'

Running head: TRANSC ULTURAL INTERVIEW

Transcultural Jnterview

Chelsea Rmhrauff

Califo rni a State Uni versity. Stani slaus

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TRANSCU LTURAL INTERVIE W 2

Transcultural Interview

As a future nurse, understanding the perspective of others holds a great deal of value. In

the hospital , a nurse has the potential to interact with individuals of a variety of cultures and

backgrounds. To gain greater cultural competency , the author of this paper conducted an

interview with a young adult female from the Philippines . The interviewee will be referred to as

I.A. and will be the primary personal contact for this paper (I.A., personal communication,

October 23 , 2018). This interview is particularly unique because I.A. lives in the Philippines .

The author of this paper met her while staying in the Philippines for an extended time. Prior to

conducting the interview, the author of this paper contacted I.A., explained the purpose of the

interview, and asked for permission. The author reviewed pertinent questions and attempted to

phrase the questions in ways that were appropriate for the culture. Technology allowed the

interviewer and interviewee to communicate in the circumstance of long distance. Purnell ' s

model is a framework designed to gain an insight into another culture (National Association of

School Nurses, 2013). This paper will discuss the 12 sections of Purnell 's model , nursing

interventions, transcultural nursing standards of practice, and an evaluation of the cross-cultural

experience.

Purnell's Model

Heritage Overview

The Philippines is an archipelago located in south eastern Asia (World Atlas, 20 I 8). The

islands have a rich history in regards to ownership by a variety of countries (Philippines History,

2018). ln 1521 , the islands were conquered by Spain. For 300 years. Spanish ownership greatly

affected the culture of the Philippines (Philippines History, 2018). I.A. believes that the
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TRANSCULTURAL INTERVIEW

, and Catholic traditions in the

colonization plays a major role in the difference in values, foods
the Spanish-American war,
Philippines as compared to other Asian cultures. In 1898, during
ry, 2018) . Filipino citizens
America gained ownership of the Philippines (Philippines Histo
ied the Philippines . Eventually, in
played a major role in World War II as allies until Japan occup
pine kpublic as it is known
1946, the Philippines became independent and formed the Philip
in the lives of Filipinos, as the
today (Philippines History, 2018). Location plays a major role

Philippines is located on the ring of fire (World Atlas, 2018).

As a result, the country is '-\ JJP'·
ons (World Atlas , 2018).
frequently subject to earthquakes , flooding, and volcanic erupti

Communication

may be more willing

According to I.A. communication varies between Filipinos. Some
s the interviewer that generally, ~
to speak their minds, while others are more reluctant. She inform

Filipinos avoid confrontation and word-choice that may sugge

st disagreements. For example, if ,iv \~
nd with the phrase "maybe". ~.,, . . , /
person A asks person B to go out to dinner, person B may respo ~
dinner, but is saying so in a polite
Person A should infer that person B does not want to go out to
rude. In other ways , I.A.
manner. Misinterpreting this communication may be considered
g another person fat is not
explains that Filipinos may often seem blunt. For example, callin
nurse , recognizing vague word
considered rude, but rather a truthful observation. As a future
y improve the care of a Filipino
choices and interpreting the hidden meaning correctly can greatl

patient.

Family Roles and Organization

al family, and legal

I.A. explains that her family consists of biological family, spiritu
in child development, financial
family members. She believes that family plays a major role
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TRANSCULTURAL INTERVIEW

support, and the teaching of morals and values. In her family , her mother holds the most status

because she gave up her career to become a full-time wife and mother. I.A. ' smother pri oritized

her family before anything else and spent her life nurturing her family. While LA. did not live

with any extended family, they were greatly involved in her life. I.A. explains that in the

Philippines, immediate and extended families often live together. Another unique factor about

Filipinos is the titles used to show respect. I.A. explained that regardless of relation, if a man is

older than the speaker, the speaker refers to the man as "po", or uncle . If a woman is older than

the speaker, then the speaker is referred to as, "ate", or aunt. If the individual s are much older

than the speaker, they are referred to as "lolo", or grandfather, or " lolo", grandmother. While not

biological family, all people are referred to as these titles as a sign of respect.

