Student#: N00180321

Scholarly Assignment:
Reflective Practice Exploring Health Beliefs and Determinants of Health
Student Name: Lara Pabandero de Lasan
Student No: N00180321
Date Submission: October 21, 2014
NURS103: Practical Nursing Theory
Professor:
Humber College

Student#: N00180321

Reflective Practice Exploring Health Beliefs and Determinants of Health

World Health Organization, (1948), defines health as a state of complete physical,
mental and social well-being and not merely the absence of disease or infirmity. To me, this
means that health is not only about nonexistence of disease, but also wellness with the
individual as a whole, not only physically but also mentally and socially. Health can be further
defined with more components, such as Humber College Practical Nursing Program Philosophy
of Nursing (Harnanan, power point slides, 2014) defines health a state of optimal dynamic
functioning of the bio-psychosocial and spiritual dimensions of the individual, family and
community. The Humber College definition adds on the concept of spiritual well-being of the
individual and also the family and the community because human beings are social people, we
live to be surrounded by other individuals, we cannot be well if we are by ourselves without a
support system. Spiritual well-being is also important to me, having faith in my life was
significant growing up until now, and that is why I chose both definitions of WHO (1948) and
Humber College. All of these components put together, best describe how I define health and
well-being. In class we spoke about Holism, which is wellness physically, emotionally, mentally,
socially, and spiritually. If all aspects are taken care of, then I believe that is the optimal health
wellness and well-being.
The purpose of this paper is to reflect on my personal and cultural health beliefs and
practices in regards to two determinants of health, to compare and contrast them with another
classmate of a different cultural background, and finally analyze how my future nursing
profession would be influenced by comparative learning with the knowledge of these cultural
differences. The two determinants of health that will be focused on are income and social status,
and social support networks. I will compare and contrast these determinants with my own health

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practices and culture, Filipino, with one of a Chinese origin. I chose to discuss the above
mentioned determinants of health as supposed to the others in the list of 12 determinants because
there were both some differences and similarities within the topics. Income and social status, I
believe has a big influence on our health practices, especially with the financial aspect of it, in
Canada, Philippines or China. Social support networks can be anybody or anything that can be
of support to an individual, their family, organizations, the government or any network that will
help and support the person, however the Filipino and Chinese have a contrast regarding patient
care and who makes the decisions, these will be discussed in more detail later.
Income and social status determinant of health
Firstly, income and social status determinant of health is important and has a big
significance to the health and well-being of a person. Theres a life quote I read, live to work or
work to live, I think this means that there are two options, to be privileged to have a fulfilling
job and love your work or career that is why a person lives, or to work at any job just to be able
to provide food on the table for your family and loved ones to stay alive. The former is generally
within the rich population where they can choose any career path they want and not worry
about the money provided by that career, however the latter is more geared towards the less
fortunate where they have to work odd jobs or any job at all so that there is food to eat at the end
of the day. Talking with my classmate, (CM) there were some differences and similarities when
it came to our experiences with income and social status. In the Philippines, in terms of health
care, to my recollection there is none. If you were poor, and did not have money to buy
medication or could not afford to go to the hospital, you would die at home. In China, CM said
that in the city, (urban area), if you were to go to the hospital there would be some government
assistance, although it was also expensive like the Philippines to seek help, however you would

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receive something from the government financially. That was the difference between the two
countries. In the Philippines, if you are lucky, an organization can help you, your family, and
your friends, unlike in Canada where we have the Canada Health Act, there is a universal
equality in getting public health services. However, CM did mention that in the rural areas of
China, it was sort of the same with the Philippines where hospitalization was a very big burden.
In China, living in a rural area increased the possibility of reporting poor health and that the
urban population were healthier compared with the rural population (Yang, Kanavos, p.804,
2012) which coincide with what CM said. This is the big economic status gap between the rich
and the poor, in the Philippines and China both, the desired career path of an individual may not
be the one to provide for the family financially and therefore will lead to working at a job that
was not their first choice. Many Filipinos want to go abroad, for a better future for their family,
although the Philippines is a great country that I will always go back to for vacations, I cannot
live there and work as a nurse. If I was rich, I would be able to live in the Philippines, but to
work there as a part of the middle class is very hard.
Social support networks determinant of health
Secondly, the other determinant of health that will be examined is social support
networks. Social support affects health, health behaviours, and health care utilization through
practical, emotional, informational, and affirmational supportsome experts believe that
relationships may be as important to health (Potter & Perry et al, 2014). As I said earlier
humans are social and we need to be surrounded by people who love and support us throughout
our lives. This statement is the same for the Filipino and Chinese culture, family support
network is very important to both cultures. CM said that when her mother was diagnosed with
cancer, she and her sibling were the first ones informed by the doctor instead of how we are used

