NURS 04 LEC: Filipino Culture, Values, and Practices in Relation to Health Care

FUNDAMENTALS OF NURSING
BS NURSING 1-4 | 2ND SEM 2023

3. Cultural Dualism - the Philippines is a transitional

CULTURE
➢ Culture - is defined as the “totality of socially transmitted
pattern of thoughts, values, meanings,and beliefs” (Purnell
2005). It is not limited to any specific ethnic group,
geographical area, language, religious belief, manner of
clothing, sexual orientation, and socioeconomic status
(Fisher 1996).
➢ Filipino culture - is the summation of indigenous forces and
foreign influences that had come to bear upon the people in
varying degrees during the last centuries. Contributory
factors to Filipino Culture Malays Chinese Indian Hindi
Spanish Americans
The Filipino culture involves two important influential
factors:
a. Belief System - Filipinos are believers of religion. They
believe so much on supernatural powers and viewed
themselves as only a speck in this wide universe. Success
is considered a blessing from above, as a result of good
luck and faith Good isconsidered relative. Happiness and
success differ from one person to another. Hospitality is
practice.
b. Value System. Cultural values are shared assumptions of
what is right, good or important. Guide man's behavior and
action as he relates himself in most situations in life. Can
best be seen from the aspects of personal and social
relationships. Majority of Filipinos value more their honor
(karangalan) rather than wealth.
In Revisiting usog, pasma, and kulam, Tan explains that “culture
is inscribed in our bodies and in our minds” (Tan 2008). As such,
the relationship of culture and health is important to understand
as it impacts an individual’s worldview and decision-making
process (Purnell 2005). Like in other fields of medicine, the
impact of cultural beliefs is increasingly being recognized as an
essential component in the genetic counseling process (Cohen et
al. 1998; Edwards et al. 2008; Penn et al. 2010).
Seven common Filipino cultural beliefs are presented in the
paper of Abad and Tan et.al (2014) and these are: namamana,
lihi, sumpa, gaba, pasma, namaligno, and kaloob ng Diyos.
Filipino word/s depicting cultural beliefs and their English
translation
society dominated on one side by the traditional culture
and on the other side by the modern culture.
THE COMMON FILIPINO VALUES
1. Utang-na -loob - it is a technique of reciprocity of debt
of gratitude to others within the family circle or primary
group, sometimes unlimited in nature, emotional rather
than financial or rational. It is sign of marginal economy
where no place is available in bargaining, formal
agreements, written contracts, specific rights and
responsibilities.
2. Pakikisama - Closely to utang-na-loob It is the value of
belongingness and loyalty to the snall in-group with
sensitivity to the feelings of others on the principle of
“give and take.” Is a folk concept of good public
relations and avoidance of conflict with the leaderor
majority of the groups.
3. Hiya - Controls a large extent the behavior of the
individual. Dependent on others will think, say and do.
Because of hiya, a Filipino cannot say “NO” even it is
against his will to do what is being requested.
4. Bahala na - Common expression among Filipinos and
this rest on the fatalistic outlook and strong
dependence on the “spirits” who will take care of
everything if they are really meant for a person
5. Authoritarianism - It is the dependence of the
Filipinos in a paternalistic rather than in a stern way
upon the elders of the family, upon their boss, if
employed, and upon people in authority as their father
figure. Commonly practice in the Filipino family to
which basically patriarchal in nature. The father is seen
as the head that makes major decisions affecting the
family.
6. Individualism - Pattern of behavior which
characterizes the Filipino as self-centered. The desire
to make the name for himself becomes the primary
motivation for success.
7. Amor-propio - Individual's highly emotional reaction to
protect his honor and dignity when they are threatened
or questioned and to retaliate. Common forms of this
are “hele hele bago quiere” or pakipot which shows a
person initially refusing an offer even if he wants very
much to accept it.
8. Health Decision - In decision- making, the Filipinos
usually consult and take into consideration the
consensus of the family members as the feelings of
those who are to be affected. That is why in health
decision making the familial values and influence is
taken into consideration

FILIPINO HEALTH BELIEFS AND BEHAVIORS: THEORIES OF ILLNESS

➢ Health in the Filipino setting is a combination of
maturative processes or development in
correspondence to the ability to function properly or to
be active. Being either Thin (Payat) or Mataba/taba
(Fat) are not considered as healthy, but not necessarily
ill.

THE FILIPINO CULTURAL PERSPECTIVES

1. The Traditional Concept - hold that Filipino culture
was developed due to the conglomeration of the
physical, intellectual, moral and spiritual aspects.
2. The Nationalistic View - regards culture as the
summation of the needs of people, the description of
their past and present condition, an expression of their
values, thoughts and emotions, and the depiction of
their historic struggles too liberate themselves.