Workforce Issues

Poverty within the Philippines plays a major role in the lack of education (Asia Society,

2018). This can have a profound impact on the workforce (Asia Society, 2018). I.A. confirms

that in many areas, this is true, however most parents greatly value the education of their

children. She goes on to explain that education is very significant because parents hope that their

children will go on to have high paying jobs and eventually support the parents. Jobs of high

paying salaries are typically the jobs that bring the most status to families. I.A . explains that

educated people often have occupations in business or the medical field. Those that are

uneducated manage by selling foods and goods. It has been found that Asian immigrants to the

United States are more likely to be employed in management, health care, and other professional

fields than any other fields (Bureau of Labor Statistics, 2012). I.A. also explains that there are

common gender biases related to type of occupation.

TRANSCU LTURAL INTERVIEW 5

Biocultural Ecology

I.A. has dark skin, black hair, and brown eyes. She is approximately five feet seven

inches, which is taller than the average Filipino. Most Filipinos have the characteristic dark skin,

hair, and eyes, and often fall at about five feet tall (Purnell, 2013). Characteristically, Filipinos

also tend to have almond shaped eyes and slightly flared nostrils. It is often difficult for the age ~r§P
of Filipinos to be approximated as a result of a youthful appearance. The coloring of skin can ~
make it difficult for health care providers to assess for cyanosis, pallor, ecchymosis , and

jaundice. In terms of genetic makeup, most Filipinos have a small thoracic cavity. ft has also

been found that this people group has a decreased Rh-negative factor. Compared to white

Americans, Filipinos have a higher instance of hypertension, sodium sensitivity, and diabetes

(Purnell, 2013 ).

High Risk Behaviors

In both the Philippines and the United States, high risk behaviors are more prevalent in

men than in women (Purnell, 2013). Men are found more likely to be heavy drinkers and

smokers than women (Purnell, 2013). According to I.A., smoking in doors and around others

who do not smoke is very common. The Catholic religion has a profound influence on sexual

education in Filipino children (Purnell, 2013). The stigma related to sex causes a lack of
·vtrrtEstw..J-
education and ultimately greater high risk behaviors (Purnell, 2013). While I.A. is Chri:Hilffl and

not Catholic, she has still experienced some of the same stigmas and received limited sexual

education. Children are simply taught to wait until marriage. This correlates with the high

incidence of human immunodeficiency virus (HIV) and acquired immunodef iciency syndrome

(AIDs) found in Filipinos in the United States (Purnell, 2013).

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TRANSCULTURAL INTERVIEW

Nutrition

meals are
I.A. greatly emphas izes the importance of food in Filipino culture. Typically,

believes that the

shared between famiJy and friends and are significant to commu nities. I.A.

her family. Some of

most important meal of the day is dinner because she is able to share it with

is also a staple in
her favorite foods include stir fried vegetables, fried fish, and fried pork. Rice

it. I.A. frequently

the Filipino diet, as I.A. assures the author that no meal is complete withou t

ce, Filipino food

eats white rice with breakfast, lunch, and dinner. As a result of Spanish influen

, 2018). While
is often a combin ation of traditional Spanish and Asian styles (Facts and Details

are often fried

fresh fruit, vegetables, and meats are easily found in the Philippines, the foods

seasoning. Commo n
before being eaten. Vinega r and bagoong, or shrimp paste, is often used for

foods include adobo, balut, and sisig (Facts and Details , 2018).

Pregnancy

it depend s
While pregnan cy is celebrated amongst Filipinos, I.A. infonns the author that

y celebra ted in the

on the circum stances . As a result of Catholic influence, pregnancy is typicall

of any other
constructs of marriag e and more shameful outside of marriage. I.A. is not aware

pregnan cy,
cultural aspects related to pregnancy. Additional resources explain that during

not consum e
cravings and food are very significant (Siojo, 2018). If a pregnant woman does

ve salivation.
food related to her cravings, then her baby is subject to vomiting and excessi

the baby may

\. Women should avoid eating excessi ve amount s of one type of food or else

~~ resemb le it. There are many other superstitions related to pregnan cy depend
ing on the home

status,
origin of the woman (Siojo, 2018). I.A. mentions that it depend s on location and social

but pregnan t woman tend to receive prenatal care.

