Qualitative study on cultural and communication challenges in telehealth: Perspectives of Filipino nurses in the United States

https://doi.org/10.70228/JHER2025037

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ABSTRACT

This qualitative descriptive study explored the impact, challenges, and best practices of telehealth among Filipino nurses working in the United States. Nine purposively selected participants took part in semi-structured online interviews conducted via Google Meet between June and July 2025. The interview guide underwent expert validation and pilot testing before data collection. Data were analyzed using Braun and Clarke's six-phase thematic analysis, with strict adherence to ethical research principles. Five interrelated themes emerged. Bridging Worlds, Missing Signals captured communication barriers related to language, accent, cultural differences, and digital literacy. Boundaries of Belonging reflected subtle forms of exclusion and bias, including patient preferences for culturally similar providers. Disconnected Care highlighted disruptions in nurse–patient relationships marked by disengagement and fragmented communication. Widening Horizons described the adaptive strategies nurses employed, such as simplifying language and using interpreters. Finally, The Tightrope Walk in Virtual Care illustrated how nurses balanced professional standards with cultural responsiveness to deliver compassionate care. Overall, the findings indicate that while telehealth enhances access to healthcare, it simultaneously introduces cultural and communication challenges that can affect empathy, efficiency, and the overall quality of care. Filipino nurses demonstrated remarkable resilience, adaptability, and cultural intelligence as they navigated these challenges, highlighting their critical role in delivering patient-centered, culturally responsive, and technology-mediated care. These results underscore the importance of cross-cultural training, structured communication strategies, and institutional support to optimize virtual care delivery and fully recognize the professional competencies of transnational nurses.

Keywords: Telemedicine, Nurses, Filipino, Cross-Cultural Communication, Remote Consultation, Qualitative Research.