Smooth Interpersonal Relationships are a core value for every Filipino community; they involve a shared identity, engagement on an equal basis with others, and giving importance to the individual versus agencies or institutions. This cultural characteristic is also known as “Personalism.” The high value placed on sensitivity and regard for others, respect and concern, understanding, helping out, and consideration for others’ limitations, often creates discord with American tendencies toward openness and frankness (Agoncillo & Guerrero, 1987; Enriquez, 1994).
Perceptions regarding physician preferences dictate who will provide care and how much trust is given.
Two main concepts determine the interaction between a Filipino and a health care provider:
- 1. “One of Us” (Hindi ibang Tao) versus
- 2. “Not one of Us” (Ibang Tao)
Health providers who are respectful, amenable and willing to accommodate the patient’s needs are considered to be Hindi ibang Tao.
If the provider is considered Ibang Tao, Filipino Americans will be reluctant to express their feelings and emotions. They will designate a family member to mediate or advocate on their behalf while responding politely to the provider at a formal and superficial level.
The concept “Not one of Us” involves:
- • civility (Pakikitungo)
- • mixing (Pakikisalamuha)
- • joining/participating (Pakikilahok)
- • adjusting (Pakikisama)
The concept “One of Us” includes:
- • mutual trust/rapport (Pakikipagpalagayan ng loob)
- • getting involved (Pakikisangkot)
- • oneness/full trust (Pakiisa)
(Pasco, 2004; Enriquez, 1994; Pe Pua, 1990).
Family and Filial Responsibility
Children are taught to show affection for older family members and respect for older adults and authority. They are expected to seek the advice of and accept the decisions of their older adults. They are obligated to care for older adults and aging parents, and maintain group harmony, loyalty, and emotional ties with parents and other family members across the life span (Chao & Tseng, 2002; Mc Bride, 2006; Miranda, Mc Bride & Anderson, 2000; Superio, 1993). In a study of Asian American older adults in New York City, Filipino older adults (N=52) were the least likely to consider care giving responsibility a burden and dependency on other people a serious problem (Asian American Federation of New York, 2003).
Spiritual Life and Religiosity
Religion is deeply embedded in and intertwined with Filipino culture. It is central to people’s lives and enables them to face life’s challenges and adversities with strength and optimism (Tompar-Tiu & Sustento- Seneriches, 1995). Filipino Americans use spirituality and religion as part of their coping practice, especially when dealing with illness.
Religious practices include:
- • attending mass
- • praying the rosary and novena
- • expressing devotion to saints and the Virgin Mother
- • receiving the sacraments and holy communion
- • reconciliation
- • anointing the sick
- • observing religious holidays and rituals
- • going on pilgrimages
In a small qualitative research study of elderly female Filipino immigrants in Vallejo, CA, most of the participants believed that certain illnesses that cannot be treated by modern medicine can be treated through divine intercession (Verder-Aliga, 2007). Prayers, church affiliation, spiritual fellowship and counseling play a crucial part in the healing process and in the promotion of wellness and good health.
In a study on culture and health among Filipino Americans in central Los Angeles, the majority of elderly Filipino subjects exhibited deep levels of religiosity, and had a strong view of God’s role in human health and wellbeing (Historic Filipinotown Health Network, 2007).