1 R \ '-:St 'l ' l l' ll RAI INT l!RVI EW 7

A.$ n l'hris.tian, I. A. beliews in the concepts of the afterlife. Her belief in God is

~i~nifo.'mH in timt.~ of illnc:ss nnd death because she beli eves in the will of God. While medicine

i$ Lt~~,i w p~,-ent and t~at disease. she believes that if a person dies, then it was an act of God .

.-\ tkr lkath. tht· b()dy is haried und friends and family celebrate the life of the deceased person.

F, pl'\';)'°$ion L1 f gTid' is often very open and lasts a long period of time (Facts and Details, 2018).

Inn Slx·icty 1fominatcd by Catholic religion. funeral s are very involved. Often times, a 24-hour

, i~il is hdd tmd th~ home of the deceased person, followed by a wake, a religious ceremony, and

a burial. Typicall y mourning occurs ov~r a period of six weeks (Facts and Details, 2018). As a

ttmm· mtrsc\ it i~ important t.o determine the spiritual practices of Filipino families in order to

undc·rstand their perspt."-Ctives on death and dying.

Spiritualit~·

--\.s a Christian. I. A. explains that her religious faith is very significant to her and her

tiunily. She attends church services every Sunday and enjoys Bible studies with her family.

\\ l 1ile she has access to Bibles ,vritten in Tagolog (Filipino language). most Filipinos prefer

Bibles written in English because the version of Tagolo4oo formal. I. A. works with a group

~alk-d the Na\'igators. which is a Christian organization found all O\'er the world. She enjoys

sharing the Gospel, or the story of Jesus with college students and people living in high poverty

art'as. LA. frequently prays and memorizes Bible verses on her own and with groups of her

fi-iends. She shares that the majority of Filipinos are Catholic. Many holidays and traditions in

the Philippines originate from Catholic beliefs and involve the celebration of saints. For I.A. and

m~my other Filipinos. rdigious beliefs influence all aspects of life.

 TRAN SCU LTURAL fNTERVI EW 8

Health Care Practices

According to I.A., there are many home remedies used when Filipinos are sick. For

common illnesses such as influenza , colds, fever, or cough, I.A. typically boils special leaves and

herbs to make a curing tea. She also uses "hi lot", which is a certain type of massage used to cure

illness. In addition to these home remedies, I.A. is not against the use of Western medicine. She

frequently visits her doctor and goes to the hospital if her symptoms worsen. I.A. explains that

people in low income areas are less likely to go to the doctor and tend to just utilize home

remedies. Coping with illness often involves the entire family and has a great focus on

spirituality (Stanford School of Medicine, 2018). Decisions are often made by the family as a

whole and the family unit is greatly involved in care. Some coping strategies during illness

include "tiyaga", or the ability to manage difficult situations, "tatawanan ang problem", or the

use of humor, "bahala na", or the belief in the will of god, and "pakikisama", or collective ✓

harmony between the people involved. Mental illness is often left undiagnosed due to negati ve

connotations within the culture (Stanford School of Medicine, 2018).

Health Care Practitioners

I.A. explains that the use of alternative health care providers depends on the location and

status of the individual. While there are a variety of tribes in areas of the Philippines that may

practice alternative medicine, I.A. typically only incorporates home remedies and Western

medicine . I.A. lives in Manila and explains that this city is a metropolitan city with adequate

access to health care. As an individual from the middle class, I.A. has greater access to health
I

care than others in the lower class. In the United States, this is a similar finding (Stanford School

of Medicine , 2018). Filipino-Americans are not typically opposed to Western medicine and
TRANSCULTURAL INTE RVIEW

readily follmv treatment plans in addition to prayer nnd olhcr lw111c rcnic<li cs (Stanford School of

Medicine. 2018).

Nursing Interventions

If I.A. was a patient in a clinical setting, nursing interventions should be speci fie to

cultural needs. In addition to interventions related to the di sease process, the nurse should first

provide dietary cow1seling to I.A. I.A. has expressed the importance of food in Filipino culture.

