Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines.
Development Studies Program, Ateneo de Manila University, Quezon City, Philippines.
Sociol Health Illn. 2022 Jul;44(7):1167-1181. doi: 10.1111/1467-9566.13503. Epub 2022 Aug 5.
Patients' embodied experiences do not always correspond to the biomedical concepts of particular diseases. Drawing from year-long fieldwork in the Philippines that involved semi-structured interviews, focus group discussions and digital diaries, we examine how individuals 'do' hypertension through their embodied experiences and the knowledge and practice that emerge from them. Drawing inspiration from Annemarie Mol's work on the notion of 'multiplicity' of disease, our analysis was informed by a commitment to privileging patients' embodied experiences and the multiple ontologies of hypertension. We find that for patients diagnosed with hypertension in the Philippines, symptoms enact illness; patients rely on their own embodied knowledge to define their illness' nature (e.g., diagnosis), experience (e.g., frequency of symptoms and non-chronicity) and praxis (e.g., self-care practices). We show how this knowledge gained from having embodied experiences of living with the disease interacts in various ways with biomedical knowledge, other diagnostic labels and clinical practices, to shape how hypertension manifests and is managed by patients. Beyond interrogating the relationship between what counts as a 'disease' and what is considered a 'symptom', our findings underscore the need to pay attention instead to the mutually co-constitutive processes of embodied experiences and disease categories in co-producing patient knowledge.
患者的身体体验并不总是与特定疾病的生物医学概念相对应。本研究通过在菲律宾进行为期一年的实地调查,包括半结构化访谈、焦点小组讨论和数字日记,考察了个体如何通过身体体验以及由此产生的知识和实践来“表现”高血压。受 Annemarie Mol 关于疾病“多样性”概念的启发,我们的分析优先考虑患者的身体体验和高血压的多种本体论。我们发现,对于在菲律宾被诊断出患有高血压的患者来说,症状表现出疾病;患者依靠自己的身体知识来定义疾病的性质(例如,诊断)、体验(例如,症状的频率和非慢性)和实践(例如,自我护理实践)。我们展示了这种从患有疾病的身体体验中获得的知识如何以各种方式与生物医学知识、其他诊断标签和临床实践相互作用,从而影响患者对高血压的表现和管理方式。我们的研究结果不仅质疑了什么算作“疾病”和什么被认为是“症状”之间的关系,还强调了需要关注身体体验和疾病类别相互构成的过程,以共同产生患者知识。