations, and mysticism, similar to a shaman. - The Philippine Department of Health endorsed just 10 medicinal plants that can be used in herbal teas, tinctures, fluid extracts, poultices (vegetable fat mixtures), tablets, supplements, powders, creams, and essential oils ◦  DOH Approved Herbal Plants ◦ Sambong ◦ Akapulko ◦ Ampalaya ◦ Bawang ◦ Bayabas ◦ Lagundi ◦ Niyog-Niyogan ◦ Tsaang Gubat ◦ Pansit-Pansitan/Ulasimang Bato ◦ Yerba Buena ◦ Malunggay ◦ Tawa-Tawa ◦ Banaba