Family members may attempt to bring homemade meals to the hospital in order to show concern

and love for I.A. While this is acceptable and may benefit the healing process, I.A. should be

educated on healthy alternatives to some staple Filipino foods. For example, instead of white ·,&J
rvrLS-W /~n
rice, the nurse can encourage the family to bring brown rice. Instead of fried foods, baked meats

and raw vegetables are preferred. This intervention is related to Leininger' s mode of care of

cultural care negation and accommodation because the intervention negotiates with typical

cultural preferences (Registered Nursing, 2018). The nurse allows traditional meals to be

provided, but encourages the family to modify the meals in healthier ways. A second

intervention incorporates family values into care. I.A. has expressed that she is very famil y

oriented. In order to include the family, education related to the disease and treatment should be

presented to the family. Time should be allowed for questions to be asked and the nurse should

share ways that the family can perform helpful interventions. This intervention is related to

Leininger's mode of care of cultural care preservation ~d _maintenan~_e_because the nurse helps

to uphold significant cultural values for the patient (Registered Nursing, 2018). A final nursing

intervention involves providing opportunity for spiritual expression. I.A. has explained that her

faith is very important to both her and her family. The nurse should encourag.e spiritual

expression such as prayer and offer the presence of a pastor. This intervention alsn appli1:•s to
 TRANSCULTURAL INTERVIEW 10

Leininger' s mode of care of cultural care preservation and maintenance because it caters to the

family 's religious beliefs.

Transcultural Nursing Standards of Practice

In this scenario, one significant transcultural nursing standard of practice is the

knowledge of culture (Expert Panel on Global Nursing & Healt~ 2010). The nurse can provide

meaningful care to I.A. by having a background knowledge related to Filipino culture.

Background knowledge allows the nurse to immediately incorporate famil y members into care.

allow time for spiritual practices, and have an awareness of food preferences. While background

knowledge related to the culture is important, the nurse should always ask the patient about their

preferences instead of making assumptions. Another significant transcultural nursing standard of

practice is cross cultural communication (Expert Panel on Global Nursing & Health. 20 l 0). I.A.

explained that Filipinos often use indirect communication. The nurse should understand that i-t-

when caring for I.A. it is important to phrase questions in a way that does not ,,.,arrant yes or no

answers. The nurse should also unpack statements with I.A. to ensure that the nurse's

interpretation of the statement is correct. This factor is very significant to providing I.A. with

exceptional culturally competent care.

Analysis of Cross-Cultural Experience

During this cross-cultural experience, the author was provided with an incredible

opportunity to practice interacting with a culture very different from her own. One verbal

challenge was the difficulty in obtaining information about I.A. directly. When asked questions

such as, "How do you define culture?", I.A. would respond with a specific definition rather than

a personal meaning. In order to better address these topics, the author chose to rephrase
TRANSCULTUR AL INTERVI EW 1I

statements, such as, " What does culture mean to you?". The author also attempted to unpack

statements by asking for examples. These modifications proved to be beneficial in gaining a

greater understanding of I.A. ' s perspective. In future interviews, the author would prefer to

perform the interview in person rather than through online communications. The circumstances

warranted this form of interview, but there were limitations. While voice changes such as tone

were able to be assessed, other factors such as body language were limited. Overall, performing

the interview was an educational and rewarding experience.

Understanding the perspective of others holds great significance as a future nurse. Nurses

care for patients that are often experiencing fear, confusion, and anxiety. Cultural background

greatly influences the way that patient,..s perceive hospital settings. Culturally competent nurses

have the ability to provide exceptional care to all people regardless of cultural background.

Conducting this interview provided the author of this paper with experience interviewing a

person of a different culture and significant insight into Filipino cultural beliefs. One of the most

important things learned by the author of this paper is the importance of asking clarifying

questions. Regardless of how much the nurse may know about different cultures, the best source

is always the patient. The nurse should always take the time to find out the specific preferences

of the patient. This paper discussed Pumell's 12 domains, nursing interventions, transcultural

nursing standards of practice, and an analysis of the cross-cultural experience. Overall,

completing this assignment has greatly impacted the author of this paper and will hopefully make

her a more culturally-competent nurse. 1

J (Y\ jJ)J/J- (t will .
TRANSCULTURAL INTERVIEW 12

References

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PA: F. A. Davis Company

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TRANSCULTURAL rNTERVIE W
13

Registered Nursing (2018). Cultural awareness and inf l.uences on health: NCLE.X-RN. Retrieved

from https :/ /wwv.1• registerednurs ing.org/nclex/cultural-aw areness-i nfl uences-hca Ith/

Siojo, R. (2018). Philippines beliefs on pregnancy. Retrieved from https://philippines-evc nts-

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/ '
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