FROM BLAME TO UNDERSTANDING: FILIPINO PARENTS’ EXPLANATORY MODELS OF CHILDHOOD CONGENITAL ANOMALIES AND THE ROLE OF CULTURALLY RESPONSIVE NURSING

Abstract

Background: Congenital anomalies can profoundly affect children and their families. Parents’ understanding of these conditions is shaped not only by biomedical information but also by family narratives, cultural beliefs, spiritual interpretations, and personal experiences. In the Philippines, culturally mediated explanations may coexist with biomedical accounts and influence parental emotions, healthcare-seeking, and interactions with healthcare professionals. Objective: This study explored how Filipino parents understand and explain their children’s congenital anomalies, focusing on culturally mediated explanatory beliefs, emotional responses, healthcare-seeking experiences, and interactions with healthcare professionals. Methods: A qualitative descriptive design was employed. Eighteen parents of children with structural or genetic congenital anomalies participated in individual semi-structured interviews conducted between January and July 2025. Participants comprised 14 mothers and 4 fathers recruited from pediatric outpatient departments, tertiary referral hospitals, and community-based support networks. Interviews explored perceived causes of congenital anomalies, family and community beliefs, emotional responses, sources of health information, healthcare-seeking experiences, and encounters with nurses and other healthcare professionals. Data were analyzed using Braun and Clarke’s reflexive thematic analysis. Reflexivity, an audit trail, repeated engagement with the dataset, and analytic discussions among the research team supported trustworthiness. Results: Four themes were developed: (1) Pluralistic Explanatory Models of Causality, (2) The Psycho Cultural Burden of Causal Attribution, (3) Negotiating Parallel Systems of Care, and (4) Nursing Communication as a Bridge Between Cultural Meaning and Biomedical Care. Participants described biomedical, hereditary, maternal, cultural, familial, and spiritual explanations that sometimes coexisted. Culturally mediated causal explanations could contribute to parental guilt, self-blame, stigma, and uncertainty, particularly when parents perceived the condition as preventable. Some participants described consulting traditional healers or maintaining spiritual practices alongside biomedical treatment. Respectful and understandable communication from healthcare professionals, particularly nurses, helped parents reconsider causal beliefs, reduce self-blame, and engage more constructively with care. Conclusion: Filipino parents may negotiate multiple explanatory models rather than choosing exclusively between biomedical and non-biomedical explanations. Culturally responsive nursing should acknowledge the meaning of these beliefs while providing accurate information, addressing harmful misinformation, reducing parental blame, and supporting family-centered care.