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to, the other way around, the patient first and if the patient gave consent, the family can be
informed. They were also the ones who made the decision for their mothers care plan, and the
patient was the last one informed of her diagnosis and the care to be implemented. The Chinese
family has the ultimate decision, not the patient making decisions for his or herself. Chen (2002)
states, the emphasis on group or collectivity is designed to ensure the strength of the family.
One sacrifices his or her personal interest if it does not benefit the family as a whole. I found
this very interesting and different from my culture. The Filipino culture is very much the same
as the Western culture when it comes to patient and health care professional confidentiality. If
one wishes not to inform their family about their health, then that information will only be
between the patient and the health care professional. Having said that, family is very important
to the Filipino culture as well, like the Chinese, family may have some influence on the decision
making process, but the patient will have the ultimate decision on how to go about their care.
Analysis
Thirdly, I think that my nursing practice will be greatly influenced after comparative
learning, talking with CM and backing it up with some research. When I interact with another
culture, like CMs Chinese culture, with their health care practices who ever my patient is, it may
be the patient only or the patient and the family as one. At the beginning of the talk with CM, we
started with various topics, learning so much things about the Chinese culture, how they handled
death and the funeral, how numbers and symbols were very important in their way of life, how
herbal and western medicine were both used in their culture and so much more. I realized the
importance of knowing how to approach the client of a different culture and how it would
influence me in my nursing career in the future. I will be able to put into practice the
understanding why a Filipino patient may cringe when I mention the list of procedures to be

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done during their stay at the hospital because they may still be thinking of how it was like in the
Philippines that they have to pay for every procedure, every equipment that the doctor or nurse is
going to use and every hour they stay in the hospital bed that they are occupying. I now have
more insight on how to approach and deal with different cultures, hearing from personal
experiences like CM, had a huge impact on me. I will be more cognisant of how the family
influences the patients decision for their care plan especially in the Chinese culture. More
understanding when the family members speak first and the patient last or have no input at all,
but also to advocate for that patient if that is what they really wanted. However, it is also
important that not all Chinese people practice that high level of family involvement. Just like
me, I immigrated to Canada when I was eight years old, and I do not practice to the same degree
as my family, I have adapted the Western culture to an extent that for some of the Filipino
customs I have to refer to my husband, parents or relatives for more information and guidance.
Conclusion
Culturally sensitive care is imperative especially in a big city like Toronto, we are the
most multicultural city in the world, and I am beginning to see and understand why there is a
great emphasis on culture in the Nursing program. Health and well-being can have many
definitions. They say health is wealth I guess that is true to some extent that if you are healthy,
you are wealthy enough to afford it. Although there are 12 determinants of health, the two that I
had chosen; income and social status and social support network were enough to influence my
future nursing practice, more so when the other 10 determinants are also explored more closely.
This reflective essay made an impact on my awareness with other cultures, it made me more
sensitive towards other ethnicities and I will always go back to this paper as a baseline of what
there is to expect when dealing with different kinds of backgrounds.

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References
Chen, Y. (2002). Chinese values, health and nursing. Journal of Advanced Nursing, V(36), I(2)
270-273. Retrieved October 16, 2014 from
http://onlinelibrary.wiley.com.rap.ocls.ca/doi/10.1046/j.1365-2648.2001.01968.x/full

Harnanan, V. (2014, September 3). Humber College Practical Nursing Philosophy. Retrieved
from https://learn.humber.ca/webapps/blackboard/execute/displayLearningUnit?
course_id=_35387_1&content_id=_1308585_1&framesetWrapped=true#
Potter, Patricia, Perry, A., Ross-Kerr, J., Wood, M., Astle, B., & Duggleby. W. (2014). Canadian
Fundamentals of Nursing, 5th Ed. Mosby Canada, VitalBook file, Pageburst.
World Health Organization. (1948). WHO definition of Health. Retrieved October 16, 2014 from
http://www.who.int/about/definition/en/print.html
Yang, W., Kanavos, P. (2012). The less healthy urban population: income-related health
inequality in China. Retrieved October 16, 2014 from
http://www.biomedcentral.com/content/pdf/1471-2458-12-804.pdf

Student#: N00180321

Student#: N00180321