The Nursing Process to Deliver Culturally Competent Care


In contemporary society, the delivery of the health care process that is culturally competent has become essential. Cultural competence entails the attitudes and behaviors held by nurses that enable them to communicate effectively with patients from different cultural backgrounds. It involves the delivery of health care that befits the patient culturally. In most cases, care is provided through a multidisciplinary approach. The following paper analyzes the application of the nursing process to deliver culturally competent care to Filipinos in the U.S. based on a study carried out by Ursua et al. (2013). Filipinos are one of the largest ethnic groups of Asian origin in the U.S. However, they have been found to have high health disparities compared to other Asian groups. The highest priority health needs are hypertension, high cholesterol, and diabetes. The chronic health conditions affecting the group are associated with cultural practices. Also, approximately 50% of Filipinos are overweight or obese (Araneta, Sario, Lee, & Quach, n.d.). The focus of the paper is to establish the prevalence rate and risk factors of hypertension among Filipinos.

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Hypertension is disproportionately high among Filipinos, unlike other racial and ethnic minorities in the U.S. Even though hypertension has remained to be a great health concern in the U.S., it is more alarming among Filipinos (Ursua et al., 2013). Studies have pointed out different factors that are associated with the increased cases of hypertension among the group. There are diverse causes; some relate to cultural practices, while others are individual behaviors. For instance, diets are saturated with fat, rich in meat, and there is the frequent use of excess additives such as sodium. The low level of physical exercise due to acculturation to the American sedentary life has also been cited as one of the factors leading to the increased cases of hypertension. Other factors are health seeking behaviors that predispose Filipinos to the increased risk of being hypertensive. For example, among the elderly Filipinos, there is still a belief in the cultural healers who combine the use of herbal treatment and supernatural powers. Among the elderly, there is a high tendency to seek traditional remedies before going to doctors. Filipino immigrants normally visit doctors when the condition has already worsened.

Aim and purpose

There has been rapid population growth among the people of Filipino origin in the U.S. For example, between 2000 and 2010, the population increased by 38% (Ursua et al., 2013). Currently, it is estimated that there are over 2.5 million Filipinos leaving in the U.S. This makes Filipinos one of the largest Asian ethnic groups in the U.S. Taking into consideration the high population, the aim of the research was to determine the prevalence and risk factors of hypertension among Filipinos. The main purpose of the study was to use the research findings to implement a health intervention program based on the cultural needs of the community.

Research method

The research entailed a survey of Filipinos residing in New York. It involved the analysis of the socio-demographic factors, language, health insurance, physical activity, family practices, and clinical measurements.

Literature Review

The culture of Filipinos influences their health and the utilization of health services. For instance, in a study carried out in Los Angeles to learn about the culturally based experiences of the group, it was established that there were persistent health disparities (Ursua et al., 2014). This was normally related to the real life difficulties that Filipinos face in trying to prevent and reduce impacts of chronic diseases. Even though the factors are complex, one of the key contributors was the cultural orientation. The lifestyle practices such as diet and sedentary lifestyles were some of the factors found to lead to the high prevalence of hypertension among Filipinos. Also, there are individual practices that compromise the nursing care process such as smoking. Other factors that are associated with the disproportional cases of hypertension include the use of excessive sodium in diet, diabetes, old age, and stress.

Also, there are cases of poor disease management among Filipinos. For instance, it has been established that there is low adherence to medication due to the lack of adequate knowledge about the importance of treatment regimes. According to Ursua et al. (2013), the problem is aggravated by limited knowledge of health care delivery systems. This is usually the case with the new immigrants. Also, there is a language barrier in which the level of miscommunication between the patient and the healthcare providers is very high because Filipinos use English as a second language.

Implication for Nursing Practice

The study carried out by Ursua et al. (2013) observed that the prevalence of hypertension was 53%. It was attributed to many factors. They included gender, unhealthy dietary practices, stress, cultural beliefs, and poor knowledge of the preventive and curative services available in the health care system. This implies that heath care professionals have an enormous task of ensuring that they tailor-make interventions to mitigate the risk factors that contribute to the high prevalence of hypertension. For instance, cultural factors such as language being a barrier to effective care provision imply that nurses need to have communication systems and materials that enhance the interaction between Filipino patients and the health care team. It is important to note that the provision of culturally competent nursing care needs prior planning based on factual information that relates with the specific group (Epstein & Street, 2011). Therefore, nurses need to have an in-depth understanding of cultural and personal issues that affect Filipino patients in order to ensure specialized care.

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Cultural competence is an important aspect of nursing practice. Bearing in mind that nurses are the primary caregivers and interact with patients from diverse backgrounds, it is important for them to have knowledge of cultural beliefs, traditions, family practices, and social aspects of individuals, and the way they relate to diseases. Besides, it requires nurses to devise culturally appropriate strategies in order to deliver holistic care to the patients (Ursua et al., 2013). Therefore, nurses and other health care providers should take into consideration the cultural factors of Filipinos when they are providing preventive and curative care. This signifies the necessity to apply culturally relevant information and targeted health care interventions when dealing with Filipinos.


It is evident that Filipinos face many health challenges due to different factors. The key factors include cultural orientations that have a direct effect on the care-seeking behavior of Filipinos. Therefore, it is important for nurses and other health care professionals to have adequate knowledge about the needs of different ethnic groups. For Filipinos, the key issues to consider include language, health-seeking behaviors, and other cultural practices that may have implications for their health status.


Araneta, C., Sario, S., Lee, J., & Quach,T. (n.d.). Understanding Filipino health and increasing awareness for future advocacy. Web.

Epstein, R. M., & Street, R. L. (2011).The values and value of patient-centered care. The Annals of Family Medicine, 9(2), 100-103.

Ursua, R. A., Islam, N. S., Aguilar, D. E., Wyatt, L. C., Tandon, S. D., Abesamis- Mendoza, N.,… & Trinh-Shevrin, C. (2013). Predictors of hypertension among Filipino immigrants in the Northeast U.S. Journal of Community Health, 38(5), 847-855.

Ursua, R., Aguilar, D., Wyatt, L., Tandon, S. D., Escondo, K., Rey, M., & Trinh-Shevrin, C. (2014). Awareness, treatment and control of hypertension among Filipino immigrants. Journal of General Internal Medicine, 29(3), 455-462.

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