Hypertension, Acculturation, Work-Related Stress, and Psychological Distress Among Filipino-American Registered Nurses (RNs) and Domestic and Home Care Workers (DHCWs)

Friday, 25 July 2014

Emerson Eresmas Ea, DNP, APRN, CNE
College of Nursing, New York University, New York, NY


Filipino Americans (FAs) have one of the highest rates of hypertension (HTN) among Asian Americans. As one of the largest and fastest growing groups of immigrants in the United States (US), very little is known about them in the literature especially about their cardiovascular health.  A significant number of FA professionals are licensed Registered Nurses (RNs) and Domestic and Home Care Workers (DHCWs). Owing to the nature of their work, anecdotal evidence indicates that many of Filipino RNs and DHCWs suffer from hypertension (HTN). Despite the population growth and documentation of HTN among FAs, very little is known about their health status and needs, specifically those that explore FA RNs’ and DHCWs’ cardiovascular health in the Northeast.


The purposes of this study are to (a) identify and determine the relationships among the levels of acculturation, work-related stress, psychological distress and prevalence of hypertension, and (b) identify and explore the perceived personal and cultural factors associated with the diagnosis and management of hypertension among FA RNs and DHCWs in New York (NY).  


A survey using a demographic questionnaire and A Short Acculturation Scale for Filipino Americans (ASASFA), a modified Daily Hassles Scale, and Mental Health Inventory instruments was conducted including a blood pressure screening among a convenience sample of Filipino RNs and DHCWs in NY. In addition, focus group interviews were conducted to those who have HTN. IRB approval was obtained prior to this study and statistical analyses were conducted using SPSS. Qualitative data were analyzed using the Consensual Qualitative Research (CQR) method.


Results revealed that majority of the FA RNs and DHCWS surveyed (N=228) are women, married, work full-time and 50% of those screened were found to be hypertensive. Logistic regression analysis did not reveal significant relationships among acculturation, work-related stress, psychological distress and hypertension. The four domains identified by the participants to be associated with the diagnosis and management of hypertension include: Awareness of the Intrinsic and Extrinsic Factors that Affect HTN, Managing HTN and Coping Mechanisms, Barriers and Challenges to Managing HTN, and Experiences with Hypertension.


The results of the study provide valuable information about the cardiovascular health of Filipino RNs and DHCWs. Although there was no relationship found between hypertension and the variables measured in the study, the high number of participants found to have hypertensive is a cause for concern. This has significant implications to nursing science and practice. There is a need to further explore hypertension among this understudied group of FA immigrants especially the factors that could contribute to hypertension. The qualitative data results could be used to design culturally tailored nursing interventions that could lead to positive health outcomes among FAs who have HTN.