1

ILLNESS VS DISEASE
❖ Illness
- a single instance of “being sick”
- the human experiencing of disease
❖ Disease
- a diagnostic category, a conceptual entity which
classifies particular illnesses,
- symptoms or pathological components of illnesses or
stages of illnesses
- an abstract biological-medical conception of
pathological abnormalities in people’s bodies
❖ Sakit
- In Philippine society, only one word exists to describe
such phenomena – “Sakit”
- The term “sakit” is closer to the meaning of illness
than to disease
- In many cases, ailments or illnesses are
culture-specific.
- Ex. Usug, Bangungot (Western: nightmare death
syndrome
❖ Sakit = Pain
- MWestern medicine – pain as a symptom
- Filipino medicine – sakit = pain in several contexts
(ex. sakit ng ulo, sakit ng tiyan)
- Sakit also has different degrees (ex. hapdi for a
stinging type; kirot for a sharp, recurrent type; antak
for internal, continuous stinging type)
❖ Sakit = illness
- Diagnosis involves the culmination of a process of
observing signs and eliciting symptoms that are
graded in terms of seriousness (often associated with
level of physical activity one can still exert)
❖ May Sakit
- A normally strong person who suddenly feels weak is
said to be have the beginnings of an illness. This
weakness is close to the English term lethargic.
- Persistence of lethargy, accompanied by other
symptoms are monitored by family and friends but the
term MAY SAKIT will only be used when the person is
unable to perform physical tasks (common criterion:
bed-ridden)
FILIPINO WAYS TO MANAGE ILLNESS
1. No matter what ailment, it is considered as mild/slight at first
notice. Patient is rarely given treatment during this stage.
2. The gravity of the sickness will only be taken into notice
when patient starts to suffer more and more.
3. If one complains of pain or great itching, this is the first
stage of malaise. If symptom continues over a considerable
period of time accompanied by the intensifying of the
symptom, the patient and the family sees the sickness as
serious.
4. If patient starts to stay in bed than continuing with his daily
routine, this is considered as another stage of severity.
5. Filipinos consider CRYING as the surest indicator of
severity
MEDICATION BY WESTERN COUNTRIES
- Some illnesses are more than just physical
● More health professionals are starting to recognize
the important role of social relationships in
determining health and disease
- “Syndrome” – slowly becoming a popular term in
medical literature but still reflects the need to delimit
the qualifiers used by the western-oriented medical
system
- Some illnesses/ailments cannot and should not be
immediately appropriated into biomedical or psychiatric
pathology
● Some physicians quickly label some problems as
medical, when some are actually more
philosophical in nature.
● Ex. A person pondering on the meaning of his/her
life = depressive order = need for anti-depressants
- Few health professionals have the ability to see that
some “problems” may actually be part of a healthy
process of an individual’s mental, emotional, and social
development
- Therefore, immediately attaching medical labels and
treatment on such conditions may be detrimental as it
medicalizes life’s processes
THEORIES OF ILLNESS CAUSATION IN THE PHILIPPINES
➢ Physical and mental health and illness are viewed
holistically as an equilibrium model. In contrast, other
explanatory models may include mystical, personalistic
and naturalistic causes of illness or disease (Anderson,
1983; Tan, 1987; Tompar-Tiu & Sustento-Seneriches
1995).
a. Mystical Causes - Mystical causes are often attributed
to experiences or behaviors such as ancestral
retribution for unfinished tasks or obligations. Some
believe that the soul goes out from the body and
wanders, a phenomenon known as Bangungot, or that
having nightmares after a heavy meal may result in
death.
b. Personalistic Causes - Personalistic causes are
associated with social punishment or retribution from
supernatural forces such as evil spirit, witch (Manga ga
mud) or sorcerer (mangkukulam). The forces cast
these spells on people if they are jealous or feel
disliked. Witch doctors (Herbularyo) or priests are
asked to counteract and cast out these evil forces
through the use of prayers, incantations, medicinal
herbs and plants. For protection the healer may
recommend using holy oils, or wearing religious
objects, amulets or talismans (anting anting).
c. Naturalistic Causes - Naturalistic causes include a
host of factors ranging from natural forces (thunder,
lightning, drafts, etc.) to excessive stress, food and
drug incompatibility, infection, or familial susceptibility.
INDIGENOUS HEALTH BELIEFS
❖ Concept of Balance (Timbang)
- This concept is central to Filipino self-care practices and
is applied to all social relationships and encounters.
According to this principle, health is thought to be a
result of balance, while illness due to humoral pathology
and stress is usually the result of some imbalance.
Rapid shifts from “hot” to “cold” cause illness and
disorder. Illustrated below are a range of humoral
balances that influence Filipino health perceptions:
● Rapid shifts from “hot” to “cold” lead to illness
● “Warm” environment is essential for maintaining optimal
health
● Cold drinks or cooling foods should be avoided in the
morning
● An overheated body is vulnerable to disease; a heated
body can get “shocked”
● When cooled quickly, it can cause illness
● A layer of fat maintains warmth, protecting the body’s
vital energy
● Imbalance from worry and overwork create stress and
illness
● Emotional restraint is a key element in restoring balance
● A sense of balance imparts increased body awareness
(Adapted from Becker, 2003)