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Pakikisama: Filipino Patient Perspectives on Healthcare Access and Utilization

ORIGINAL RESEARCH

Charles G. Jose, MD, MPH; Rachel Lucy, PhD, MA; Alma Manabat Parker, BA; Joana Clere, MPH; Linda Montecillo, RN, BSN; Allison M. Cole, MD, MPH

Corresponding Author: Charles G. Jose, MD, MPH; PeaceHealth Ketchikan Medical Center

Email: cjose2@peacehealth.org

DOI: 10.3122/jabfm.2023.230165R2

Keywords: Access to Health Care, Clinical Medicine, Community Medicine, Community-Based Research, Cultural Competency, Diversity, Doctor-Patient Relations, Education of Patients, Family Medicine, Health Communication, Health Disparities, Health Equity, Health Literacy, Immigrants, Language Barriers, Minority Health, Patient Navigators, Patient-Centered Care, Population Health, Primary Health Care, Qualitative Research, Quality of Care, Rural Health

Dates: Submitted: 04-28-2023; Revised: 08-06-2023; 10-06-2023; Accepted: 10-19-2023

FINAL PUBLICATION: |HTML| |PDF|


PURPOSE: Filipinos have unique social determinants of health, cultural values, and beliefs that contribute to a higher prevalence of cardiovascular comorbidities such as hypertension, diabetes, and dyslipidemia. We aimed to identify Filipino values, practices, and belief systems that influenced healthcare access and utilization.

METHODS: We conducted 1-on-1 semi-structured interviews with self-identified Filipino patients. Our qualitative study utilized a constant-comparative approach for data collection, thematic coding, and interpretive analysis. 

RESULTS: We interviewed 20 Filipinos in a remote rural community to assess structural and social challenges experienced when interacting with the healthcare system. Our results suggest that Filipinos regard culture and language as pillars of health access. Filipinos trust clinicians who exhibited positive tone and body language as well as relatable and understandable communication. These traits are features of Pakikisama, a Filipino trait/value of “comfortableness and getting along with others.” Relatability and intercultural values familiarity increased Filipino trust in a healthcare clinician. Filipinos may lack understanding about how to navigate the U.S. healthcare system, which can dissuade access to care. 

CONCLUSIONS: For the Filipino community, culture and language are fundamental components of health access. Healthcare systems have the opportunity to both improve intercultural clinical training and increase representation amongst clinicians and support staff to improve care delivery and navigation of health services. Participants reported not routinely relying on healthcare navigators.

ABSTRACTS IN PRESS

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