Pakikisama: Filipino Patient Perspectives on Health Care Access and Utilization

Abstract

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 health care access and utilization.

Methods: We conducted 1-on-1 semistructured 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 health care 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 health care clinician. Filipinos may lack understanding about how to navigate the US Health care system, which can dissuade access to care.

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

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.

Figure 1:. Deriving cross-cutting themes